MIL in nursing home - what now?

[VikingLady]

Totally clueless and DH is taking this badly and being an ostrich. MIL was taken into a care home on Christmas Eve, semi voluntarily (doctor insisted but she agreed to go) due to confusion/possible dementia. Initially she's booked in for a fortnight for tests, but she's deteriorated rapidly and we have to consider all outcomes.

Who organises paying her bills? She's agreed with the community nurse, GP and the home that we can talk for her, but that's not POA. And what happens regarding her car? We can't even legally move it onto her drive (it's still at the doctors) as we're not on her insurance!

These are probably really basic questions but I'm clueless. My dad died suddenly with nothing like this. We don't have any spare cash to pay for solicitors advice. We can't even pay for the taxi to the home but are walking the hour each way with the kids!

This might seem a bit cold but someone has to sort the admin, and that's genre my role. Thank you - please help!

Sorry you're going through this, hard at any time but especially Christmas

With her car, do you have friends with a car that you could ask to move it for you? I know I'm covered to drive another car for third party on my insurance.

You do need to sort POA as long as she still has capacity to grant it. You can fill in the forms yourself and I think there is a discount available for the cost of registering it if she is in certain benefits.

What is her financial situation ie. Does she have savings and dies she own a property?

Thank you.

She has savings, investments etc but we don't have the details. She does own her house, too. I'll look into POA ASAP!

Unfortunately we don't have anyone we can ask to move her car. We'll just have to risk it, I think. I am wondering whether DH can be put into her car insurance if the stay becomes permanent but with the car remaining hers, so we can take her out as long as she's still up to it.

Assuming she lives on her own then the house will be expected to fund care if it is necessary for her to stay. Fir the first 12 weeks the value of the house is disregarded but if she has savings etc over 26k she would be eels funding.

One thing you can do is a third mandate form with the bank where you or DH could go on her bank account. You'd need to read up on it but it might solve your immediate problem of getting care bills etc paid. POA is key at this point, it depends on whether she has capacity to grant it. If not it has to go to the court of protection for guardianship which is a lot more complicated.

There is a big thread in the Elderly parents section with people much wiser than me. Please do come over if you'd like to , we can offer moral support, and

You don't need solicitors to complete a POA it is really straightforward - just check it really carefully before sending it off as it will be refused if there are any errors.

Could he ring the insurance company and be added as 3rd party for short period. Rac/aa may recover it if she was a member.

Sounds like she will need to fund her care. Is she well enough to sign a cheque to pay fees and something to enable you to assist her.

If either of you have insurance on your own car, you will probably be covered to drive hers. Otherwise it is possible to get temporary cover from a car insurance company, provided you hold a current driving licence.
Have you had a chance to talk to the manager of the NH in regard to the care planning process, future needs, fees etc? If not then please ask to do this, they will be able to advise you re the future. At this stage you do not need to go into any detail about her means, just be a bit vague and do not 'agree' to anything until you have the information you need to help her make any decisions.
It could be that this admission has been organised under arrangement by the local healthcare organisation for people who need extra short term care to avoid admission to acute hospital and there may be no fees due for several weeks anyway, time to get a full care needs assessment done, after the Christmas holiday period is over.
It could be that her condition has deteriorated due to a treatable acute infection so it might be that she recovers somewhat when this is treated.
Best wishes .

Sorry to hear that you are going through this.

The car is probably the easiest thing to get sorted. Do you have access to her house and can you get hold of the car insurance policy? Most policies have a clause whereby anyone is covered to recover the car home, if the policy holder is taken ill. Best to call them to check...

Likewise, find out how the bills are usually paid. If its direct debit, they will all be fune until, that is, the money starts to run out.

Sooner you can get unto the house and check the bills set up the better. Its good she has you to sort these kind of things. All the best with it.

Hi if Mil has been driving until Christmas Eve she has been fairly independent?

Confusion (especially sudden onset) in older people can be caused by any number of things urinary tract infections, constipation, dehydration, vitamin or mineral deficiencies. The GP will in the short term be looking to rule out more obvious causes first.

She may well recover from this episode if the cause is treatable, and return home as before ( or with additional care to support her at home).

With regard to poa, if her capacity is already questionable ( is she fully able to understand the impact in order to give informed consent) then it may be too late and you will need the court of protection.

I think in the short term you need to move her car. If you know bills are due speak to the companies involved and put them in the picture ( worst case scenarios she may get a red bill but that's hardly her biggest worry atm) And sit tight for a couple of days as she may surprise you yet.

Thank you - I didn't expect so many responses!

The car is ok. A relative moved it. I'm sending DH over on his own tomorrow to go through her paperwork and check whether everything is up to date and in order. We'll call the car insurance company to check. Thank you.

She would understand a POA, but I'm not sure if she'd be allowed to do this given she's been (voluntarily) admitted with confusion. She says she's no idea why she's in. She's in the dementia wing of the home though so communal areas are loud and full of people who are clearly mentally impaired, which has driven her to spend most of every day in her room. It's not going to help her!

I'm hoping it's resolvable but the doctor and community nurse clearly don't think so. This is all made so much more complicated by her disliking me!

Really glad you've got the car sorted, one less thing to worry about.

With the PO.a capacity is complicated. It is done on a decision by decision basis so someone might be deemed to have capacity to decide whether to take meds but not have capacity to deal with their finances. Also it fluctuates. She would need to understand the info given, be able to retain it and make a decision about it . So she would need to understand that it's a form to give DH authority to act on her behalf for finances, agree to it and understand it at and understand it at end of conversation. A friend of mine has worked in mental health for about 25 years and she turned round recently and said she thought she understood capacity and the mental health act but something had happened and she had come to the conclusion she didn't. It is also accepted that capacity fluctuates.

I might be tempted to use a family friend of hers as the certificate provider in this case. The sections have to be signed in order. I'm going from memory here but I think section A is the bit she signs, section B is the bit the person signing to say she understands it and has consented to DH acting on her behalf, then section C the the Attorney's section. Section B can't be signed before section B and there shouldn't be long date gaps - bit dry but read through the notes on the form that goes with it on the online download.

The other thing is you can't do a capacity test when someone has an infection that can be expected to resolve eg. My !pther had cellulitis which can cause delerium so the memory clinic wouldn't do a capacity assessed to the nursing home until it had resolved. So in MIL's case infection, low vitamin levels from the tests would need to be ruled out.

Hope that makes sense. Capacity is complicated and if you really look into it there are some grey areas.