What do you wish you had got in place earlier?

[TeenPlusTwenties]

My DPs have got 'old' overnight.
Well obviously not, but they have been managing fine in lockdown with our remote support, and have always been independent and self sufficient. Dad (90) was clearing gutters in September, they were doing bonfires etc. Mum (84) is CEV and gets puffed out quickly.

He had to be in hospital unexpectedly for 4 days last week, and it has brought it home to him and us how fragile their 'independent' life is.

They have powers of attorney & wills in place.

But what else?

• a stair lift as Mum wouldn't have been able to cope if Dad had had to be in bed when he got out?
• they'll need a weekly cleaner/housekeeper when pandemic lifts a bit to help with cleaning, laundry etc
• they aren't good with mobile phones, but will be more motivated now as Dad could hardly drive the phone when in hospital
• downstairs bathroom would be good but complicated to arrange, especially right now. Dad drew up plans 2 years ago but Mum didn't want to...

Should we set up for online banking and organise so my DB or I can do it? Or should we encourage getting the POA going now to do it formally?

What are the stupid small things that are a pain to organise at a rush from a distance but with a bit more time would be easy?

We last did this 15 years ago with PIL, but we could see them weekly, and they had already downsized to a bungalow. Plus we were younger, not in a pandemic and didn't have children then.

Something that is helpful if you don't need to use financial POA for the time being is to get an account with the same bank as their current account in your own name. Nationwide were incredibly helpful, and as I had a very elderly account with them, and set up online banking for that, I was able to get my POA registered and a bank card etc for mum within 3 weeks and no branch visits, and it was the same for NS&I.

Dad wasn't very keen on Wiltshire Farm Foods, but they are reliable and helpful. I also used ParsleyBox for shelf stable meals for an emergency

They have been very clear they don't want us 'caring' and would rather be in nursing homes. When the time comes.

I’d have this at the top of my list. Find out the best nursing/ care homes nearby to you and to them. With vaccine roll-out you may get over the door sooner to view than you think but even a lockdown phone call with the managers of several would be a start. MIL is just about surviving at home but my SILs have earmarked two places if things start to fail. Obviously they don’t want the time to come but it’s very likely.
The other thing is to have an emergency bag for hospital stays ready and waiting in a cupboard for both. And you. Pjs, toothbrush, spare charger and cable, spare knickers etc

I wish we’d persuaded my parents to downsize to a bungalow or sheltered housing. They both became ill and deteriorated rapidly, even with a stairlift it was difficult. They needed other changes too, wet room, internet etc.

We haven't executed POA

Sorry for not answering the question you asked but I'm curious about the 'executing' of POA. We filled out the forms, including witnesses and signatures then sent them off to be registered with the Office of the Public Guardian.

Are yours registered ? For both property and financial affairs and health and welfare? I would encourage you to get them registered as quickly as possible, as the process takes some time.

Thereafter, we used them as and when.

Look at leasing a stair lift or buying a reconditioned one. There is very little that can go wrong, the reconditioned ones are very likely to be as good as new.

Making sure that all their bills are paid by direct debit / standing order, that you have access online and that any statements come to your address.

We had the POA but never really used it as I could access everything online.

Don't beat yourself up for not getting things in place already. There is always resistance, we got used to just accepting that things wouldn't happen until there ESX a crisis.

I'm so sorry you are having to deal with so much at once.

Have you looked around for possible homes for when the time comes. So long as there are beds available, the process can be very quick for self finders. My late father had a medical appointment on a Thursday morning, decided he needed to go into a home. We spoke to the local lovely one that day, he moved in for 'a few weeks respite' on the Friday.

To be fair, he was back home within a week, as soon as we could arrange life in carers https://www.country-cousins.co.uk and back to the home within a week.

Respite seems to be a popular way of making a stay palatable.

I need to read up on POA because I am remembering what we did for EPA and I think my parents have the newer LPA.
Anyway when I wrote 'executed' before I meant telling the banks, showing ID etc etc.

I need to read up on what can be done if they have capacity but would prefer we dealt with stuff for ease & if they no longer really have capacity.

I think checking what they still proactively pay would be a start and getting those converted to Direct Debit. Plus maybe setting for online banking and then giving my DB the passwords.

This may be head in sand, but we aren't at nursing home stage yet. (Possibly blinkered due to DGM being in own home until 100.)

With the new style financial POA you could decide whether you use it straight away once registered or only when capacity was lost. There was a section on this in the form that needed to be completed.

Getting a local carer/ cleaner in soon is really helpful.
Is there a local Facebook group for their area you could join and ask for recommendations?

Make sure you have hand holds by outside doors, bathroom etc. Keysafes are fab, Dad really benefited from having a handrail on both sides of the stairs. Do they already have a walker with a tray attached? If not it really helps. Maybe look at getting plug 'grips' etc

Thanks to this board I put together an important info folder for dm with a page of key contact numbers/ medical history stuff. Very visible by her phone in a red folder.

telling the banks, showing ID etc

Arranging online access to everything was key for me. It meant that I could do lots of things from the comfort of my own home.

Only the nursing home actually asked to see the POA. This might be because I dealt with most places online ...

Hi OP you seem to have everything covered and some really good advice here. The other thing to consider is that hard conversation about an Advanced Directive. We are all good to die and having thoughts about how we'd like that to look can be really helpful at times of crisis. It needs to be written down I think there might be templates online.
I knew my dads views but as he hadn't written anything down his consultant ignored us. If I knew what I known now I'd have fought harder.
Good luck

@Mum5net

They have been very clear they don't want us 'caring' and would rather be in nursing homes. When the time comes.

I’d have this at the top of my list. Find out the best nursing/ care homes nearby to you and to them. With vaccine roll-out you may get over the door sooner to view than you think but even a lockdown phone call with the managers of several would be a start. MIL is just about surviving at home but my SILs have earmarked two places if things start to fail. Obviously they don’t want the time to come but it’s very likely.
The other thing is to have an emergency bag for hospital stays ready and waiting in a cupboard for both. And you. Pjs, toothbrush, spare charger and cable, spare knickers etc

I think @Mum5net has an excellent point - time and again I see situations where a care home is almost inevitable and yet the family only start to look around once crisis hits. It's invaluable to have an idea before this point.

Put their banking details on an app on your phone, my mother is not tech savvy at all and giving her access to the app, would be right up there with giving Donald Trump access to the nuclear codes and I am not even joking.

A camera set up so that you can check up on your phone. I have found it useful to watch elderly person in bed.
It's difficult to plan everything for the future -- the unexpected happens.

Downstairs toilet and wet room. 100%
My Nan is due to have one fitted in the next couple of weeks. (She's had the first vaccine dose last week, so not as greater risk).
But definitely something she feels needs to be done asap

Thank you all so much, you are being really helpful.
Luckily Dad had the vaccine 20 days before he had to go hospital (he was one of the very early ones), so that helped with peace of mind.

Following so I can find this thread later and show my DH. We need to have more in depth conversations with his lovely parents. I've already been shown where the paperwork is in their home but it looks like, from this thread, we should be discussing LPA's, care homes etc. They live in a 4 bed detached house and even with the starlift is not going to be suitable for ever. And both together they are great, but either one on their own..no ..not good. And we are an hour away with secondary school age children.

POA can be drawn up and validated but it has to be registered before you can implement it - this can be done at the time of validation which is what we did, so the OPG just sent back the validated LPA with a covering letter saying that it is registered and you’re therefore good to go with banks etc. Have you got any certified copies if you need to send off any in the post? Don’t let the original out of your sight.

I would advise that you register it with your parents’ accounts, I notice PP said they could access everything online so didn’t use POA but I’m not sure this is actually legal (though I know everyone does it) - if your parents’ mental state deteriorates in the future they may start becoming obstructive to you accessing things and then you’re snookered.

An over-bath shower as they start to become more infirm is an accident waiting to happen.

Would they talk about their funerals? My dad had a prepaid funeral plan with a local firm, he stated exactly what he wanted to happen including music etc., made things really easy for us at a difficult time.

There is good and clear information on Advance Directives here:

compassionindying.org.uk/

And it has templates to complete one as well as details on how to make it legally binding (for refusals of treatment - can't force anyone to give treatment that's not in your best interest, but does offer protection from invasive or life prolonging interventions you don't want to be subjected to, because it's a criminal offence to give treatment that's been refused in an AD).

If you go through the online one it takes you step by step through different scenarios (eg dementia) and the circumstances in which you might want to refuse specific interventions. There are explanations too. It's not just a blank slate leaving you to ponder huge, scary stuff alone.

It's a bit more gentle than having to think it all up yourself, but then it has space for you to add free text where suitable.

Not a fun topic, but I think they handle it sensitively and it can make it feel less frightening to take some control and know your wishes have been clearly expressed. (Much less upsetting than my hospital's leaflet on the subject of DNACPR decisions).

Also, worth noting that an AD only kicks in if you no longer have capacity. So if you did have capacity and wanted to make a different decision to the AD, you could still change your mind and consent to treatment. Very much still have control.

I've probably over explained that, I just think knowledge can make us feel much stronger and more in control when it comes to scary stuff like this.

Oh, pp talking about the pendants to call for help. When I was looking at this I discovered there are loads of extra options now. For example, wristband fall monitors that activate if they detect a stumble or a fall and then connect you to help if needed (there are various safeguards so not sending ambulances unnecessarily etc). They look like a wristwatch or fitbit.

Or smoke alarms that are connected to the care alert system. Sensors to detect if someone hasn't gotten out of bed in the day, or if they've left the house at night (e.g. if dementia and concerns about wandering away).

There are all kinds of different options depending on where the risks and difficulties are.

My parents are slightly younger but my mum had a random fall in the garden and broke / dislocated her collarbone. As her other arm was already slightly weak it did cause issues.

They had a downstairs room from when they looked after a disabled child with a sink in / they adapted this to add toilet.

They put a day bed in their raised up a few inches so it didn't need as much effort to get up.

Again added height adjusters under the arm chair to help getting up.

Previously they had changed to a corner bath with a sort of seat so she could sit on that to have a wash.

Following this thread so I can make a to-do list - thank you OP and other posters. This is such a fantastic resource for something I’ve been dreading having to deal with.

Stairlift I agree we need to get on and do. Should be straightforward in terms of workmen in house, just long lead times. That was not my experience. Ours was less than a week from making initial calls to companies to the lift being installed. Are Stannah the go-to people? They're good. I would suggest go for reconditioned - they're rarely used for much more than a year- and an independent local company. You can get a reconditioned Stannah without having to go to Stannah. The problem is not the installation but whether the user still has capacity to press a rocker switch in the direction they want to travel, and to hold it down till they get there.

Remember, if a stair lift is installed a few years early, you'll have to keep in maintained and in good working order till it's needed. And the fact that it's available may make your parents more likely to use it instead of walking, and may contribute to the speed of decline of mobility.

Should we set up for online banking and organise so my DB or I can do it? Or should we encourage getting the POA going now to do it formally? Has the PoA been registered with the Office of Public Guardian? If not, do that straight away. Once that's done, putting in action is a matter of showing it to each organisation you're dealing with.

Was the PoA (Finance)written to be able to take effect when the person still has capacity? If not, get them to consider drawing up a new one. My father, while still perfectly capable of dealing with everyday spending took to overthinking everything else, reading all the small print in immense detail, getting it muddled with every other bit of small print he'd read on any subject, so he ended up incapable of signing a direct debit, or re-investing a maturing savings bond. My being able to take over that sort of thing made life a lot easier for both of us, and he was still able to manage his current account himself.

I've always gone into branch to activate PoA, which is relatively quick (out within an hour). If you have a financial advisor, they can certify PoAs, and depending on your relationship with them, they may do it free. Get several copies - companies will return but inevitably one will go missing. Always ask for options - I've had a couple of places accept a scanned copy by email - that's more likely to work for insurance companies, electricity suppliers etc.

Also downstairs wet-room (ie not step to access the shower). Just been really useful for our ex-neighbours - she broke her hip, and by the time she was discharged from hospital, husband and son had switched around furniture so her bedroom was now next door to wet room. Remember that Social Services think a perfectly acceptable solution to getting someone home is to park them in a downstairs room with a commode.

I need to read up on what can be done if they have capacity but would prefer we dealt with stuff for ease That can only be done if the LPA was written so it could be used while they still have capacity.

Something else that is useful - see if they will write a letter to their GPS saying that GPS can share medical info with you. Helps enormously when they are no longer quite capable of relating what the doctor actually said. or asking sensible questions at the time.