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Elderly parents
Original poster

Tricky situation POA

32 replies

Pianokicker · 26/05/2020 15:59

Don't quite know how to handle this situation regarding my mum.

I have POA for health and welfare for my mum. She has some dementia but I would say she still has capacity (in my opinion). She is currently living at home with my elderly dad. Dad (90) can no longer cope with her needs, even with two carers 4 times a day, she basically has no mobility. The OT has been in to assess her and they have ordered a return 7500, sliding sheets, commode, foot protector and a hospital bed etc...for their tiny flat (this is all according to my dad of course, I haven't seen them since lockdown began).

So we are having ongoing discussions regarding a nursing home, my mum hasn't agreed to go, and I can't see her agreeing to it, the upshot is that my dad has to continue to care for her.

What I am trying to get at is that because she has capacity can she make a decision that negatively affects someone else? My dad is really suffering.

Lockdown has made this horrible situation about 100 times worse of course.

Sorry if it's all a bit waffaly above, thanks for reading.

OP posts:
Heygirlheyboy · 26/05/2020 16:06

Are you considering activating the POA? (In Ireland this can take months by the way even if it's in place with solicitor) I wouldn't go down this route if possible especially as you say she has capacity. However it's clear some intervention is necessary. All that equipment takes up a lot of room, will carers be able to work with those installed in the space they have?? Have you nursing home potentials nearby? And availability? Would employing private carers be a possible option? What is your Dad's view? I'd 'chair' a family meeting, via zoom or ideally in person at a safe distance, laying out your concerns and your own limits re help you can give. Hopefully together you can come up with something that will improve everyone's circumstances. It's all really difficult. Have you discussed wishes etc prior to this?

Heygirlheyboy · 26/05/2020 16:11

PS in my own case we decided prior to lockdown that I would be part of my Dad's unit, the risks of not doing so outweighed any benefits and I supported him in cocooning, while isolatjng myself otherwise. Is this an option that would reduce pressure a bit? I have a link for a very helpful booklet that we filled out together with my DPs and it laid it all on the table in a neutral way and it meant hard decisions were made.

RandomMess · 26/05/2020 16:22

I suppose she doesn't have full capacity anymore because she is unable to see and consider the impact it has on your Dad...

Presumably in the past she would have been far less selfish?

JulesLo · 26/05/2020 16:27

Is there a spare bedroom in their flat? If so 24 hour live-in care might be a short-term solution that will give everyone a bit of breathing space. No pressure on your Mum about going into a nursing home - it will take the pressure off your Dad, and off you about what to do.
I know that's deferring the decision but, at least, you'll then make a decision without all that extra stress.
Of course, you have to have a spare bedroom for a live-in carer so that might not work...

Heygirlheyboy · 26/05/2020 16:29

I really hope the OT has measured up and ensured that equipment can fit..

Original poster
Pianokicker · 26/05/2020 17:03

Thanks for the replies

My mum has never been selfish, I think it's part of the dementia that she can't really see the effect on my dad, so maybe she does lack capacity, gah it's all so difficult right now.

The flat is tiny (it's a 2 bed in name only), the hospital bed would have to go in the living/dining room (they'd have to move furniture out). There just would not be room for live in care unfortunately and besides they are currently coming in as a team of 2 to move her (might reduce to 1 person when they have all this equipment, I don't know). I think there was a suggestion that my dad could use some of it to assist her but really we are beyond that now.

Unfortunately I'm not in a position to look after mum.

Could anyone advise me what the normal procedure in England for activating POA would be? I assumed it was on the say so of an assessment with the GP? I've read the advice on the government website and as far as I can tell the bar for lacking capacity is pretty low.

Thanks

OP posts:
RandomMess · 26/05/2020 17:06

See to me it sounds like she doesn't have capacity anymore due to her dementia although she has the appearance that she still does.

I hope you can get it sorted, must be so upsetting and stressful for your Dad as well as you Thanks

Aurorie11 · 26/05/2020 17:15

Does your Mum have a social worker? My mum was similar 4 care visits a day and my Dad couldn't cope. The social worker and members of family, it was agreed that care home was best solution and there was a conversation with Mum and questions were put in a way to get agreement to go into care

GinghamStyle · 26/05/2020 17:26

It depends on whether it’s an EPA (if not signed by you will not be valid) or LPA which just needs registering. Registration can take 8-12 weeks and so you’re best starting the process ASAP.

As an attorney, you have a duty to act in your mum’s best interests. It might be worthwhile having a chat with her GP re capacity. In this situation, the POA is beneficial as if Social Services do become involved, you’re a spokesperson for your mum to make sure that what happens is as she would want ie staying at home as long as possible rather than going straight into a home etc. Also, depending on the wording in the LPA, you may be able to use it before she loses capacity. If she drew it up at a solicitors, it may be worth speaking with them about whether your mum mentioned any specific wishes re homes etc when she made it. The solicitor will also be able to advise you about the care options available and the next steps to take. If you were someone I knew in RL, I’d advise you to phone a lady in my office who deals with LPAs.

Original poster
Pianokicker · 26/05/2020 17:44

Thanks all
I have LPA, the GP is going there tomorrow so we will see what comes of that.

It all kicked off just before lockdown with a fall and hospital admission for mum, she was frail but they were doing OK; however the deterioration since has been swift (mental and physical).

OP posts:
FinallyHere · 26/05/2020 19:58

Hope it goes well with you tomorrow

In our case, we found the home instead people really very good but there came a time when two carers were need that a nursing Holme was the safer option.

At that point we contacted homes who offered an initial trial period which we called respite care. As it happened, my mother only once or twice asked when she was going home and then her condition deteriorated really quite quickly.

Hope you find a good solution All the best.

HRHPP · 26/05/2020 20:10

Even with no or fluctuating capacity her wishes and feelings will be considered. You can’t just remove people from their home . A best interest decision will have to be taken and a Dols applied for .

Speak to the OT and social worker about how to support your dad . He will be entitled to a carers assessment which will give him his chance to ask for help.

purpletrees3 · 26/05/2020 20:22

Sorry to hear about your family's situation. In this scenario I'd be very clear with the OT/SW on what your Dad isn't coping with. Is it physically or mentally etc. Please consider what your Dads wishes are in all this too, yes he may find it tough but maybe he's happy with things that way as he gets to have his wife at home with him. In the first instance I'd check what carer support services are in place locally to support your Dad. I'd also look into respite services to give your Dad a rest & to potential ease the transition into full time are if that is what is everyone's best interests. Best of luck

drayco · 27/05/2020 08:34

She needs a mental capacity assessment around understanding her own needs and where she wants to live.

The GP can do it as can a social worker. GP might be best bet at the moment as SW may not be doing visits at the moment. This will help activate the POA though best interest decision still needs to be made.

It's very common that this happens and the other spouse is left to cope. If it continues she may find herself in emergency respite anyway when it's carer breakdown.

cptartapp · 27/05/2020 08:46

Your dad doesn't have to continue to care for her. As a last resort, force social services to act and bring your dad to live (until your mum is relocated into care) to live with you. Make very clear to him that his move I still temporary. Give social services 48 hours notice of your plan.

MereDintofPandiculation · 27/05/2020 09:51

Also, depending on the wording in the LPA, you may be able to use it before she loses capacity. That applies only to the financial LPA, not to the Health and Welfare one.

Original poster
Pianokicker · 27/05/2020 12:04

Thanks all, GP is visiting later.

Dad is 90, he's basically been a full time carer for my mum for 2 years, he has no quality of life at the moment, and he is emotionally and physically exhausted, he knows mum could be better cared for in a home. My mum has paranoia and believes she is being persecuted and that we are scheming against her, she attacks dad (verbally), this is all part of the parkinsons dementia. But actually mum would be much more comfortable in a nursing home where they can properly look after her, at the moment the carers get her up and put her to bed but in the meantime she is sitting in a collapsible wheelchair all day (sort of slumped over). At the moment I'm focusing on the practical side of things because I can't dwell too long on how much pain and discomfort she is in. It's really since her last fall 2 weeks ago that it's got to this crisis level.

The LPA is all registered, I'm hoping we can all reach a consensus. Maybe I'm just catastrophising. My mum with her full faculties would be horrified at all this and would probably be booking herself off to dignitas.

OP posts:
JulesLo · 27/05/2020 17:31

I really do hope it all works out for you, your Mum and your Dad. Hopefully being able to talk it through here has helped too - it's so common that families end up in a crisis situation with elderly parents because nobody really likes to plan in advance for their infirmity. And crises develop very quickly as you've found out.

Here's a quote that brings it home for me:

"There are only four kinds of people in the world:
those who have been caregivers,
those who are currently caregivers,
those who will be caregivers,
and those who will need caregivers."

  • Rosalynn Carter
AnnaMagnani · 27/05/2020 21:37

I would say she probably doesn't have capacity if she is unable to take on board the information that her husband, your Dad, can no longer continue with the status quo.

For a LPA for Health and Welfare you don't have to 'activate' it in the same way you do for LPA for Finance. It is decision specific - so she might have capacity for one decision in which case she gets to make that herself, and not for another - in which case you can make it as the LPA.

As her LPA you can only make decisions in her best interests, thinking how she would have made them if she still had capacity - you can't just go off and make the decisions you want.

However in this case it sounds like the decision is making itself and she would really want to look after your Dad and be mortified she was paranoid about him, if she didn't have dementia.

Original poster
Pianokicker · 27/05/2020 21:47

Thank you Jules

Things didn't exactly go as I would have wished today. Dad is back pedalling somewhat on the care home issue. He is still clinging to the idea that the equipment will magically solve all the problems. My mum failed the test for use of the return 7500 so they are now ordering a hoist! I'm secretly hoping it won't fit in the flat, the one in the hospital I saw was pretty big. Also realistically it isn't safe for my dad to use it so mum would still have to wait for the carers to toilet her etc...
At this point it's still mum and dad's decision I guess, I'm just disappointed as they are both suffering for it.

OP posts:
HappyHammy · 28/05/2020 13:38

The gp can assess mum capacity. With the hoist there is a real risk to them both if dad uses it. You can contact Age UK or adult social services safeguarding team if you feel dad is at risk by helping with her care.

HRHPP · 28/05/2020 18:28

You can get a tracking hoist if a mobile won’t fit

Original poster
Pianokicker · 28/05/2020 18:31

Thanks Hammy, SS is an option I was considering (for dad)

OP posts:
Original poster
Pianokicker · 28/05/2020 18:37

@HRHPP

I'm rather hoping that all this equipment won't fit (and/or the carers can't use it safely due to lack of space), it may force the issue, whilst that may sound unkind it really would be better for them if mum was in care.

I appreciate that that is my opinion though and their wishes at this time override my thoughts.

OP posts: