Best interests meeting

All about caring
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I wonder if anyone can offer any advice.

We are having a best interests meeting this Friday about mum. She has been in a care home since last July, although she was allowed to go home this April as she was deemed to have capacity and she wanted to go home. It was clear (very quickly) that it wasn’t working for several reasons. She was then found to not have capacity and had to return to the care home. She still says she would like to go home, hence the best interests meeting.

Just as a bit of background, mum has mixed dementia and very limited mobility. Dad has mental health and cognitive problems but doesn’t have a formal diagnosis of dementia (yet). Mum has no insight into her care needs and dad has no insight into mum’s care needs, his own limitations and his ability to care for mum. He isn’t able to be patient with her (so lots of frustration, as well as arguments and shouting). He usually says he wants mum home despite how things were when she was home. He seems to forget how things were and denies telling me (after two days of her being home) that he couldn’t cope with her and thought she should go back to the home. He also told her on at least two occasions that if she didn’t “behave” she would have to go back to the care home.

(FYI - Mum had carers three times a day when she was home and dad has carers twice per day).

Obviously Friday’s meeting is going to be a difficult one. We will all be asked our opinions although my brother and I have voiced our opinions about how we don’t feel we can support the decision for mum to return home on other occasions. My dad has managed to coerce my brother into not voicing his opinions on Friday and he may well try and coerce me next but I think it’s important to be honest, in as nice a way as I/we can. It’s highly likely that I (or we, if my brother changes his mind about being open with his opinions) will be disowned by dad, as that happened at another best interests meeting, and at his own discharge planning meeting, last summer.

We have LPA for finance but not health and welfare, so whilst we will be asked our views, the final decision rests with social services. Right now, I’m glad we don’t have the one for health and welfare as that would be just another complication given how things are.

Re the LPA for finance I’m not sure where I would stand if I’m disowned again, ie would it simply be a case of don’t act on it but leave everything as it is, eg the fact that I’m registered as attorney with utilities companies? My brother has registered with the building society but not with anyone else, including the bank, so it’s me who has taken on the bulk of LPA responsibilities so far. My parents only have joint accounts.

I feel so unsettled and stressed right now but can’t even begin to explain (or even register) how I’m feeling other than that. I feel a lot worse given that my brother and I are not on the same page now (although we usually are when it comes to issues relating to our parents).

The way things have been over the last year has taken it’s toll on me physically and mentally and I’m going to need to explain that at the meeting too. I was in a similar way before mum came home before but I ended up having to do even more than I was already doing for them and we had the really stressful task of getting mum back to the care home which affected me (and my husband and brother) a lot for about two weeks afterwards. I am struggling more now than I was back then and often find myself having to take a step back to look after my own mental health.

Thanks for reading this “essay”.

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Sorry am very tired up right now but put all your concerns in writing and get your brother to do the same. Get that to the social worker before the meeting, explaining the problems you’re having

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Have you asked for an advocate for yourself? You are entitled to one.

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@Walker_22031
I don’t have personal experience of a Best Interests meeting - I hope others will be able to share their learnings and experience to help you. However, I did want to reply and offer some empathy and general support.

I can see how you’re in a rock and a hard place and it’s extremely stressful & worrying. It’s very obvious that you care a lot for your parents as you’re feeling so twisted up, and struggling to see a path forward. I thought it’s worth saying that, of course you know it but perhaps the actions of your brother & father make you think that others don’t see you have your parent’s best interests at heart too?

Having said that, personally, I believe that we each need to have a sense of agency, being ‘in control’ of our own actions and their consequences, aligned with our values. Easy to say, hard to do. You can only do so much. I think, based on what you’ve written, you already know what you want to say and do. It also sounds like you’re trying to set boundaries to respect your relationship with your brother, your marriage and your health which is wise and healthy!

I’d hope that social services listen to you, and I probably have a higher hope that they take you aside and talk to you independently, away from your parents & brother. BUT hope and reality have proven to be at polar ends usually. So psyching yourself up for advocating for yourself as well as your parents will be tough from what you’re describing. The only recommendation I have which Mum and I always did to counter Dad’s ‘I’m fine’ (he had vascular dementia) was to write down
questions and specific points to share. Bucketloads of empathy on that one!

A side-thought - if your Dad ‘disowns’ you does this mean he removes you from the LPA or the Will - this requires a solicitor to re-register it (time, effort, cost). If he doesn’t act on his words (update the LPA) then perhaps you & your brother will have to articulate what you each will do and not do (a good thing to do regardless of LPA for your own sanity perhaps?!?). If Disowning means removing you from his Will, this also, as you know requires legal administration. Separate from the LPA your Father & your brother & solicitor would have to define who would be the executor of the Will. Both documents require your signature if you chose to be part of it.

Behind your father’s actions, perhaps he himself is scared because he’s discerning the changes in his memory and actions. Having your Mum home may seem to be a stabilizer for him. I don’t mean these as reasons to warrant her returning home, but I recognise how trying to turn back the clock to how it used to be could be pushing him.

I’m glad to see Charles and BB have replied too
Take care

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Hello Walker
I agree with writing down all of your concerns. You can add to it as something pops into your head.
There was a saying on the old forum. Its NEEDS not WANTS that matter. Clearly your Mother needs to remain in the care home and your father needs her to remain regardless of what they want. You and your family need her to remain for your own physical and mental health.
Its very difficult for you, I definitely understand that and I hope you can have someone with you at the meeting

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Thanks for your replies Charles, Bowling Bun, Victoria and Pet.

Charles and Pet - I have emailed mum’s social worker with all our concerns previously (and spoken about them at length) and mentioned my brother’s reluctance to share his opinion recently. The social worker said in this scenario a person could email with their opinions but that the contents would be read out loud in the meeting anyway.

Pet - thanks for your description of NEEDS vs WANTS. That makes perfect sense and has brought me some well needed clarity.

Bowling Bun - I didn’t know that I could have an advocate too. Thanks for the suggestion. I’ll look into that.

Victoria - you’ve raised many great points. When I say “disown” I mean we were told he never wanted to see us or speak to us ever again.

Re the LPA, this was finally registered after we had starting talking again last time. It could be reversed of course but dad would need help as he doesn’t have the cognitive ability to deal with something like that.

Re wills, my brother believes there is one but my parents don’t remember if there is. I’ve never seen one. I had to sort through their paperwork when the LPA came through (as it was in a terrible mess and had lots missing where one or both of them had been throwing away important paperwork). It could be elsewhere in the house though.

Based on previous chats with some of the people who will be at the meeting, it’s likely that the only people who will be in favour of mum going home will be my parents and my mum’s advocate. I hadn’t thought about whether others might think I don’t have my parents’ best interests at heart. To be honest, I’m so headshot at the moment with everything that has been going on that it is trickier for me to get my brain in gear at the moment.

I have put some thought into what I will say though but I’ll need to do some more before Friday. Like Pet said I should jot things down as I think of them.

We think dad’s motivating factor for having mum home is wanting things how they used to be (but without the understanding that they can’t be the same as they used to be) and wanting mum to do things for him such as preparing food and drinks and doing laundry, but you might have a point about him needing her as a stabilizer Victoria.

Re mum, even when she was home she would say she was fed up and she wanted to go home, probably because she was confused about where home is, thinking, at one point at least, about a house we left in the 80’s. She feels lonely quite a bit in the care home too, although dad visits almost every day for 6 or 7 hours at a time and my brother and I visit as often as we can.

Thanks all for your support. It is very much appreciated.

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Granting someone Power of Attorney means that the attorney must be treated as if they were the person themselves.
Dad set up the POA so that in the event of him being incapacitated in any way, you would take over everything. He can’t take it back, disown you in any way!!! I suspect one of the reasons he gave it to you was that he didn’t trust your brother? He could have given both of you POA, but chose not to do so. My mum changed her will, giving me the majority of her estate as I as the one who was always there for her. Shd didn’t tell one of my brothers, and he was sorely aggrieved, to the point of getting his solicitor to send me a nasty letter. My solicitor sent an appropriate response back, and I’ve never heard from that brother again, in 8 years. Now I know why mum never told him, he would have made her change it back again, when sometimes he didn’t see her in a whole year.

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Walker, these points are worth copying and pasting into your meeting notes/points;

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Thanks for those ideas Melly. I will add them on.

Thanks too Bowling Bun. My brother and I have both been made attorneys but he hasn’t registered with the bank or utility companies yet. I’ve dealt with the bulk of the financial stuff so far including doing the Land Registry tasks that the OPG recommends attorneys do.

I heard from someone that LPA’s can be reversed so I checked and a donor can, so long as they still have capacity. It involves a Deed of Revocation which involves very specific wording and to be witnessed. Or they can complete a Partial Deed of Revocation if they want to remove a specific attorney. In the circumstances I don’t think it would come to that but I’m wondering where I stand if he says he doesn’t want to speak to me again. For example I get bank statements sent to me as post goes missing in my parents’ house and I need to keep financial records so I need access to the statements. Once I receive a statement I give dad a copy.

Sorry for how things are (and have been) with your brother. Families can be so complicated can’t they?

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As a best compromise, is it possible your parents could go into a care home as a couple? Would your father be open to that, do you think?

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So sorry for the delay Latreia. I tend to go a bit quiet when I’m struggling! That’s an option which has been discussed several times but most of the time that idea gets rejected. Thanks for suggesting it though.