Is DF eligible for continuing healthcare and should/could we get POA?

[Rukminy]

DF 89 has heart failure, severe kidney disease, has had severe bowel incontinence for years and is now doubly incontinent. He takes meds for his thyroid and his hands shake a lot but he hasn't been diagnosed iwith Parkinsons. He has lots of falls caused by blackouts.

A few months ago, he fell and broke his neck. It's not ever going to heal but he was able to use a frame to get around and was coping with some help from family until the lockdown during which he has deteriorated massively. The bowel incontinence got even worse. It was totally unmanageable. He lost even more weight and had a fall. He hates hospitals and tried to prevent me contacting his GP but I did and was told to call an ambulance.

Things have got worse in the last few days in hospital. They are having to do everything for him, he can drink unaided but they are feeding him and the bowel incontinence isn't easing. He's bed bound and has been treated with antibiotics 3 times for infections in the last week and they've found that he's got a broken shoulder. They say he can't go home with carers as he needs round the clock care and they want to send him to a nursing home. He's so ill, he can't even argue with this. I'm worried they'll say he lacks capacity because he's almost deaf it seems as though he doesn't understand what is being said when actually he just can't hear. He can't communicate properly as his voice is very weak and he struggles to talk now.

Do you think he would qualify for continuing healthcare?

Should we try and arrange a power of attorney or is it quite an easy process to get the court of protection to appoint family members as deputies?

Thanks

I’m sorry, but if your father has already lost capacity, you cannot get a POA. Court of Protection is a long and complicated process (made worse by the massive backlog from Covid) You probably should speak to a solicitor regarding applying to the COP.
I’m sure someone knowledgeable will come along and answer the healthcare question

Yes, push for a continuing healthcare assessment, he clearly has nursing needs.

Lasting Powers of Attorney can be set up quite quickly now if he still has mental capacity. Forms available online, you could start that process today. Don't wait till he's lost capacity - could take 6 months if Court is asked to arrange deputyship.

Can you communicate well by writing things down for him to read and respond to?

If he has capacity set up LPA ASAP, assuming he consents.
Yes get a continuing healthcare assessment.
If he has no capacity then consider applying for a deputyship.

You can try and get a POA but you may have missed your opportunity given how ill he sounds.

There are two types - Finance and Health & Welfare.

Obviously if you have Finance it is v useful as you can manage his finances, without it you do need Court of Protection.

For Heath & Welfare - most elderly people do not have them. They are good to have but they tend not to radically change the decisions being made. If you turn up as a very interested daughter advocating on his behalf who was just about to apply for POA, that is going to hold a considerable amount of weight.

Have you asked about his prognosis? I am wondering from your description whether he would qualify for Fast Track Continuing Healthcare.

Thank you all so much for your very helpful replies.

I haven't asked for his prognosis. I will do that today and I will speak to the hospital staff about a continuing healthcare assessment if I can find someone with time to talk (his ward is so busy, they are run off their feet).

I am sure he still has capacity but to someone who doesn't know him, it could appear as though he lacks it because of the communication problems. I will do as suggested and write something down explaining what a POA is and asking if he would be happy with this. I don't even know if he could sign anything now though because the hand shaking has got even worse since he has been in hospital.

It's such a desperately sad situation because he has always led a healthy, active and independent life and being bedbound and totally reliant on hours is his worse nightmare.

From my experience, very different to yours, but my DF can hardly talk, has no insight and makes decisions with detrimental consequences for his health however he is deemed to have capacity, so not being able to hear might not necessarily mean he can’t make decisions, he just needs to be able to communicate them.

However getting CHC may be tricky, these threads are littered with failures and you will have to be persistent, doggedly fighting for his entitlement. I’ve found the assessors will mark down even when there are 6 other parties in the room, (carers, nurses, specialists, management, families, psychologists, social services etc) who mark up, the assessor is the only one who counts, unfortunately mine lied to my face and said Dad would get CHC, de didn’t). He is currently mobile but can be aggressive and refuse care and was marked up for behaviour, however as his illness progresses he will become less aggressive and less mobile, but he will be marked low for behaviour and high for needs and then will still not Getz CHC. It’s become and fruitless box ticking task that I now insist happens to keep the assessors doing a job. If your Dad has a property that will likely cover his care, otherwise your local authority will be paying and he may still have to contribute.