LPoA - does it trump my Dad

[FlatOutAgain]

Hi, I have another thread that details my story with my Mum in hospital and the advice was great - thank you

Unfortunately mum has deteriorated mentally whilst in hospital although the physical side of things have improved in that she can now walk around.

Herein lies the issue as she has become somewhat uncontrollable on the ward. I got a call late last night and the on call Dr. said that she had become physically and verbally aggressive. They wanted to put a Deprivation of Liberty in place and needed my consent. I agreed to this after a long conversation as she is a danger to herself and others. Without the paperwork the security staff would not assist which is why the Dr. was filling out the paperwork but needed consent.

I have LPoA for health and welfare.

She has not been officially diagnosed with dementia but we are in process with the memory clinic. She had a CT scan and the on call Dr said that there was some brain shrinkage and she would have a psychological assessment on Monday. I will update the memory clinic who had set up a CT scan but now that will no longer be needed.

It is clear now that mum has dementia and the Dr. said this last night but cannot make an official diagnosis but that should be soon with either the assessment on Monday or the follow up by the Memory Clinic.

My Dad doesn't have a very good mental capacity but does not have dementia and he just wants Mum home and says he can cope. Unfortunately he can't cope at all and has his own physical needs.

I cannot go in to the hospital today as I have other things to do but have been in everyday and have been taking Dad.

I have explained to everyone each time I go that I do not want her discharged until I agree.

The hospital discharge team are up-to-date on things and will put a care package in place once they have the discharge date.

My concern is that Dad is on his own with her today. Does my LPoA trump anything he says today to the medical staff?

Thank you

Yes. It might we worth mentioning your concerns to the doctors though so they make all staff aware of it.

I have explained to everyone each time I go that I do not want her discharged until I agree. ah sorry missed that you had. But if you're worried about it just give them another call so it's fresh in their mind.

If she's violent on the wards and there a DOLS in place, I'm not sure home will be the safest setting for her or your DF.

In your shoes I'd be pushing for a Multi Disciplinary Meetinf to assess where she will be best after Hospital.

They might decide home is the best but I'd let the trained professionals decide.

Do both of your DPs have SWs and are you keeping them regularly informed, specifically of things like your DF's inability to care for you DM?

Sorry did the typical MN thing of not answering your question 🤦‍♀️

If your DM gave you POA and didn't give it to your DF, then she gave it to you because she trusted you to make the right decisions for her.

Thank you

I will keep letting them know that the decision is mine.

@PritiPatelsMaker thank you. I will raise the multi disciplinary meeting with the discharge team. Not sure what SWs are?

Will speak to dad gentley to ask if he is hiding that she has already been aggressive towards him. I don't think this is the case but knowing my dad he would hide it if she was.

Spoke to a senior nurse on the ward this morning who said that as soon as I left then mum was angry and accusing her of not knowing her job etc. The nurse actually apologised for telling me. They are so nice to her but it must be difficult for the other patients on the ward. I could not apologise enough to such a wonderful team.

I have the hope that mum will calm down at home with dad and the right care package in place.

This has gone downhill so quickly that I don't want to make the wrong decisions because of time.

Thank you again

Yes definitely raise a Multidisciplinary Team Meeting before discharge although some hospitals really don't want to do them, you might need to push.

For us, it eased a lot of guilt for DFIL as it wasn't his decision for DMIL to go into a Care Home, it was a decision of the HCPs at the meeting.

SWs are Social Workers. If they haven't already been assigned one each they need them quickly and you need to tell them exactly what's going on. In all honesty your DM can't go home if there's a risk she's violent to your DF when he's vulnerable himself.

Getting the diagnosis may be useful as depending on the type of dementia, sometimes medication can help slow the progression. Things may be better in a familiar environment, but try to keep an open mind and look out for signs that she needs more care.

Yes it does but you have a duty to consult with others important to your mum eg. Your Dad and take into account his views, you don’t have to follow them though

Thank you again.

I have been in touch with Adult Social Services who have created a record for Mum (not for dad) and it is on hold as the Hospital Discharge Team will deal with things in the first instance.

I will contact ASC again tomorrow to ask about social workers. I am also going to set up TeleCare for dad this week so he has a pendant should he suffer a fall as currently he is on his own. This is now a priority and they reckon it will take around a week to put in place.

I will also speak with ASC about dad to see what can be done.

I am unsure when the diagnosis will happen as it could be by the psycologists tomorrow (not sure) or by the memory clinic if they are able to work with this weeks CT scan. I thought they said they needed an MRI but on the appointments it says CT scan and she just had one of those.

Thank you again I am sure you understand that having some help on here means a lot as me and my Dh are working through this alone and at times it is coming at us from every direction. My sister who is 2+ hours away is trying but that is now just adding to the confusion as she is calling hte hospital as well. I will ask her to leave it with me as that would be easier and I am the one with PoA. I like that she is trying but at times I need some headspace and she keeps calling me for updates or to tell me something. I honestly want a few hours of peace and calm but it seems it is the only conversation in town at the moment

Speak to the Ward about getting your DM a SW. they may have already done it