Where to start?

[3timeslucky]

I am not from or in the UK but have an elderly relative who is (IoW). Her husband died recently, she has no children and no family in the UK. I'm the closest relative (in Ireland). She is 90 and housebound and has some support in a nurse who visits and someone who does a shop each week. Also a cleaner. She was a teacher all her life and there would be a pension but I don't really know her financial situation. She is mentally as sharp as a pin (this is based on phone calls I, my dad and my cousin have had with her).

She has asked for some help "sorting some stuff out" and I'm going to visit her but want to understand how the system in the UK works and what her options are. She has mentioned EPOA but has not mentioned moving out of her house.

I know it is a big ask but can anyone explain the overall system or point me to good sources of information and what I should be looking at.

EPOA
Entitlements to supports at home
Other supports that might be available
Nursing home/old-folks home/elder care supported living systems and costs (we call them nursing homes I'm not even sure what the UK term is). I know this is very different to in Ireland without knowing how it works.

Anything else I/she should be looking at.

Because she's in the IoW the logistics from Ireland are a nightmare so nothing can rely on being able to "pop-over" regularly and keep on top of things. I really don't know what the best options are for her.

Thanks in advance.

Enduring POA is not a thing anymore unless you set it up before 2007.

You can get Lasting Power of Attorney - there are 2 types: Finance and Health.

Am not sure how well either would work in this situation as you aren't in the UK.

What 'stuff' has she asked you to sort out? I'd start there. A mentally sharp 90 yr old who can manage at home with a cleaner and a weekly shop is not ready for a nursing home.

Age UK has good advice. If she already had care coming in does she have a social worker. Would she consider legal power of attorney so that you can help more if needed for example online banking, being able to talk to utility companies.

Start with Age Uk isle of wight

https://www.ageuk.org.uk/isleofwight/

they do tons of stuff and can advise both you and her if what’s available plus other support services.

She might just need help decluttering or something like that.It might be worth checking with her that she has her paperwork in order and has made a will.

By the way, when it comes to power of attorney, it can be taken on by a solicitor rather than a family member if no-one feels able to take on the responsibility.

Thanks for the guidance.

I don't know yet what exactly she wants. While she is sharp and seems to be managing, recently she has spent both 2 days with no electricity and 2 days with no water including no toilet she could use as the water levels rose up through the system (she's quite remote and not on the "normal" water system). AFAIK it was storm related and hopefully won't recur but it gives an example of the kind of thing she's struggling with (equally when the oven broke and she spent months eating from a microwave only, when the back door needed replaced and couldn't be opened). I get the impression that things are fine when they're fine but if the wheels come off at all she's really stuck. I'm not even sure services exist to fill those kinds of gaps.

I don't think she's ready for a nursing home, but conversations will probably include talking about circumstances in which that would be her preference. In my experience with parents and in-laws, better to have the conversation when it isn't imminent.

EPOA - power of attorney gives a named person the power to act on her behalf. If it's a pre-2007 EPoA, who is named on it? (And they are a bit of ag pain tonise because they're an old system.) If setting up new-style Lasting Power of Attorney there are 2 types. Finance will let you deal with banks, power companies etc on her behalf - and can be used alongside her while she has caicity to manage some things herself. Health and welfare only kicks in when she no longer has capacity

Entitlements to supports at home/Other supports that might be available - contact Adult Social Services for an assessment - this will cover need for visiting carers and any adaptations to the house such as grab rails or chair risers. If she has savings over £23k they won't pay for carers but some adaptations may be free, and there are often discounts in things like falls alarms.

Nursing home/old-folks home/elder care supported living systems and costs (we call them nursing homes I'm not even sure what the UK term is). Various levels. Sheltered accommodation has an on site warden but provides little or no care. There may be an on site restaurant but meals not cooked for everyone as standard. Care homes provide meals and help with personal care, but not nursing (so they will dole out prescribed meds and help with washing, but won't do dressings, IVs etc). Nursing homes provide higher level of care, including having trained nurses on staff. Hospices are for high-needs end of life care. All of these except hospices need to be self funded if she has savings over £23k.

An Advance Decision is also useful - an if/then document setting out what medical care she might want in different scenarios.

Do you know how she found her cleaner and what the cleaner is like?

My DM's whole network of support is based around her cleaner - cleaner's husband is her handyman, if he can't do it he knows someone who can. They also knew a gardener and most recently had a friend who works as a care assistant.

You can be registered with utility companies as a vulnerable customer so prioritised if there are problems. However this doesn't help if the boiler goes and you don't tell anyone.

My DM has a Taking Care pendant alarm - the most useful feature is a box that sits in the kitchen and registers how active she is. They rang me in the winter to tell me her house was only 12C, and yes it turned out the boiler had gone and she hadn't rung anyone to repair it.

It would be worth meeting her cleaner and the 'nurse that comes once a week' - presumably the district nurse, to tell them about problems they haven't noticed and see how they think she is.

Great suggestions and advice, thank you.

Some of the questions I don't have answers to (though I do know there is no existing POA of any sort in place, which concerns her).

It seems her solicitor is willing to do financial, but not health/welfare. She has a solicitor and has made a new will since her dh died I think.

I'm definitely going to try and link in to those currently supporting her and make sure they know they can contact me. Also going to pin down who is supporting her now and whether there's anything additional that would help.

The mention of the cleaner's dh resonates. I know her cleaner's dh has done some DIY for her. Again I need to find out more detail about what might be available there.

I'll look in to Advance Decision and how that works in the UK.

Thanks again. I really appreciate your replies.

It would be very odd for a solicitor to do LPA for Health and Welfare - I can't see anyone reputable agreeing to do it given it is really based on knowing the person and expressing what they would want in different situations.

I've dealt with a LPA for Health and Welfare who was abroad and TBH it was very difficult as we could never get hold of them, they weren't 'on the ground' so couldn't see what was happening however well we tried to explain the situation.

If you can only do one, Finance is the most important as it keeps the bills paid and keeps the money going as long as possible.

EPOA can only be registered once the donor has lost capacity (according to the OPG) and covers finance only. LPA can be registered as soon as it’s signed, so it can be up and running as soon as it’s needed. And, in the case of the Finance one, it can be set up so it can be used while the donor still has capacity.

Look into Attendance Allowance if she’s getting less able to do things for herself. It’s not means tested.

Extra care housing is a useful thing to be aware of.

Rather than deluge yourself with info, it might be better to ask for more targeted info once you know more of the situation. You can get answers very quickly on MN!

What do people do for Health/welfare LPA if they have no local relatives? Who makes those decisions for them if they are unable themselves?

The vast majority of people don't have an LPA. And most people will never be in a situation where they can't make their own decisions. Or if they are it is only for a very short period of time.

For Health and Welfare, professionals have to act in the patient's best interests. If the person has absolutely no friends/relatives there is a system of Independent Mental Capacity Advocates who are appointed to make sure the patient is represented.

For Finances these can be administered by the Court of Protection. In reality lots of people come up with work arounds such as joint accounts, giving family members their card number and so on.

Thanks. She's naturally a very organised and "in control" woman who I think is now feeling vulnerable that there's no-one to make decisions for her in the way she could for her husband. Having retired to this area and outlived many it probably adds to the sense of isolation that comes with having no children or siblings. I really want to do whatever can be done to give her peace of mind that if she becomes too unwell to manage that something is in place to make sure she and her affairs are taken care of in the way she wants.