As regulars in Roll Call thread are aware, my husband, Graham is currently in hospital suffering from a serious respiratory illness. I have LPA for Health and Welfare for him - arranged after he suffered a stroke a couple of years ago. He tells everyone “Chris has POA for me, deal with him”.
Currently, the hospital is accepting me and involving me fully in his care and medical care planning. He has been suffering from hallucinations and bouts of delirium where he does not know where he is or why he is there and asks very strange questions. Through all of this I am spending as much time as I can with him and helping reassure him.
Does anyone have experience of TEMPORARY loss of Capacity when it comes to invoking an LPA?
I just want to be ready in case I need to take decisions with the medical team on his behalf and be sure I am on firm ground. I don’t think there will be an issue, but the other thing I have considered is that as my nephew is trying to visit (first contact in a year and not sure what his motive is!) and G gets confused and VERY tired very quickly, I feel visitors should not be allowed. With LPA I could say that I do not want G to have other visitors at this time, but don’t want to put them in a difficult position even though they would have to accept it if G himself said NO.
I may be over thinking things and hope it doesn’t come to a problem situation.
Thanks for comments/observations/experiences.
POA should mean that you should be treated as if you were G. He signed it knowing that you were the most important, most trusted person in his life. If he couldn’t speak up for himself he would expect you to speak for him.
Yes, that’s fine in the case when someone loses Capacity but what I want to know is if anyone has experience of TEMPORARY loss of Capacity and use of an LPA, as I just want to be forearmed in case someone on staff says ‘he has capacity’ and then a couple of hours later he is “away with the fairies” again as happened yesterday when he suddenly because confused and started asking a nurse if he was dying and why that huge Teddy Bear was in his room and why he was there. A doctor did ask if he knew his name, the date and where he was and he got through that fine, but then the other questions and comments came out which made me raise my eyebrows and give him reassurance.
I know it’s all down to infection etc but I’d like to be able to ‘force’ the medics to include me rather than say ‘you are not the patient’. I’ve been nagging to remind them of his short-term-memory issues and repeating to everyone that I have to go over things with him a couple of times til they stick and some get it while others don’t. It’s like his first day there when he told me with total certainty that the hospital had run out of catheters and Conveens and they had asked that I bring in supplies. That was total nonsense!
Sorry, @Chris_22081 - this never came up, amazingly, during my time at the carers centre.
I know you’ve had this all on file and it hasn’t been read by staff. I can only suggest having a copy of what’s on file with you at all times.
Chris, mum had an older style POA which I could use as it is signed. The newer POA is slightly different, as it needs registering.
If you go to the OPG (Office of Public Guardian) website, there is a very short form to fill in if someone is losing capacity.
Thanks Charles. The big issue is that he seems to drift in and out and on Saturday he was “completely gone” whereas Sunday morning he was fully lucid and yet by lunchtime he had drifted away form reality again. Given that someone COULD challenge my decisions and that’s what I want to avoid.
Funnily enough I even worried about instructing them ‘No Visitors’ as if someone asks G he would say ‘oh yes come in’ be cause he is never rude or direct - in case someone takes offence - then be completed washed out in five minutes and the Ward Staff don’t have time to monitor how long someone stays. i am going to tell them today “No Visitors” anyway and see if that helps.
It’s like the idiot friend after his stroke when G had no energy at all and he asked if OK to phone - I replied ‘yes but PLEASE no more than 10 minutes’ - 50 minutes later G was slumped in a chair completely drained from the guy banging on and on and on and G was too polite to say … please end the call. When I challenged him the guy said ‘I am sure it was only about ten minutes (he had got on his hobby-horse of Scottish Independence)’… See how I have to intervene and be Mr Nasty sometimes!
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Chris I’m sorry you are going through this. Proving “Temporary” incapacity is a minefield and I have got nowhere when my mum has been in hospital in similar circumstances. Yes she can say who is the King and what year it is, which is what they always seem to use to decide whether she has capacity, but the decisions she makes about her own situation and care make no sense at all and I haven’t so far been able to override them with staff. I remember commenting on here about the commode issue… she said no and I had to fight staff to override that. I feel for you, there don’t seem to be any grey areas with capacity. They have it or they don’t.
Thanks for the comment. It’s good to know others have faced similar problems. G is slipping in and out of reality and this morning asked why I had not been in to see him before now… It took a few minutes of going over what has happened and what we have discussed over the last week to bring him back to the “now”. If he had told others I had not been to see him they would probably have believed him!!!
Talking with doctors and nurses is mainly OK but I want to stop other visitors - not out of selfishness but ore to protect him from too many people trying to be ‘helpful’ yet only causing confusion in his mind because they don’t have the full picture of what is happening.
A nurse just said she is glad I am here and asked if I can stop him removing his oxygen canula - I have put it back twice and apparently before I got in she had done it twice as well. He also wants to get out of bed - NOOOOOOO. Someone else may help him and then there would be a problem.
He is also convinced he is “on the way out” and is asking me ‘If I am not here in the morning, please ask Patrick to say something’. I asked where he was going as he wasnt due to be discharged yet!!!
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A memory test is NOT a test of capacity. A mental capacity test involves giving the details of the decision to be made and the facts around the decision. The test is whether the person is able to retain the facts long enough to make a decision, and is able to weigh up the pros and cons of the decision. Finally, and only then, the question remaining is whether they can communicate the decision.
That’s it. Nothing else counts, so if they’re doing a memory test call them out on it. It’s NOT a capacity test. Mental Capacity Act - Social care and support guide - NHS
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Thank you Charles, you are quite right and I remember you helping me with this in the summer when Mum was in hospital. If WE all know the difference between memory tests and capacity tests, why do medical professionals insist that asking the patient to remember their year of birth constitutes a capacity test? I don’t understand it………
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Because it’s the test they used before the Mental Capacity Act. But it’s not legal. Use the link as ammunition when challenging…
It really is ridiculous - Graham has been asking staff why big fish are swimming around his bed and a Giant Teddy Bear is staring at him and yet no one seems to notice he is hallucinating… THAT is why I am spending all day here as they do not check him regularly in the single room (not that they did in 4/5-bed obs bay) and he’s been trying to get out of bed and taking his oxygen canula off cos he doesn’t realise what it is for… He just asked again ‘why am I here?’ in front of a nurse and she ignored him - I had to answer and reassure him. FFS !!! Sorry everyone. If one of them questions my authority I think I will blow a fuse.
Thank you! This is such helpful information 
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@Chris_22081 @Charlesh47
(Big caveat I’m VERY wiped tired so no filter or tact)
Chris, in the wards here there is no one vetting/looking at visitors, no one checking visitors unless I’m in the room. No one proactively is doing anything because they are reactively ticking boxes for observations or completing tasks…there are some very good people chasing to care, and a lot of others doing what they ‘have to do’ to stay on productivity task…
Based on this, I’m sorry to share that if nephew & wife turn up there’s no one who would do much EXCEPT for the nurse you’ve formed a relationship with
I’ve had to be the one…to set boundaries, tell them NOT to visit, phone…I.e. Bad Cop
BUT it prevents an ‘event’ which is worse
Sorry if I’ve missed a step or misinterpreted something…it’s been …well all you know
As always, we’re the ones standing guard over our loved ones on their behalf, protecting, and advocating…
So my recommendation - do a call, set the boundary tell them they are not welcome
You and G deserve support, the LPA in my experience gives you access and status to advocate but doesn’t influence actions of what people do on the ward…sorry! like I said tired and cynical
Sitting and caring for G in hospital is the only guarantee he’s ok, I say that because that’s my tried and tested solution (not ideal but saves our sanity and hearts!), in the moments I was there LPA/capacity etc was not mentioned because other patients were screaming or wandering corridors ‘you can’t keep me here’ was one lady every 5 mins over 12-15 hours
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“No filter or tact” hang on this can’t be the @Victoria_1806 we all know and love if you are admitting to that!!!
Do not worry. I am aware that they don’t police visitors like they used to - I can wander in and out of the ward through “security doors” without once being challenged and I am certain I could walk into any ward in that hospital (well perhaps not ITU) and give a cheery ‘morning’ to anyone who even bothered to look at me and carry on into ANY room I wanted without fear of challenge or molestation (ooooh!!)
On Sunday a guy wearing pyjamas trousers and nothing else - which were dropping down about to hit his ankles - opened the door and started to walk in before a burse called to him and dragged him back to his own bed. Again there was a bloke wandering up and down the corridor (I am going to presume his “loved one” was being attended to for some persona care) and kept staring into each single room as he passed. I got so annoyed that I got up and closed the door blind with a snap as he stared in, just to make a point. I would never dream of looing into another patient’s room - that’s being a Peeping Tom and Voyeurism is a crime!
I doubt nephew would dare visit and expect he was just trying to ‘make a point’ so he can big himself up by saying ‘well we TRIED to visit!’ I am there from around 10am til beyond end of visiting hours anyway so he wouldn’t come into the room - well he might but she wouldn’t, and then he’d have to scurry off after her. If I am there and they turn up I will probably say ‘when did Graham ask you to come in? I don’t think he did!’ just to embarrass them even more. I know some will say that just makes matters worse, but at least they would never try again!
It was very interesting yesterday as Graham had a few times when he was “away with the fairies” and it was obvious because of the blank look on his face and eyes focussed on somewhere ‘far, far away’. On one occasion a doctor came in and didn’t speak to me but immediately started talking AT Graham who stared completely blank at him. He paused and asked ‘does that make sense’ - no reply. Now at that point, surely and half sensible person would realise something is not quite right and check… It took me speaking up and saying ‘perhaps I should introduce myself, I am Chris, Graham’s husband and for the record I hold LPA for him. You are aware Graham has some short-term memory issues following his stroke in December 2021, aren’t you ? I have asked for it to be clearly shown in his notes. Now, shall we start again - "Good Morning, I am Chris, Graham’s husband, Graham is a little lost at the moment so if you’d like to talk with me I can brief him fully when he comes back into the room. I do have authority to discuss matters and make decisions on his behalf.’ Oh boy that went down well! Flustered doctor riffled through papers and started again. I then gave him MUCH more background info than he had and he had not asked for but admitted it filled in a lot of gaps. When he left G turned to me and said ‘who was that - he seemed nice enough’. I replied ‘he will be nice now I have set him straight!’
WHY is it SO F***ing hard for a hospital to have a consistent way of people checking basic info before launching in as though the person they have walked in is already “up to speed” and “on the same page” and “understands medical jargon and general terminology”? I sometimes feel like being VERY rude and suddenly saying 'Me no speeky Doctor - me speeky English - You sperky English mista? (and that would be to a White Anglo-Saxon doctor - not trying to be racist in ANY way, just getting the point across that not everyone speaks HIS language.
On that note - I will get on with the day as
“It’s Tuesday - it’s Five-o-Five and it’s…” Ouch not yet daylight! Sorry @Charlesh47 couldn’t resist after your little post the other day about age checks.
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Thanks hon @Chris_22081 as you know I’m still unhappy with hospital stuff, virtual ward and just all the lack of social care support in the new budget and how the increase in national wage and national insurance contributions with NO exemption for GPs/pharmacies/charity-care means that some local care supports may not be around much longer…
Specifically the hospice at home care and some of the already stretched GP services
General public are not aware that GP services are not 100% NHS funded, or that many care services are private and contracted by authorities, or that overnight nurse support is ONLY available via a charity here…I may not have lasted long without the help of the charity in 2019
Ranting cos tired
Ohhh and flipside of your comment - young/old white doctors are super surprised when I (youngish looking chinese woman) enunciate clearly in BBC like english ‘big’ medical terms…and STILL I’m sure a white male may get faster responses…
BUT since I don’t usually SEE many doctors in the hospital setting, I usually push and pull emotions of the nursing staff
having said all that we’re extremely blessed with mum’s oncologists there are some REAL gems
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