Power of attorney

[DoIneed1]

Hello I was hoping for some advice. My 80 year old MIL is in hospital, but wants to be discharged. She is bed bound and has incurable cancer. We don't think that she is best placed to make these decisions.

Is the best way forward for the family to serk power of attorney? If so how best might we do this?

Thank you in advance.

Has she lost capacity to make decisions i.e suffering from dementia? If not then she has to agree to you having POA.

She will not be discharged without a care package being put in place. Her closest relative should be included in this discussion so you can put your opinions across then. What does she want to do, go home with carers coming in or is she relying on her family?

There's financial POA and health POA. Only works if she has capacity to sign paperwork from solicitor, otherwise the route is deputyship (latter is expensive and takes 6 montgs). Speak to a solicitor. Also 3rd party access to bank accounts to pay bills might be useful but you'd need to talk to her bank about how this can be achieved during covid as facetoface meetings are now mostly over the phone (which might help you if your mum cant get to the bank with you).

If she has capacity to make decisions she has to agree to LPAs in the first place. Health and welfare LPA ,even if in place, can not be used until she is deemed to no longer have capacity. You need to speak with discharge planning team/social worker, to see what can be arranged to support her with a care plan to return home. Someone in her position can be cared for at home. She may be eligible for Continuing Health Care funding under special rules as she unfortunately has incurable cancer. So sorry for you all is this is a most difficult time

Sorry while I was typing others got in before me with similar advice !!!

My sympathies for you, your DM and family to be going through this.
From my experience ( just as someone who went through similar) there are 2 main things to consider :

1. As PP have said, it’s key that you voice your concerns to medical staff that she may not cope at home. She may need support (Carers) or even this may be a bridge too far. They would usually get an Occupational Therapist to assess your DM in hospital and make a recommendation. They have been very helpful IME and provided aids etc, anything from falls alarms and handrails, pressure relief mattress etc to complete care package. I believe that if they thought she could go home safely with a care package, they would put a council-provided package in place which would be free for up to about 6 weeks. After this point, ‘you’ would need to arrange private Carers if your mum has savings (think its a threshold of about £23k).
2. Even if you already had a financial and a health POA in place, you would not automatically be able to override your DM’s decisions. Mental capacity assessment is made on the basis of which decisions are being made. The principal is that a person may have capacity to make some decisions but not all/others. What happened with my DF was that the GP referred him to Older People’s Mental Health and his capacity to make the decision ( to leave residential care and return to his home) was assessed. The psychiatrist decided that he did not have the mental capacity to make that decision as he was unable to appreciate the risks.

I really feel for you, it is such a worrying time.

The guideline turnround for registering the PoA is ten weeks so even if she's happy to do it and mentally competant it isn't going to be any help in your current situation.

If she will agree to signing POA then do so ASAP - they take ages to get registered - about 3 months, and that was last year before covid. You can suggest to her that if she signs the financial one it allows you to pay all her bills for her and keep an eye on things. Im not sure how much the health one is worth as DRs will keep next of kin informed and seem generally happy to accept instructions from family members if they can see everyone is on the same page etc.

Thank you everyone for your advice.

We are trying to find out whether she is going to be treated as a nhs continuing care patient. Even that info has been difficult to get. We hope to find out tomorrow.

We have told her consultant, nurse and OH that as a family we are totally against her being discharged at the present time. She is going to be bed bound for the rest of her life. The hospital has offered equipment and carers. But do far not given us any other info. OH did visit her house.

She will not sign over power of attorney. She is confused at the very least. She also lies about things, she always has, so it is difficult to really know what is going on with her.

I've just had to do if for my dad. I did the finance and health one. It was quite easy to do on the .gov website. But my dad still has full mental capacity at the moment. He is worried though as he is very poorly.
It has certainly made me want to make sure my affairs are in order sooner rather than later

If she has capacity to make her own decisions she doesn't need an LPA (she could sign one but it doesn't come into effect until she lacks capacity). If she hasn't got capacity she can't make the decision to have an LPA and you could look at Deputyship (AgeUk have good info and the Government website). If she is CHC funded she will have a nurse assessor coordinating her care and it is fully funded. Is she is not CHC she should have a social worker coordinating care and this will be financially means tested. Either of the above should be considering her capacity to understand, retain, weigh and communicate with regards to specific decisions such as 'how/where can my care and support needs be best met?'. If she is deemed to lack capacity a Best Interest decision will be made and this will very much be informed by you, other family, her precious wishes and current wishes. Hope this helps.

Thanks for the additional replies.

MIL has surprised us all by agreeing for us to take on POA.

No one has come back to us re her care post discharge as yet. I have snap inkling that we have put a spanner in the works by asking awkward questions. As of Thursday we were told that she was being discharged on Monday. No equipment has been delivered to the house and we have made it clear to multiple staff that we don't want this to happen. I am really disappointed that the NHS has failed to tell us what is happening. Seemingly deliberately.

You don’t need a solicitor for a POA. You do need someone who can sign that MIL at the time of signing has mental capacity to sign the POA. In normal circumstances that can be a friend or neighbour, but if you are in hospital I don’t know if you could get a doctor to sign it so can testify she is of sound mind at that time. As long as MIL has capacity at time of signing it doesn’t matter if she loses that capacity before the POA is registered, although you won’t be able to act until it is registered.