What does lack of LPA look like in worst case scenario?

[LoveRules]

My elderly frail and deaf mum will not entertain the idea of sorting out an LPA for health or finances.

She lives in her own four bedroomed house with £££ savings so could afford private care if/when it's needed.

Today I went for a consultation with a will writer for my own affairs and ended up hearing of why it's so important to have an LPA.

The will writer used to work in a senior role in NHS Social Care and explained that a person who has had a fall and in hospital on pain relief can easily be deemed not incontrol of their own faculties (albeit temporarily) and therefore will get placed into a state care facility at their own choosing - might be awful and might be miles from family/friends.

Even though my mum has savings without an LPA I will have no say in where she is placed and will not be able to access her finances.

I relayed all this shocking news to my mum who's response was as always one of annoyance for my suggesting it and how she is too ill to think of such things right now (oh the irony) besides she will sort out if she ever needs to.

My dad meanwhile has had an LPA for decades now.

I'm putting one in place to help deal with the horrendous situation if I were to become incapacited in any way.

I thought id share this here and also I'd be interested to hear of any real life experiences of grim scenarios so I can keep badgering my mum or get my brother her favourite to do.

The wills woman explained the courts step in like when a child is taken into care and the parents then have few rights in what happens next.

Proper grim. I can't believe anyone would willingly not have an LPA let alone a sensible clever woman like my mum. It's bizarre and upsetting tbh.

My Mum also refused either LPA for health or finances as a) she was going to live forever and b) she didn’t want me selling the house out from under her.

Re health, they were really good when she was in hospital and receiving palliative care. They asked me about withdrawing drugs, such as stroke medication, and explained what would happen if they did - she could have another stroke which would likely finish her off, or could leave her without speech. Ditto the antibiotics. I did feel informed but wasn’t always sure that I was making the right choices.

OP, in your shoes I think your house move is the right thing to do. I also agree with you to detach as the only casualty will be you.
My DF, in the last fortnight of his life, realised he did need POA and had been wrong. He would, if he had lived, tried to have made some amends and sorted things differently going forward. That knowledge was useful in the nine years since.
But if your DM is determined then you truly need to take a stand and by articulating your position you are preparing yourself wisely to side step some of the carnage that lies ahead.

Further to my lengthy post on a previous page, I should say that too much information is the enemy of this kind of thing. Elderly parents can't handle it - ironic, as that's the reason they need LPA.

A succinct 'Okay, I won't be able to help you out, I won't be able to carry on as I have done, THEY will be in charge' might work. Subtly but definitely refuse to do certain tasks - small chores - to say, 'Yes, but you haven't authorised me, you haven't given me LPA...' Have the forms ready about your person just in case.

Any complaint, and reply, 'Yes, but this is how it will be in a care home you don't like, you will be stuck with it. This is what you want.' Currently there is the sense of the best of both worlds for her - you are running around as a slave, she has a feeling of control. No reason in her mind to alter that.

Currently there is the sense of the best of both worlds for her - you are running around as a slave, she has a feeling of control. No reason in her mind to alter that.
@NewspaperTaxis That's genius. You've described that perfectly. May have to quote that in the future.

Both are important though both parents physical heath declined quickly we never really needed the health one. DM had 10 years of Alzheimer’s. A few tips.

1. If you need something quickly third party access on a bank account is simpler, as you wait for the POA to go through. It at least allows you to pay day to day stuff and watch for fraud. The latter was an issue for us so we changed DMs phone number and hid anything with her bank details, keeping her happy by ensuring she had enough cash to go to the shops and a debit card on a simple no overdraft account that could be topped up online.
2. We told her that if she did not sign, Social Services would be in charge. For us the trick was to get the priest to be witness. He, for all the right reasons, told her she needed to sign. My cousin got her dad’s best friend to do the same. Think of people outside the family who command respect.

We had to go through Court of Protection, bizarrely to pay back a loan. (For transparency it had been secured against property, and the Land Registry would not remove the charge without COP agreement.) The COP is not user friendly so we had to use a lawyer. Even though all that was needed was a simple confirmation and clearly in my mother’s interest, it took a year.

I have a friend who is a consultant psychiatrist who specialises in geriatrics, who does a lot of capacity assessments for the COP. Some cases of attempted family abuse are shocking. They need to be careful.

The whole adult social care thing is mysterious, there is always another level. For instance, while you may have LPA in Health and Welfare, do you not still have to 'activate' it? And how do you do that, because often GP surgeries can play hard to get on this issue, my local one would not officially do it. That can lead to a situation where - and I'm not 100 per cent on this - you can wave your LPA in H & W at the hospital/care home and they can say, yes, but actually we reckon they do have mental capacity and they told us an hour ago when awake they want to stay. And you haven't 'activated' it. I mean, seriously, what can yo do? Because a patient can have mental capacity but if they're elderly and out of it, ill in hospital, then surely you are the one to step in? But doesn't it have to be 'activated'?

The whole area of adult social care is murky - currently there are long delays in getting PoA and I suspect this may be deliberate, to stop families getting that crucial control.

Be aware that having LPA may not make things any more straightforward. My MIL, 89 and with advancing dementia, was persuaded to do both LPAs just in time. She also had a RESPECT form completed by DH as her attorney.

When she was admitted to hospital following a fall, we ensured that the staff had a copy of the LPA for Health and Welfare and that they knew who the attorneys were. They were not consulted at any point during her stay or during the discharge process. DH received a call to say that his DM was being discharged that day and had to point out that she was immobile, incontinent and there was no-one available to care for her.

She was moved to a care home for assessment. Again, a copy of the LPA was provided and DH made sure the staff knew who the attorneys were. The family was not consulted or advised when MIL became ill. DH went to visit and found his DM very close to death. He called an ambulance. It was never clear whether the care home had organised or provided any form of medical care. The LPA started clearly that MIL did not want to be admitted to hospital, but the care home manager was insistent that they did not offer EOL care! Paramedics did not want to take her to hospital because they thought she would die on the way, but the care home manager insisted. As you can imagine. DH was very distressed.

MIL was taken to hospital, survived the journey and when DH got there, she was in Resus. No-one would speak to DH, he wasn't allowed in the room and he could not advocate for MIL at all. She lived a further eleven days, at best semi conscious. Staff never discussed her care with her attorneys at all and obstructed the family's attempts to speak to her consultant. The consultant, when we were finally able to speak to him, was arrogant, unpleasant and very unwilling to move MIL to EOL care. Indeed, she never actually received any EOL care.

We did everything we thought was right to try to protect MIL and failed on all counts because of the appalling lack of compassion and understanding from those who were supposed to be caring for her.

DH and I have done LPAs, but I have no confidence that they will make any difference in the end.

The well known example is this:

https://www.express.co.uk/celebrity-news/1562473/kate-garraway-husband-derek-draper-covid-battle-power-of-attorney-legal-affairs-health-gmb

So not just our parents, us as well.

That's bloody awful @NorthernDancer what a terrible thing to happen, can you reveal what hospital that was? I don't really understand any of this - in our cases, we didn't want Dad on end-of-life (EOL) care, we wanted him to pull through but it's thought Epsom Hospital finished him off, the pre-talk warning us he might not pull through I now suspect was the 'end of life' talk they're legally obliged to have with the family before doing the deed.

I don't understand how they could do all that - though you do get the sense a family would have to be hands-on in the first place, we were lucky generally as we were full-time carers.

@NewspaperTaxis The thing about the Health and Welfare PoA is that it only comes into effect when the donor has lost capacity. So if they are judged to have capacity to make the required decision, the LPA is irrelevant. If they are temporarily “out of it”, only immediate decisions will be made. Obviously it’s better if possible to wait for the person to come round and then make the decision, than to ask the Attorney and make the decision while the donor is still out of it.

All the LPA allows you to do is to speak for the person according to their wishes. But that doesn’t guarantee the treatment you want just as it wouldn’t if you were talking about treatment for yourself - that is a medical decision. There are treatments that they avoid for elderly people, not because of age, but because of frailty - a treatment that would work for a fit person would just make things worse for a frail one.

MereDintofPandiculation thanks, though this can be abused. If asked my mother always said she would prefer to be seen alone. She had no awareness how handicapped she was by her Alzheimers and could put on a good show, even though she was never quite sure if I was her mother, sister or daughter.

My mother repeatedly complained of some pain, so she eventually got a referral which her carer took her to. At the hospital she denied she had any pain so was discharged. As they would not listen to the carer I commuted down from London for the second referral. I had an LPA. It was the same woman, who made a big thing of my mother choosing whether I came in for the consultation. No. The woman emerged triumphant. My mother had confirmed she was fine. All my protestations that my mum probably thought she was 14 and had just had her appendix out, fell on stony ground. There was not problem because the my mother had said in the moment that there was not one, so the hospital were not going to investigate. An easy wait to deal with wait lists.

Next step was to chat to the GP and agree that the easiest path (trips down were costing me as well) would be a good private physio to see if the pain was caused by something he dealt with. It was and he treated it. £100 for three appointments, and my mother kept her mobility. One reason why the NHS is losing support.

Some very interesting points here.

On balance, I would say it is still better to get LPA in Health and Welfare - and Finance - than not. Even if you doubt whether it works as you'd like.
It's a bit like if, say, your house gets burgled, you show the footage of them to the police, and they do nothing about it and you still lose your TV and valuables. Okay, so why bother?
Not having LPA is as if the burglar is actually ALLOWED by law to enter your house and nick your possessions - that's the difference.

@LoveRules 'Her stubbornness makes me match it with a dramatic reduction in empathy and a ramp up of apathy.'

Your words here really struck a chord with me. It took 10 years, yes 10 years of me asking my dad to sort out both the poas and finally at the age of 90 eighteen months ago he agreed. By which time a lot of my positive feelings for him had drained away. There are many reasons for how I feel, but the stubborness and not caring how difficult things would be for me without the poa have really had an effect.
Suffice to say, he has now been diagnosed with dementia, and I am just in the process of using the poa with his banks. Thank god he finally agreed. I wish you luck.

Can I ask, to be nominated to have an LPA does the nominee have to sign any forms? My DM has apparently put me down but I haven’t signed anything.

Yes, you as attorney have to sign and have your signature witnessed. Did she do it recently or a long time ago?

If she puts you down as executor of her will, you don’t have to sign or even be told.

I wonder if it is a very old one, or she is confused.

DH's parents insisted that they had a POA but DH had never been asked to sign anything. (All close relatives are encourage to sign even if they are not nominated to ensure family harmony/agreement.)

He was unwilling to raise the subject with his parents, so I finally wrote to the golden child (his elder brother) explaining the problems I had faced and explaining what needed to be done. No reply from the golden child but about three weeks later DH had POA forms to sign. I am staying well out of their arrangements but I am relieved that the basic error of not having one, has not been made.

@PussInBin20 that sounds like my mum's Advanced Directive which she assured us all she had written, discussed with her GP and had had witnessed. And the will change she assured my brother she had made so that he didn't inherit directly. It's not that we would force her to do those things but telling us she had when she hadn't was... difficult.

Not having a financial LPA is wreaking havoc in my family. I looked after Mum, who I am confident is in the early stages of dementia and brother and sister left me to it. Then all of a sudden big brother stuck his nose in and had my mum second guessing herself and she didn't know who to believe. I have had to wash my hands of it, and its devasting and I do not trust my brother, who is one of those that forgets my mum exists for 11 months a year and then wants full control the other month.