Fluctuating capacity and property to sell

[FiniteSagacity]

We have both LPoAs and DF is (for both his physical and mental health) in a nursing home. His house needs to be sold to fund his care, he has very little left in liquid assets and is in reality in debt to his children.

DF is feeling ‘better’ (no wonder, the nurses have worked wonders) and ‘passed’ tests for Dementia so no diagnosis and social care have described his capacity as fluctuating and said he has no insight into keeping himself safe (very, very, true - on last visit to hospital this is exactly the language the doctors used).

My question is, what do we need to act in his best interests but ‘against’ his wishes on any random day?

To be clear DF has said that he will sell the house (which is really rundown and not even habitable by a physically fit person) and that he won’t sell the house. So on any day (or at different times on the same day) he can seem cooperative or obstructive.

By best interests, I mean that even with care in his own home, the hours required of visiting care (or a live in carer, which he says he does not want) would cost more than the cost of the lovely nursing home he has been in respite in. The council were on the brink of environmental health condemning his house and we put them off visiting because DF couldn’t be there, in case this caused issues with the sale.

His house needs to be sold to fund his care, he has very little left in liquid assets and is in reality in debt to his children.

Can he afford to live permanently in the respite care home once the house is sold? Sounds like his place is inhabitable so it's unlikely he will be allowed back, so there might be no choice in the matter. (Which is a good thing as the SW team has made the decision for you.) The SW team in most cases are your best source of good advice and help.
Do you have siblings? Are they in agreement it needs to be sold? I'd hire a skip and race to get it on the market ahead of the winter months.

@Mum5net I’d already started the sale process and have interested private buyers when DF was in agreement. My siblings are all in agreement that the house needs to be sold.

I just don’t know if we should get/will need anything more to support our actions - we are 100% acting in DFs best interests but (this week) it seems not his wishes.

DF really doesn’t have capacity and was killing himself when he was living alone without support, he has multiple complex health needs. But he’s now more mobile, can hold a conversation and ‘pass’ as sane. If you talk to him for long enough or in the evening/when he is tired the batshit is obvious really quickly which is why the fluctuating capacity.

Sorry, to answer your question - the house proceeds would mean DF could self-fund for at least 2-3 years and SW has assessed as needing nursing level 24 hour care. Manager has also applied for DoLS. We’re hopefully getting 12 week disregard funding but not sure when.

Could DF changing his mind jeopardise that?

I don’t know whether to discuss with SW because DF could easily change his mind again!

He has crossed the line of not being safe. Being safe 24/7 trumps his fluctuating wishes of being back in his own place. It's rotten but it's true.
His quality of life has been improved by you and the family's intervention. You have acted in his best interests.
The paper work is in place, especially as the care home manager has applied for DoLs and the SW team were going to condemn his house.
You absolutely have the green light to proceed.
You don't need any more bits of paper or hoops to climb through. There are no dissenters -siblings and SW on the same page. Phew,
DMil's house was sold in virtually similar circumstances albeit in a good condition.
SILs changed the subject when DMil talked about going home but very quickly it became apparent it was her parental home she wanted back to...

@Mum5net thankfully there are no dissenters other than DF, thanks for the reassurance.

DF has just been so angry and I get that he’s raging against losing his ‘freedom’ but in reality that was self-neglect and crises.

The paramedics were at the ‘we’re not coming back every day to pick you up off the floor’ point and doctors recommended 24 hour supervision. I know we’re right but DF was more compliant when he was in a state!

I’m at the point of actually saying ‘please call the office of the public guardian and tell them’ but DF is convinced PoA is governed by the CQC… no idea how he ‘passed’ tests.

Every time you clear a hurdle, a new and unexpected one takes its place, @FiniteSagacity. I gently suggest you take a bit of a step back from DF. He has lots of company and seeing fresh faces every day with the changing staff rosters. You will have been charging at 100 mph to get him to this stage. Now he is entirely safe, spend less time with him so you can recharge. My DM was sectioned to a MH unit but right at the beginning,her lead nurse told us to try to take a fortnight off as we could at long last sleep without worrying what next.

Good advice @Mum5net I think we both need the space.

The fact that even during a day he can have serval changes of view regarding the house proves that he doesn't have capacity to make that descion, as it suggests he is not fully retaining the appropriate information. When he agrees is after you have discussed the pro and cons with him and then when he disagrees is it cause he has forgotten previous conversation?

A capacity assessment is decision specific and should be completed when dad is at his optimum, so not when he’s unwell or tired.
Ask the SW to complete an MCA for this decision together with Best Interests Decision and get it logged on your dad’s file. This should protect you.
When he’s lucid, how does he think he will pay for his care and his debt to his children if not by selling his house? How will he maintain it if he keeps it? He needs to be able to weigh his decision rather than just make sweeping statements of Selling / not selling to make an informed decision and therefore evidence capacity! Good luck

@D1ngledanglers thank you for that suggestion. I think I’d like to feel on safer ground.

It’s hard because there’s no Dementia diagnosis but you’re right that it should be about his capacity to make this specific decision.

In reality, DF cannot even manage to send an email himself now let alone run his own home. DF thinks he doesn’t need carers but is ignoring everything they’re doing every day and night.

We saved him from losing his legs and we’re being punished by him having the energy to argue (not very effectively) against what is in his best interests.

@Sailawaygirl I think I’m part of the problem as me personally suggesting things means they are disagreed with. I think others need to have the conversation now.

@FiniteSagacity no formal diagnosis is required for an MCA but the assessor needs to have “reason for doubting capacity” which may be that he doesn’t recall his care needs (essential for making this decision as the wider picture), fluctuating confusion / memory, his general behaviour (but citing specifics).

my sibling and I have just sold my parents house, we both have lpoa, no contract or consent was required from my mum to sell the house.

A mental capacity assessment is time limited and decision specific, but it can also be done over a period of time. It sounds as if there would be clear evidence of your father's lack of capacity for the decision on funding care over say 1 week.

Who do you think would be questioning this decision in the future?

It took me a few weeks/short months to agree with my siblings to sell my mother's flat. I was haunted by the idea that she might recover and had dreams of her accusing me of all sorts. In reality she continued to decline. My siblings and I were on the same page. In fact there was noone to accuse us of anything.

Wishing you peace soon, because I know a bit about just how awful this is, and it sounds as if you have had a long and traumatic period of crisis.

Thank you for sharing @Brendabigbaps and @PermanentTemporary it is really reassuring to hear other experiences.

Like @PermanentTemporary I’m having nightmares DF will recover and he says I should pay for the nursing home because it wasn’t his choice. But I shouldn’t worry - at both the last 2 hospital visits we were gently told DF won’t get better and the only way is downhill, it’s about speed not direction and they used the words 24 hour supervision.

The home linked Doctor who assessed DF for Dementia said no diagnosis yet, reassess in 3 months. But he was not assessing capacity, was new to DF and there are other mental health issues including executive function. DF will never actually execute on his threats to call or email his Solicitor.

It has just been a long hard few years and DF is so angry.