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?

It’s not unreasonable at all. However, your relative sounds incredibly paranoid and unwell (for a long time by the sounds of it) - it could be that they’ve told adults SS they don’t want information to be given out to anyone including family members.

Frustrating I know.

Apply for Appointeeship with DWP for the State Pension/pension credit to be paid to you. Of course they check by visiting the proposed Appointee and the Claimant, but based on your description this is the sort of situation Appointeeship will help with. In these days meantime ask the Council for Foodbank vouchers. Contact whatever utility supply/insurance companies you know of you know to explain the situation if you think these are not being paid. A LA won’t place someone is a care home under DoLS just because there is a cash flow problem. That is not the least restrictive way to proceed.

I think the OPwill be quite concerned about a visit from someone to her relative to explain that they are going to “meddle” she she may well see it, with her monies?

My relative seems to have been persuaded however, at least for the moment.

@RainSoakedNightsif she lacks capacity to make decisions about finances and there is evidence she decided prior to losing capacity that she didn’t want to claim benefits and doesn’t agree with the welfare state it probably won’t be in her Best Interests to do so now. Best interest decision making drills down into the decision it’s likely she would make if she had capacity, her values, the decisions she made when they had capacity.

@PropertyD 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?

This with bells on. My family have been lucky regarding PoA etc and our Dad is pretty amenable but not so the parents of many friends and daughters on this forum. In many ways they really deserve leaving to it but we're aware that being bloody minded is often part of their declining faculties and if they were thinking straight they might appreciate their way of dealing with life no longer works.
But gosh it must be so tempting for the OP and those in similar situations to just say 'sod it, I tried' and take the phone off the hook so to speak.

Sympathies. Reading this has made me grateful I have PoA.

Yes, absolutely this! The problem is, my relative is very convincing. If you get her at a good time, she really can explain in great detail how she will accomplish various "life admin" tasks. She can tell you the bus numbers, the stop she needs to get off at, how to get from the bus stop to the bank etc. However she has very little executive function and can't actually do any of it. She has to have someone prompting her.

I don't know what the DWP interview with her would include. But if it was just asking her how to apply for benefits, she will just get very angry and shouty about refusing any benefits. And will also be extremely angry with the family members, who will also be serving her the deputyship legal papers.

I don't know how much support the hospital will give everyone (including her) if she does become violent or a danger to herself? Or if the DWP will deem her angry refusal, proof that she can administer her own benefit affairs (in which case we're stuffed, as we need to administer her benefits to have enough money to get her home until the deputyship is awarded...)

Oukey, you are still beating around the bush

In what way? I'm genuinely curious. And to an extent I agree with you, while she's in hospital, she's warm, safe, fed and clean. None of those things are certain after discharge, and none of those things have been true in the weeks following past discharges. Do I want her to go home? No. But we are where we are, it's not my choice.

So maybe this is another question - what happens at an appointeeship interview with the DWP and what, if anything, do we need to set up in advance because there is a risk of abuse and possibly violence? Also, how do we tell the DWP about the formal capacity decision, as there's no space on the form? Surely they need to know that the person they are seeing has been deemed to lack capacity under the MCA?

Ring your local (or any?) Age UK Appointeeship Officer and ask them OP. They have a national helpline (and online advice too). They know about this stuff, in detail.
I think the DWP may be more canny about this than you’re imagining.

Report safeguarding concerns (for her or by her) to social services.

My relative has ended up with two carers for every visit because of his occasional aggression. I thought that would make him more liable to get angry but he seems to have accepted it at the moment.

(He doesn’t know why he has two carers, mind you!)

We tried today with the Age UK helpline, they aren't certain they can advise in these circumstances (undiagnosed functional MH, no age related illness), but have given us a different number to make an appointment with one of their specialist teams, so will get on to that.

I may be being unreasonable about the DWP, my interaction with them has been PIP/DLA related (professional) and that was never a happy or constructive experience. But maybe they're better with this stuff....

It would just be great to hear from anyone who's been through the appointeeship experience with someone who has some cognition and "front", so we know what to expect...

Well that’s what I’ve just done, but not with the DWP yet. The Age UK Officer must be confident that the DWP won’t raise any objections. Am not sure whether they’ll even directly speak to my relative as there’s been a MCA for finances

Hopefully the specialist team will be of use for you tmrw.
We have a dx thank goodness.

Sounds like you have to let her fail. Let her go hungry. Until such time as she consents for someone else to help her??

DWP won't do anything in the circumstances you describe. But they may make a referral back to adult social care on your relative's behalf. It will send you round the houses again, but it all adds to the evidence based that they can't cope - meaning that eventually social services will have to step in.

If they are functional but with MH issues, has there been a formal diagnosis and is there a MH liaison nurse/crisis team in place? If so, I would be pushing there rather than GP. If not, then you need to keep badgering the GP for a referral and keep stating safeguarding concerns (neglect is a safeguarding issue by the way, as is self-neglect).

Early stage dementia and MH issues are often very similar, and pushing to go one route over another complicates getting the right help at the right time. We had that issue with DM. But they do exist as co-morbid conditions and a switched on GP or social care team should know this so don't lose sight of the pre-exusting conditions too.

You can print off and attach any additional information you think the DWP needs, in addition to any hospital letters, prescription list etc. Not sure how effective it will be in your particular circumstances, but it's definitely worth a try!

Social services have already stepped in - this is the fourth crisis now, so finally it seems they are motivated to act. But there's no MH diagnosis, and the hospital psychiatry team have told us they don't see elderly patients for new non dementia diagnoses. She'd have to go through her GP and the community team to access a diagnosis, and that's just not going to happen as she won't voluntarily engage with any of those services. .

Can you keep using the term SOVA - Safeguarding Of Vulnerable Adults - this is a SOVA situation? This means you or professionals can act without her consent, as I understand it. As a PP said, self neglect is a safeguarding issue.

But I understand these sort of situations are very nuanced and difficult, and professionals have to act within a) their rules and b) their budgets….

You are in that no man's land then until she is so ill they can't not step in, I am afraid. DM was exactly the same. There isn't a sensible shortcut.

Also, Social Services stepping in where you are now, is very different to when there is a crisis and an admission to a residential setting. Up until that point the person is free to choose. At the point of real crisis, social services can legally assess them as needing to be deprived of their liberties and to not return home. How long it takes to reach that point with your relative is anyone's guess.

Good luck.

And may be this is all the old woman wants, to live a bit her life

I have arranged to meet with the Age UK Appointeeship Coordinator tomorrow (at my house, very accommodating guy!)

I will update here.

I need to ask things like, "How do we pay for essential repairs to my relative's roof, there won't be enough in the appointee account for that, but there will be in the other (presumably dormant) account, into which his workplace pensions will continue to be paid?"

Sympathies.

I at least have PoA. And one that lets me act if I believe EPICF (elderly person i care for) to have lost capacity. Which I do for lots of things especially deciding whether or not they can still safely live at home.

However, they are fronting really well and confabulate amazingly. Other PoA and I had a big sit down chat about "the future" with them and it was most illuminating. Apparently I've done nothing over the last year as EPICF has done everything.

Especially the tasks I've struggled with eg. getting their falls alarm reconnected after digital voice knocked it out. The were able to describe in great detail how they had managed this. If I didn't know better I would completely have believed them. Except it was me who did it including complaining to the ombudsman!

It does partially explain why the professionals involved keep making what seem like mad decisions to us. And of course the other attorney (my Bro) thinks it's hilarious that I'm getting zero credit ... and if EPICF wasn't taking the credit themselves they were giving it to him.

When actually he will openly admit he has done fuck all except agree some big expenditures with me and give me the odd glass of whisky after a particularly fraught day.

I "hearted" that post not for the huge difficulties described but for your dedication!

Main update which I felt I had to post here asap after meeting Age UK guy - his role / office (Appointeeship Coordinator) only exists in Northants, Coventry and Warks, sadly. However all local authorities have staff who can perform the appointeeship role, so ask social services about it if your relative is in another county.

Most Age UK charities do offer money management services though - eg taking someone to a cash point if they can't otherwise access cash, assisting with paying bills etc. But they can only help ie the individual has to clearly have capacity.