LPA - health & welfare

[smartieslover]

My mother has an assessment next week for dementia. The Community Psychiatric Nurse is visiting and I will be there. At the moment neither of my parents have an LPA for health - they do have one for finance. Basically would it be acceptable to ask the CPN to sign as the certificate provider at this meeting? My parents have moved near me and have no friends to ask. Obviously I would discuss it with my mother before the meeting

Does your mum have capacity to understand what she is signing. Otherwise CPN won't be able to do it.

Yes she does. It’s early dementia

Agree, if the assessment suggests they no longer have capacity you can’t get a poa.

I would say she has capacity and would understand what she was being asked to sign. She’s become very muddled with words -she can’t find the right word. She’s quite anxious and doesn’t leave the house.

The financial one is the essential part, in my experience. We had the health one too, but when it came down to it medical professionals made the calls, and weren’t really interested in what anyone else thought, so although ideally you’d have it in place, I wouldn’t lose sleep if it can’t be arranged.
Sorry you are dealing with all this, it’s tough.

I agree with the above. HCPS and professionals involved in your DMs care will usually consult with family regarding the health care she may need, but ultimately they will have the final say if they think your wishes are not in her best interests. I would, however, strongly advise getting the financial LPA wheels in motion. (It doesn't have to be a professional to act as CP - my MILs best friend signed hers)

Thank you for this information. My brother is down as finance LPA so I’ll talk to him about getting that going

@smartieslover Care homes like you to have the health one in place. If your dm can do it, get it done. It just gives you that bit more authority.

The H and W one is important too. Without it, people have been forced out of accommodation, given treatment they would not have wanted, and had decisions made that split their families up.

You can ask the CPN (who might decline) or her GP (who might charge), for example. But if you understand the capacity requirement and are confident she meets it, why not use just someone you know who meets the criteria? It's fully legit.

The only time it was mentioned was when they moved into a nursing home - they took a copy and then no one mentioned it again for the next 7yrs! Agree that it should help, but we didnt find it any help. They were still shipped off to hospital when we, and she, would have rather treatment for various things stopped.

So in your case H/W was not that pivotal. However people have different circumstances. In some, H/W is absolutely crucial. There are stories online of how things went badly wrong without H/W.

H&W important as they become elderly and frail. It means you can decline hospital and just keep them comfortable. In severe dementia, a trip to hospital can be detrimental. It's better to keep them in situ where they are in familiar surroundings and properly cared for. I have declined hospital twice recently and each time, the paramedic said it was the best thing to do. A&E in winter is a high infection risk.

My mum has recently died in a care home. She was in care homes for the last 5 years and I found the POA helpful with hospitals and homes. I’d get one while she has capacity

What evidence have you got of this happening?

See @unsync above for a quick example.

The general risks pop up readily on a search. Two examples I have read about are a elderly couple who wanted to move into a shared care home room together but were split up by the local authority due to funding issues, and a young disabled person whose parents suddenly died and the sale of the family home was forced. They were moved into a flat and lost quality of life. Relatives without H/W LPA were unable to prevent each case.

Unrelated issues to also bear in mind are disputes between attorneys (where letters of wishes or advance directives might help), and having different attorneys for H/W and P/F (same for both is better).

@user6386297154 My DM didn’t have one when she moved into the home so I took steps to immediately start to get one. I mistakenly thought it was done 20 years earlier when we did finance one. Unfortunately before it came through DM died but we had all agreed that her illness would be managed in the home. So I guess not having it made no difference but DM was mentally ok. The bigger issue is when they are not and you need to advocate for them. However it must depend what’s actually wrong. None of it’s easy though and you just try and do your best but not all homes will nurse old people.