POA / Deputy roles

Hi all, I hope everyone is ticking along. Sorry It’s been a couple of weeks since I was last here.

I was wondering if anyone had any experience of someone having a temporary loss of capacity? Thinking about it there must be several examples of where this might be the case, such as a reaction to a medication, a urine infection, a stroke etc, where you may not necessarily know if the person is going to regain their capacity or not. Can you become a deputy through the Office of the Public Guardian but then revert to a POA if the person recovers enough?

My last updates were that Dad was starting to settle in the nursing home but his knee was beginning to give way more. Unfortunately it caused him to have another fall and to cut a long story short, he’s broken his back. They are trying to get a brace fitted so they can x-ray him to determine the next steps. Meanwhile he’s been laid flat for over a week, barely eating or drinking, losing condition, in a fair bit of pain and also obviously in an unfamiliar environment (especially being blind and fairly deaf.) He was fine the first 36 hours but then went downhill rapidly with acute delirium. It’s been so bad at times that he has missed medications and they had to get security guards to hold him down to prevent him getting off the bed. They’re trying to control what they can in terms of what might be causing it but they’ve said it will fluctuate and it could be weeks or months before he recovers from this part (the back is another story!), but even then it may not be absolutely back to where he was.

While dealing with this, I’ve also been dealing with the family who own the other half of his house and despite knowing he has broken his back they are pressuring us to sell. Unfortunately I only have general Power of Attorney as so much else was going on that we hadn’t had the full POA certificated. Now we can’t do that and we don’t know when we can, if ever. I called the Carer’s Helpline and they said I could become a deputy as they can act on the knowledge of how the person is now but I don’t know if this changes anything with regards to the general POA, or if the full POA is better and we can move to that at some point in the future. The vulture family are going to go mad if I suggest waiting for a while and I don’t know how long would legally be considered reasonable.

Every time I think it’s safe to go back in the water, another shark comes up and say "just one more thing…

It might be worth talking to a lawyer about this: most offer a free half hour consultation.

My understanding is that even though they won half, there’s no way they can force a sale at this stage, although I have to ask if your reluctance is because you really want your Dad to come home now? With his recent injury, it’s even more unlikely to be a viable prospect, if I’m honest. If you’re concerned that the current economic situation might adversely affect the value of the house, it may be worth using that argument - but I’d check to see what has happened recently with prices locally. Much longer and they may well start to falter, but best to see which way the wind is blowing. Vulture families are much more likely to go with a sound financial argument…

Deputyship can be revoked once/if the person supported regains mental capacity. This is where POA wins out. Check that your POA can be fully activated first - it depends on what kind it is, as far as I know. I’m not a legal specialist, so always best to check.

Thanks Charles. I’d like to get it sold and we’ll need the money in the next 4-5 months for his care home fees. He wants to go through his stuff (not clothing, things like the garage & kitchen etc), no idea why as he won’t be able to take any of it with him and he can’t have much of a say over who has any of it because nobody wants it. Like with his clothes, he’ll just say “I want to keep it” and when I explain there’s not enough room for 10 pairs of shoes and he’ll have to pay for it to go into storage he’ll just say “just leave it, I’ll find a way”. This is his standard capacity, you know the type where “you may not agree with their decisions”… He went totally of his head (and still gets angry about it now), that I had to move his clothes in one of his spare rooms to accommodate the NHS live in carer. We have a lot of neurodiversity in the family and it comes from his line so it’s not surprising that he has autistic traits. Plus he has little to no control over his life so I understand him wanting to go through HIS things but it’s blooming frustrating at the same time!

The Deputy ship from what I can see looks like a bit of a nightmare compared to the POA. Supervision, yearly reports, having to get permission to deal with his bank after proving we are capable, even though I’ve been doing it all anyway! And even then we can’t sell his house and need a specific sets of permissions to do it.

Price wise, the market in his village is very good at the moment so we don’t want to wait too long, especially with inflation & COL crisis etc. But how long do I wait for him to be physically and mentally able to go through his things, and / or sign the papers for the POA or the house sale? What a mess.

From what you describe he should be entitled to NHS Continuing Healthcare.
Under these circumstances there is no urgency to sell the house to pay for nursing home fees, as his care should then be free. My mum had to move into residential care, she was a hoarder and emptying her house took us a year, an absolute nightmare as she refused to sell her stuff at the good prices I had, for a long, long time. She insisted that all her clothes went with her, all absolutely squeezed into a double wardrobe at the home. After she died I gave them all to the home to give to other residents. There were some who had their fees paid for them by relatives they never saw. However this made getting new clothes a problem. All the new nighties I bought “disappeared”, only the oldest scruffiest were left in her drawers. So sad.

Definitely follow Charles advice and get legal consultation.

If you father does not qualify for continuing healthcare the Gvt will want his assets sold to pay for his care, so you need to know the details like what happens if there is money left over at the end of the care or if the money runs out who is then liable for the care home fees?

If you sold the house and split the money and your father moved in with you, then a few months later he moved into a residential home, the Gvt will be knocking on your doors asking for every penny of that money back to pay for his care, saying it was defrauding your father of his care.
The Gvt have really tightened up on the loopholes over the last decade or two.

He definitely won’t be moving anywhere else unless for some reason the care home refuse to take him back (it’s a nursing home so there shouldn’t be TOO many things they’re unable to cope with). He now has his brace fitted and they have stood him up etc so he should be able to take steps when he’s strong enough. I should imagine there will be physio to do which the home may be responsible for but at this point we don’t know how much more involved his care will be. He was totally continent before but may now not be able to get himself to the toilet. He could manoeuvre himself in the shower and turn over in bed etc but we just don’t know at this point what he will need help with and how much that will improve. It may be just a precautionary phase and I have no idea how that affects the fees at the home, or the funding.

Currently he has enough money for about 5-6 months so we do need to get on and sell. Should he outlive his share of the house money then his care would be funded by the local authority but we’d either have to top up or he’d have to move rooms unless there was a good reason not to.

I totally get what you mean about the nighties Bowling Bun - we’ve already lost so much, despite me buying and ironing on indestructible labels. I might keep a couple of boxes of clothes at the house until it sells and we have no choice but to move it. I just didn’t want the vulture family to poke around at his things but maybe Dad will realise he doesn’t need them by then and we can give them away.

Henry’s Cat
What an emotional time for you.
I have my fingers firmly crossed that the nursing home will take your Dad back.
I don’t wish to cause alarm, however my husbands physio stopped when he went into a nursing home. I asked about it and was told it’s not provided. I would advise you to check.

Thanks Pet - that raises an interesting question - when is physio… physio? I have to see physios a lot because of a connective tissue disorder but I obviously have to do exercises on my own in between times. If I was still caring for Dad myself I would help him with any exercises he needed to do but I wouldn’t be a physio. Would the staff in the homes not help him or is it one of those things that some do, some might use as a reason to charge more, and others might refuse? Wondering about all of this and Dad’s care needs when he comes out made me speak to my SIL about fees. When we were looking for a suitable place and calling around for prices people didn’t ask much about his care needs. He definitely would have been one of the easiest to look after as he is / was continent, no dementia, no gadgets, ambulant etc. Now, or whenever he comes out, we have no idea what help he will need and I’m worried they’ll suddenly say there needs to be an increase.

He finally had the brace fitted and managed a safe transfer from bed to chair etc so the physios signed him off. I visited the following day and they managed to move him to the chair while I was there but with 3 people having to help. He was pretty lucid and able to comment on some of the ‘strange dreams’ he had had but was struggling to respond to speech. The following day he was so out of it when I visited that he couldn’t seem to coordinate closing his mouth to swallow water. He’d refused all food and drinks but I managed to push food in and help him to close his mouth to he could swallow. He couldn’t talk, didn’t seem able to hear, etc. Then he suddenly said he needed to open his bowels (that’s not what he said of course). Eventually 3 people tried and failed to get him up. He just couldn’t seem to coordinate what he needed to do and was so unsteady they went to get a hoist. Within about 15 minutes he graduated to being able to hear and then started shouting, cursing, trying to hit out etc. I had to stand guard while they went to find enough staff and the right equipment to give up on the commode and just get him into bed. Yesterday he just wouldn’t wake up at all. He’d apparently been grumpy, refused the brace, not eaten or drunk anything. An hour and a half I tried but he just snored and snored. I can’t seem to find out what the plan is and what exactly they are looking for before they discharge him, and what they will expect the home to deal with.

From what you describe he needs to be assessed for NHS Continuing Healthcare which would give free care. Something is seriously wrong, has the possibility of mini strokes been considered and investigated? No way could you manage such variable behaviour on your own.

Henry’s Cat
The staff at hubby’s nursing home wouldn’t help with any exercise he may have needed. He went in after learning to use a walking frame but soon lost capability. Bearing in mind he ha vascular dementia,so it could have been that he forgot how-to use the frame? I will never know. It’s something you would need to ask at the home regarding physiotherapy. I assumed, wrongly when he went into the home that it would be similar to the hospital and assessment nursing and care.

It’s so tricky isn’t it? Apparently today he is more lucid and is eating and drinking so I think CHC would throw his case out pretty quickly even though he would JUST about fit the initial assessment criteria without these two new issues. I messaged the nursing home with an update a few days ago and said we might have to look at CHC and was that something I had to request from somewhere myself or did it come from them (even though I know the answer) and I’ve not had a response yet. I have no idea how anyone determines if / when things are as good as they are going to get, and what they do if it continues to fluctuate.

The brace he has is a very new design that nobody seems to understand and I don’t know how they instruct the home on this when they are not on site. It’s even new to the physio. His pain and his food and fluid intake could be managed by the nursing home, and with the right prescription (ha!) they should be able to manage him when he gets aggressive. They have hoists if he continues to struggle to transfer. But the hospital must think there is still enough risk to his back to keep him there or that something else is amiss, or they’d want to get rid of him wouldn’t they? It’s a bit deja vue - they kept him in for 4 weeks in December when they hadn’t needed to take him in at all and there was no change in his condition (other than getting weaker through being in hospital and not being looked after!)

He had a head CT on arrival because that was the primary concern after banging his head but it was all clear. Now they can’t do anything because he’s so uncooperative but there are no extra signs of any brain issue, other than this delirium which is apparently very common. The trouble is, they don’t seem to want to listen to the fact that he was fine when he arrived so they don’t know his baseline. I’m so tired of having the same conversations with them every day.