At home, no capacity and no deputyship - access to money

[roundaboutthehillsareshining]

So my elderly relative is being discharged home with a care package. Fine, it's what she wants and it's the least restrictive option, so it's got to happen this way (even if it falls apart in a few months and she ends up back in hospital for 6 months). Anyway, there's nothing physically wrong and no dementia. Her team believe she has a new functional MH condition, but that can't be diagnosed in hospital and she won't engage with community care, so that's a dead end.

However, it's likely she's going to be found to lack capacity to manage her financial affairs. Her bank account set up is hopelessly complicated (at her choice) and can only be administered in branch, which she's not going to be able to access.

So if she's at home, and unable to access money, how does she pay for food etc until the deputyship comes through? The family can't afford to subsidise her, she isn't eligible for benefits as she's got money coming in, she just can't access it. So what happens? Anyone been in this situation before?

She had capacity before, and she either took the bus to the bank and got cash out via her complicated bank account arrangement, or didn't pay the bills (there's quite a bit of that happened as well).

Social Services are very involved, they are arranging the package, transport, etc. But they just aren't answering any questions about how this person is supposed to actually exist at home in the gap between discharge and a CoP order. Or, if she actually does have capacity, how she's supposed to live safely if she can't access any money.

As a short term measure I would think gardening, new clothes and excessive phone bills can go (obviously she will need a phone for emergencies). Things like insurance would already be in place? Utility companies have support for people who need extra help and I thought they didn’t cut people off too quickly these days as they have to adhere to agreed standards. Really it’s food money and others more experienced than me have already answered. I fully take the point though that just because a person has family, it is assumed they will be able to carry the financial costs if needed.

Not helpful because I had POA for both parents after a bit of fuss but anyone heartily sick of hearing about elderly people doing it their way or the high way and being an observer in their own chaos?

Of expecting others to pay for them, do things their way or not doing it all even if it means bills are unpaid? I took over late parents accounts but a colleague at work is run ragged by her parent who doesn’t believe in direct debits, who wants to go to a bank or post office to pay bills. Only issue is they are almost housebound now and expect colleague to use this same method?

If so arranged everything in her best interest they can do the same for her finances if she lacks capacity. Ask for a best interest meeting and a meeting with her consultant and pals, don't involve yourself at this stage with arranging getting her safely home, put in a unsafe discharge concern to the hospital and community social services and her GP.

It sounds mean but I think you perhaps need to step back and let social services sort it out. I think the reality is if at home with no money / food a care home probably becomes a default.

I suspect they hope family will step up and save time / effort. I’d just make it clear that you can’t help and step back.

If she does go home the carers will notice that there is no food qnd no money to pay for anything, who is paying for,the care package, what is there responsibility. If they are asked to prepare a meal and drinks they will soon notice theres nothing in the fridge. They hopefully will make a referral to adult social,care safeguarding team and get her hospitalised again.

@roundaboutthehillsareshining Will her carers get involved with SS if it becomes apparent there's no food in the house? We've already been told they can't facilitate or support her getting to the bank....
Well Ss funded carers won't as they are for personal care tasks, but she could use AA to pay for a private carer to do this task?

We had a spookily similar situation with fil. None of us live remotely close by and not able to help. We have offered many a time over the years for him to move here but...

Discharged from hospital with no capacity with carers coming in a few times a day, except he would often go wandering so would very rarely be there when they arrived. A couple months went by and he had a terrible accident involving hot oil and a fireplace. There was no food, house was a shit hole, his clothes were all caked in shit.

Was in hospital for months recovering and there was one nurse who was bloody amazing at pushing ss into getting him formally assessed and into a care home. He had no option.

Unfortunately, you probably will have to step back. Liase with the care company and ss if you can, but accept that's all you can do.

Food is the most important.

everything else can and will wait. As she gets debt collection letters you call and explain you’re awaiting a deputyship order. If a solicitor is applying for you, they may do it. A deputyship application can be put together at home within a week or two. It’s intensive but it can be done, and then you submit - it can take up to a year but has got faster. It’ll take a good 5-6 months before things get to the stage of CCJs.

and frankly, it’s not the end of the world if it ends up that far. It’ll get paid as and when. Nobody is going to turf her out overnight.

We are recently in this situation and my relative was simply taken to a secure unit under a DoLs and held there until a care placement was found (6 months later). They wanted to go home too but without capacity, no power of attorney, no-one willing to be deputy in the family, and no family nearby or able to pay for them it is not possible for them to go home with carers. Make it clear to social services there is no one who can do this, she will be without food and essentials. This can't happen, going home isn't an option.

The only thing you can do is speak to the discharge team about having no access to money. This might be an occupational therapist or a social worker depending on the set up at the NHS trust. I would also recommend speaking to the ward manager.

I work on complex geriatric ward and we deal with these kind of scenarios (and similarly bonkers ones) a lot.

Discharge process is slow and frustrating the system (where I am) is both broken and completely overloaded.

Feel free to msg me if you want to ask more specifics.

Carers should make the safeguarding referral if she has no food in the house, but so can you. Sadly you may have to wait until she is home to hit that button, but do just that. You need concrete evidence of her inability to cope. The system just isn't built to manage complex needs like this in abstract. You have to show them what her life is like without you propping her up. (Have supported elderly and very strong minded relatives before, who will say black is white so convincingly. Ss have to see the evidence - and then may take some convincing. (She will say that relatives are coming with food tomorrow. . . You may need to pre-empt this.

A letter to her GP explaining that you know she is unable to access shops/food and is in imminent danger of starving may help. State that you know for a fact that relatives are unable to provide for her, that she has no access to her money but that she is proud and will deny this and say she is getting help. Safeguarding is everyone's business. Her GP should be able to then make the referral.

Don't worry about the utilities etc for now. Let the red bills build up as evidence of her lack of ability to cope. Sometimes you have to let things get worse in order to highlight the need for help.

Get a message to the gardener that she can't pay him at the moment and let him decide he will have to stop coming, until she's sorted out her affairs. Don't tell him yourself that he has to stop coming. Let him decide.

Obviously you don't want her to starve, so if you live a long way away, you can send her a 'Welcome home' package of a few essentials - cup a soups, a packet of pasta (if she will eat it) a loaf of bread . . . But not too much or it will appear that her cupboards are well stocked.

It's an awful situation. Put your hard hat on, take a deep breath and try to get the system to help her. You cannot do it all yourself.

This or drive her to a cash till and let her withdraw some cash she can give you or others to get her what she needs. My Aunty was in a similar situation she had capacity but physically couldn't get to bank and she would not trust internet banking or putting card details into supermarket site. She would use a cash till but only the one outside her bank. My sister used to drive her over in the evening when it wasn't busy and help her out to use it. She got enough cash to pay for things. Sometimes she gave me sister cash for something and she'd order it online on her card then.

@roundaboutthehillsareshining I had this with DM. You can either apply for appointeeship (wasn't an option in our case as DM was adamant she was fine) or tell Social Services they have to sort.

They have dealt with this before so don't let them fob you off. If they have deemed she cab be discharged just quote at them it is neglect to leave someone at home without access to money for food. And raise a safeguarding alert.

I know the system is stretched but it criminal just assuming the family will pick up. No one can fund a second household at short notice for 6 to 9 months which is what the delay is on COP near us.

My Dad was diagnosed terminally ill OP and there wasn't time to sort out POA or any form of accessing his bank account. Thankfully he was still able to give consent over the phone so we rang his bank, explained the situation and registered for online banking. That way, I was still able to access his money and pay his bills. He also ordered an additional card that was in my name.

The hospital said that they would send our elderly friend home with a bag of groceries. It turned out to be two big bags of tins that they had collected from the food bank. Not a very helpful solution - but at least they tried to help!

Sounds like you step back and let the chaos ensue. If there’s nothing you can realistically do, what else is there - she needs to fail, so SS step in with a workable solution.

This or drive her to a cash till and let her withdraw
The main problem is they don't even have a card.

Op has explained that a) she lives at a distance so cannot just take her relative to the bank when she wants to go and b) her relative may or may not consent to being supported in that way anyway as she has a tenuous grasp on reality, and believes that she will be able to travel by bus or is about to become a millionaire so won't need to.

Sadly, even with a dementia diagnosis, it can be desperately upsetting and very hard to access social support for someone who does not, or cannot, grasp how much help they need, nevermind for someone who does not have a diagnosis.

OP I utterly understand as I am in a similar situation.

ss have this batshit plan - only voiced when I kept asking “But how is he going to buy food??” - which involves a carer, whom he may not even have met before at this point, taking him to his bank branch to get his debit card unblocked. IF he succeeds in remembering his security details / they manage to find a way via him bringing other ID docs etc, they can then get him with drawing cash from an ATM. That’s if he doesn’t straight out accuse the carer of being about to steal his money whilst in the branch.

Their plan to prevent him then proceeding to do what he’s done twice in the last two years with us, viz. then using his card online or in the village shop and inputting wrong codes so that it gets blocked again? They make him lock his card in the mini sage they are planning to install in his home, so that he can’t access it alone.
I was informed if he didn’t agree to this it would become a “best interests decision” and he wouldn’t have any say in the matter.

I told them I’m going to sit back and watch, because it will fail.

He’s already got police involvement for quite seriously threatening neighbours.

Mini *safe, obvs!

Perhaps slightly more helpfully:
I rang Dementia UK for advice. They said it was quite unusual, but they thought if necessary the LA would have to buy him food and set up some kind of deferred payment system as sometimes is used when someone enters a care home.

I think it’s unusual to find a vulnerable person who both has no one with POA/ deputyship, and has income other than benefits ie from private pensions, therefore it is impossible to have an appointee.
Although I note a PP said you could have state pension / AA paid separately somehow so that they could be used for essentials? But the helpline didn’t seem to think that was possible.

Surely all mentally incapacitated people get some form of others caring for them despite the amazingly difficult bank set up. There is money!! The government and care homes will gladly take it

LA says there’s a two year wait for them to apply for deputyship, which is our only option.

Two. Years.

Both govt and (sensible) care homes have to ensure they act within the law around finances though, @TheGentleButFirmMadonna .