Power of attorney- mentally ill family member

[Resisterance]

My sibling has been seriously mentally ill (not formally diagnosed but some form of schizo affective disorder) for many years and lives with our parents. He doesn't leave the house or we anyone. He doesn't exist anywhere and there is no record of him ( I.e. no benefits etc) because he thinks he's being followed by an enemy country. He isn't.

As my parents are getting older and rent rather than own, I worry about the implications of my siblings' care and support when they're gone. I have asked them to set up an account or some kind of provision for him for this reason but they've just told me ( after years of asking) that they haven't got round to it. In part because they're still in denial about how acute the situation is.

I really think we need something in place to pay into so we can support him in the future. But you can't open an account for someone without their permission. And he wouldn't give permission because of the enemy country thing ... he thinks ' they' would find him.

My parents don't have much money and I'm not in a much better situation (single mum) so there's really no lump sum to give him when they go. So what would be best is an account could pay into monthly to build something up for him. Is there any way to do this?

World we need power of attorney to do so? How can we get this without him wanting to sign anything? What do people do when complex mental health issues are involved? He would fail the mental capacity act so could he be said to give consent anyway?

I've spoken to mind charity but they say there's not much they could suggest. I would really like to find a way to build some safety net for him into the future.

When my parents pass away he won't have any money or anywhere to live so it's concerning me how I would manage to support him as a result.

Well that's a really helpful comment.

Are your parents frightened of him at any time?

I'm asking because my dear husband, the gentlest man in the world, could be really frightening when he was psychotic.

I'm sorry to have to say that unmedicated schizoaffective disorder, if he does actually have that, has a really poor prognosis.

I think I would just focus on talking to your parents about looking after themselves, and about ways to protect the one who is eventually left alone at home. If they are frightened of your brother or for his life, they shouldn't hesitate to call the police.

OP I work in end of life care and it happens that an elderly person dies and an adult child with disabilities/severe mental health problems emerges unknown to all services who has basically been hidden for decades.

I don't think a LPA is going to be your answer - it sounds as if he would never sign one anyway. And although it allows you to make decisions for him, this isn't much use without funded services.

Neither is going to be setting up a bank account for him - how will he access it? And any decent amount of money may stop his eligibility for benefits.

The most useful thing you and your parents can do is make services aware of him. Start claiming all the benefits he's entitled to. Get a carer's assessment from social services for your parents - part of this is 'what happens to the person I care for if I'm ill'. Ideally get GP to refer him to mental health.

Just get him unhidden so that when the worst happens his existence isn't a mystery.

Not really. I could have added to the multitude of helpful posts saying they won’t be able to get a POA.
Fact of the matter is by protecting their son and almost enabling his behaviour it has made the situation worse. If he is schizophrenic then it could be as simple as medicating it and the man could lead a relatively normal life. Instead he’s been kept away from society. While I understand this is his doing and not just his parents, the situation should have been sorted much earlier

Are you serious that your parents have never got anyone else involved in his care? He’s never been diagnosed and never been helped to establish some kind of ‘normal’ life? No treatment or medication?

From a practical pov, how does his life currently work? Does he do anything for himself? Does he shop / cook etc? Does he work at all? What age is he and your parents? What do your parents expect to happen? Are you expected to take over from them - and to care for them too, if they need it?

@OP I would consider paying for an independent social worker to help you get a plan of action in place. They’ll know how to navigate the system and may be able to offer more local/specific guidance to help your family in this situation.
You can find one who specialises in adult social care and mental capacity by using the British association of social worker website

Thanks all for this varied advice. He's not in distress as he's looked after and supported. He's bright and sharp just paranoid about 'people' knowing where he is so he stays home.

I think it wouldn't be necessary to be sectioned as he's not a danger to himself or others so wouldn't be eligible for a section 2 under the mental health act.

I'm not really asking about that either here mote about ways to support him financially in the future as I imagine that will fall to me. So it would be good to have a plan of action in place so that he's OK long term once my folks get older.

I'm aware of the challenges of my parents decision making so it's not helpful to have that pointed out thank you.

It would be useful to have an idea of what he is capable of in terms of day to day living. and what age he is / your parents are?

Are you planning to have him move in with you?

Does he trust you? and if he trusts you now, how will you deal with that changing?

He's capable of most things - cooking, cleaning, support around house and garden, washing and dressing. None of those are an issue. But as he won't leave the house and garden it means not seeing people and no one knowing who or where he is.

My folks are in their 70s. I don't have the capacity or space to have him when they go so that's another issue.

Again it boils down to him being known to Services and building up a relationship with them.

It sounds like he would function OK in a supported living set up but not independently.

https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/supported-housing/ You might find this page helpful….but to access anything he will need to have face to face contact with services at some point so this is probably the main hurdle at present.

@Resisterance I’m a MH nurse and I have a couple of questions. Firstly, has he ever seen a HCP about his mental health? He currently sounds like he’s very unwell and that he has been for a long time, but medication could quickly (literally, within days) resolve his presumed psychosis. He doesn’t have to live like this. My other concern is about where he currently gets food/clothes etc. You said that he never goes out? What if he was left completely alone for an extended period of time? Would he starve himself or would he venture out? You say that he wouldn’t be sectioned as he’s not a “danger to himself or others”. Most people interpret that as either violent or suicidal, but section 2 is much broader than that: it just needs to be for his “own health or safety”. It sounds like he is at risk of self neglect without significant input and so that would apply. Honestly, I would apply for an assessment under the mental health act. He needs to be seen and treated. He needs support and so do you.

I can see you don’t want to address the challenges of your parents decision-making, @Resisterance , but this isn’t just about making plans for when your parents are no longer here, it’s about getting your brother the support he deserves and is entitled to at this point in time and you need to involve others for that.

I meant to also say that his best interests need to be considered and keeping him away from HASC isn’t doing that considering the situation.

Have you had any discussion at all with your parents about what should happen to him when they pass? What are their views?
If you haven't asked the question, you really should

He needs to get a diagnosis so he can claim benefits he should be on the housing waiting list fir his council. The best thing you and your parents can do is to help him to do these things so that when your parents are unable to look after him he can be in his own home and function.

@Resisterance, I know everyone keeps saying it, but you really need your parents to get involved with services.

From what you’ve said, your brother can’t have a power of attorney as he lacks capacity. You or your parents would need to apply to the Court of Protection to get a Deputy Order (for Finances or Welfare). You/they can then make decisions about his future. These orders are not the same as POA and are very rare. You are also overseen by the Office of the Public Guardian and have to submit annual reports. Therefore, I’m pretty sure neither to you are going to do this.

Your brother sounds like he would be entitled to Personal Independence Payment (PIP) and Universal Credit benefits. You/your parents could be his DWP (department for work and pensions) appointee. Which means the payments go into a separate account that you set up and manage.

Ultimately, he will need somewhere to live when your parents are gone and unfortunately that will be down to Social Services and the Local Authority to decide where he lives. I don’t see sectioning him now helps anything. Apart from the fact, as others have said, it’s not something you can do.

You could try contacting your local Safeguarding Team and speaking to a Social Worker for advice. I know it varies from area to area, but ours are very good/knowledgeable.

Since your brother has not been diagnosed, it could be he has ASD for example. At his age, diagnosis with take years as well.

Others will see your parents haven’t helped him when I’m sure they have been trying to protect him as well as they can.

There won’t be a quick fix, but I wish you all good luck.

Have you talked to him about the financial side of things? What he thinks will happen? I wonder if he might see that he has to make some compromises in order to survive.

@Anewuser The thing is, there could be a “quickish” fix. As a nurse I’ve seen people with untreated, and apparently intractable psychosis, be sectioned and finally prescribed medication. Within a year they were living fairly independently in the community and with much better quality of life than before. Yes, it could be something like ASD which is potentially much more complicated-but it sounds like the brother has never been seen by a HCP and so it is very difficult to know exactly what the diagnosis would be.

You said he has a serious mental illness and would fail a mental capacity test but sounds quite high functioning. Would he manage a bank account, paybills, buy food? What does he want to do in the future, is he safe living on his own or Would he be happier with supported housing with a flat of his own. Not having a diagnosis or any professional input doesn't help and could be of a benefit.

Does he trust you? Will he talk to you about these things?

Having seen this type of scenario play out a few times in my work life, I suspect your parents are working on the basis you will simply take over their role. It’s an assumption I’ve seen a lot with daughters. They don’t want to face the future of them getting older & not being able to support him so they bury their heads in the sand about the implications.

but he’s not your child, he’s your sibling and it’s not fair to expect you to take on the role of parent to him.

sadly other than putting money away yo help in the future, I think there’s little you can do if your parents won’t engage with services in their role as carers let alone your brother.

it’s very hard and I’m sorry you’re in this position

Thank you all. There's some useful advice here and I really appreciate it. To be honest I've been watching it play out for a long time but my parents denial about it on the journey to it becoming acute has meant it is now acute.

Yes he can dress wash etc but you're right he couldn't pay bills and deal with paperwork and go shopping so it would fall to me. I think my parents are just head in the sand about it and also trying to do the right thing by honouring his wishes.

The issue is that he refuses to see anyone or go anywhere so I'm not sure how to address getting someone to come and do a care act assessment for him. And whether my parents would even be able to accept that. It's horribly stressful.

I don't know if he would take medication..I think it unlikely as he would see it as being drugged by an enemy force etc. How my parents would police that to is unclear.

I think it's unlikely he's got ASD.

He was a depressive and 'managed' by being a big drinker in his 20s and 30s and used to get into fights doing stupid masochist stuff and in his late 30s was really badly beaten up with metal bars so I think he now has some brain damage which is what has tipped the paranoia into the acute state it is.