Power of Attorney

[Hadalifeonce]

Does anyone know the criteria for enacting a PoA?

My sister and I have PoA health and welfare for DM. We have had to report her to SS for emotional abuse to our brother (SN), she demands he does all her intimate care, and lies to everybody about it, telling them she does it all herself.

She is having several 'falls' at home, and until recently has been demanding DB get neighbours to help her get up; we have advised neighbours to press the alarm button if called to help.
She has told DB she will kill him if he presses the button again, she has been taken to hospital twice in 2 weeks, was advised by discharge assessor that he would like her to get 1 week in rehabilitation, she refused.
We have been asked by the paramedics to advise her GP about the number of call outs.
She is a pathological liar about everything, even irrelevant things, she has mobility problems, but is not immobile, she demonstrates to OTs and other HCPs what she can do, but when alone with DB refuses to do anything herself.
Although we know we can't trigger the PoA, because we don't like the decisions she is making; we are wondering if what is happening is enough? She is making decision which are detrimental to both and DB's health.

I’m in Scotland.

We had the H&W part of the POA enacted a few months ago, and the condition was that 2 doctors had to assess dad and make the declaration that he was without capacity.
The psychiatrist who had diagnosed him visited to do the assessment, amd the GP also stated he was without capacity, so it’s a very formal thing. Following the doctors doing the assessments, there is a form on which it’s recorded. It’s kept at the care home, but I’m not sure how it will work with your mum being at home
I think that’s pretty standard, but if you read through the POA, it will tell you the criteria.

Unfortunately, the PoA just says we can't do it because we don't like her decisions, it's all pretty woolly.

I am waiting for her GP to make an appointment to visit her, which I will attend; we are hoping he will bring in the psyche team at some point.

It might be worth going to speak to the solicitor who drew it up before the GP comes round. That way you’ll know what you need to ask of the doc

Does your brother live with her. He sounds vulnerable and you could speak to his own medical team or adult social services about the situation.

Brother needs to write down what he has to do for her, preferably keep a diary for a couple of weeks, and to present that to the GP - or if he can't do that, then you need to do it for him. People dealing with elderly people are aware that what they say about their needs and capabilities does not always match the truth.

And yes, if your brother is the main carer, he's entitled to an assessment of his needs. Though not having gone through this process I don't know how much practical use it is - got to be worth a try, though. Your brother has SN, so they should be taking this seriously.

Mental capacity isn't an all-or-nothing, nor is it necessarily lost for ever. Someone may lack capacity to make a medical decision but still retain capacity to decide whether to have tea or coffee. You must make decisions "in their best interests", and you shouldn't make a decision on their behalf today if the decision can wait till tomorrow when they may have recovered the capacity to make it.

In the short term, you might be best tackling this via your brother and his needs - he needs to be protected from her.

What would you like to gain by the POA, it might be better for your brother to get assessed, he sounds vulnerable and he should be looked after and not be expected to do anything he doesn't want to do, it's also not the neighbours responsibility to call the alarm button or help when she falls. Like pp says, it would be better to get your brother help at the moment, he sounds at risk.

I agree that from what you've posted your DB is the one most at risk.

Would he consent to adult social care assessment for himself which would inevitably highlight the issues with your DM?

I have poa for my Dad and have never had to prove anything. The care company and GP etc. have seen it so know it's in place.

We were too late for Mum, we had financial one in place but forgot about health one until her dementia was at a point where it was clear she didn't meet the capability criteria.

But despite not having health POA for her, we have still been able to make requests for assessment for her etc. e.g. local authority OT and adaptations. You may still be abke to request LA care assessment for your DM . Its worth asking.

Good luck. Sounds like a really difficult situation to manage and so upsetting because of the impact on your DB.

DB can't read or write, do can't record anything, we are working with SS for him, trying to persuade him independent living is a good idea. Not really sure what PoA will give us, if DB moves out we will need to get more carers for DM, at the moment she refuses as she wants DB to do everything. I assume we would have the power to overrule her.

I think you have to take it one step and a time. Focus on DB, firstly because he deserves to live free from the responsibility of your DM

An secondly, because until he is out of the home, there is the danger that your DM will be assessed as having live in care from him.

What she needs and what will happen at that point has to be evaluated then.

POA doesn't allow you to do exactly what you want. Your DM can still refuse to engage with carers. But, if DB is no longer there, she may change her mind.

Do you have finiancial POA as well?

DB can't read or write, do can't record anything, I wondered if that might be the case - in which case you need to speak to him daily if you can, and record what he tells you about what's happened each day.

I've come across a tendency for anything a carer or medical professional observes to be regarded as "evidence" whereas anything you say is "relative says". But "relative says" is more likely to be considered "evidence" if you write it down as a daily record.

PoA Health and Welfare won't do anything for you until she has lost capacity to make her own decisions - in other words, until she no longer understands what decision she is being required to make. And I'm not sure from what you've written that she has lost capacity.

That's why everyone is saying "start with your brother and his needs".