Out of ideas. Dad ill, infirm, vulnerable and alone.

[FJL203]

I don't know that anyone can advise on this and I don't even know what I'm asking for advice on. I can't see the wood for the trees atm.

The situation is this:

My Dad -

Is 72.
He can barely shuffle on a zimmer frame - it takes him half an hour to cross his studio flat to get to the bathroom.

Is very intelligent and articulate but with some mild short term memory loss.
Has a past history of 2 heart attacks, mild strokes, pneumonia.
Came out of hospital last week following a chest infection.
Has emphysema.
Weighs only seven stone.
Has very poor eyesight now and, due to an accident last year, has writing skills "like a child".
Has just been diagnosed with a shadow on the lung.
Is petrified beyond words and is awaiting an MRI scan and a PET CT scan.
His breathing is poor and his conversations are punctuated by coughing fits.
Has a blood pressure problem which causes him to keel over sometimes. The docs have identified the problem but not the cause or the cure.

He's living in warden controlled accommodation on the 1st floor. He is unable to get out of the flat.
He's fallen more than once - his carer, who comes in for half an hour three times a day for very basic tasks is not allowed to help him up, (nor is she allowed to do his shopping).

I'm a considerable distance away and for more than one (genuine) reasons re my own children and personal situation am unable to drop everything immediately and go to him. Even if I could that won't resolve the problem, which is that his accommodation is not suited to him and is putting his physical and mental health at risk. He could come here but would be no better off in a house with an upstairs bathroom etc. Moving my family to where he is is an option but will take a considerable amount of time to achieve.

Dad can't cope. This once so strong man phoned me at 7am sobbing that he hasn't slept, he's too scared to in case he needs the bathroom ( I know, I know, he might need it whether he sleeps then wakes or whether he remains awake), he's so frustrated with being on his own 24/7 apart from the drop ins from the young woman carer, he's in a state.

Yesterday, with his permission I made calls to his GP surgery and social services and it was planned for him to be collected this lunchtime and taken to a residential care home for respite and rehabilitation, with nursing and social care on site, company and an open-ended stay. The idea was that at the conclusion of that stay he would be moved to suitable long-term residential care.

He waited anxiously for it, hanging on to that hope, but the transport didn't arrive. At about 2.30pm he was told that there had been a mix up, he was only going to be assessed today for possible entry into residential rehabilitation and that there were no beds there anyway for a few weeks.

When the assessor came out she concluded that as Dad's BMI was so low and there was so little muscle to him any physio would be harmful and so they wouldn't have him at that particular home anyway.

I've been back on to social services, who've tried to find residential care today but the 2 places they tried say Dad is too high need for them. The community mental health officer for older people has visited him and is pushing SS to find him somewhere but says there are only a limited amount of places which could take Dad.

At present they've arranged for his carer to come in for an extra visit this evening but that's all they can do.

He just needs to get out of where he is. He's vulnerable and afraid, at risk of falling and can't get out of bed a lot of the time and is totally unable to leave the flat. He's literally been banging his head on the walls.

SS are going to try another care home tomorrow to see if they can take Dad for respite. But if they can't? This is worse than last night, at least last night he thought there was light at the end of the tunnel and somewhere to go.

I suppose I'm asking - has anyone had any experience of this kind of battle? Is there anything else I can be doing or asking SS/GP/anyone else to do?

I don't even know the system, I don't know who controls who, what agencies should be involved or could be involved so I don't know whose door to go knocking on.

I would echo the need to push for both care and financial POAs.

1. If something happened, for example three years ago my uncle ended up in hospital with pneumonia and was essentially unaware of his surroundings for several months, during which time key decisions needed to be made for him. (He was also very underweight, with his doctor believing he probably had a cancer which no one could find.) Care and Financial POAs were vital. The same would apply if he had a stroke.

1. If he were to pass away it will be much easier if one of you understands his finance. IHT needs to be paid quickly. If you dont know where the money is or a property needs to be sold, the estate either has to pay crippling rates of interest to the Inland Revenue, or you might need to borrow to settle the tax. If things are not in order it will be much harder to sort things out at that stage, and expensive if he has names a solicitor as his executor.

The point of the POA, as I see it, is to support where the person does not have the capacity. The rest is up to them. Even then you do your best to balance needs and preferences. There are strong requirements in terms of keeping finances separate, and keeping records. As a further safeguard I got my mother to appoint an accountant to do her tax which means a third party see the POA accounting.

Finding someone else to broach the subject can be a good idea. My uncle listened to his best friend. My mother to her priest.

At minimum he should consider a joint account, or a third party mandate on his main account so someone can pay his bills if he is ill.

As long as you are likely to agree on approach both of you could be named on the POA, particularly on the care side where you may need to make decisions on the spot. This then allows you to share the workload. Some banks seem to have restrictions where there is more than one attorney, and now I have it under control I am finding most if not all can be done from home.

This wont help the immediate crisis but will prevent any crisis from being worse than it already is.