Best of Interest Meeting - another one!

[Tracey_170312]

Just after a bit of advice with regards to POA (Health & Welfare).
Last April, my nan had a 2 week Mental Capacity Assessment by the OT. I was invited in for a Best of Interest Meeting, where they deemed her unable to have the capacity to make her own decisions (they wanted her to be in 24 hour care, she didn't want to go). At this point they didn't know that I had POA, and to be honest they wasn't very impressed when I produced the documents!.
About a week or so after when they had convinced her to go into 24 hour care they invited me in again and said that they thought she had got capacity and now she wanted the care on offer - I obviously disputed this and she was sent home.
Move on a year later my nan is now in hospital and yet again I have a Best of Interest meeting, she has never wanted to go into 24 hour care, but the consultant has told her that is what she has to do, her mental capacity is so limited (declined massively since last year) that she thinks this is her only option and that is what she has to do so agreeing with everything that anyone says. I've informed the hospital about my POA being in place but they are disputing this saying she knows what she is saying... anyone sitting with her would see this differently. She doesn't understand that if she goes in it's for good, she thinks if she doesn't like it she can just go back to hospital. She constantly says the same things over and over again and doesn't take on board anything that is said to her.
So, after a brief oversight into my constant battle can they choose to acknowledge and then disregard my POA?
Just to add she has an excellent care package with 6 calls a day with the carers doing everything for her.

[bowlingbun]

The whole point of a POA is that you are there as a representative of nan, they must treat you as if you were nan.

If she goes home, and fails, then that is the time to reconsider, because she can go back into hospital or residential care. Are they in fact trying to avoid her being a patient again in the future?!

I know just how bullying hospital staff can be, so maybe you should consult a solicitor, ideally the one who did the original POA? Explain what is happening, and what they can do to help you?

Have they done an NHS Continuing Healthcare Assessment yet? This should be done, with your involvement, before any final arrangements are made.

[Tracey_170312]

No I haven't had any involvement with anything as yet they just rang me and said that they were sending her into 24 hour care. It was only when I finally lost my temper and told them she wasn't going anywhere until someone had discussed things with me.
It took me 3 attempts just to speak to the OT by phone.
Plus they don't make things to flexible as they don't understand that also work full time and have a family to look after.

[jenny lucas]

Hi, this is only a thought, but here goes.

I'm wondering whether letting your nan go into 24 - hour care might be the 'simplest' thing to do because it gets the hospital etc off her back ....but THEN, when she is at the care home, she can 'change her mind' and decide that no, she wants to come home after all.

I don't see how anyone could object to that change of mind - after all, the hospital have just decided she has capacity, and therefore is 'free' to choose the residential home option, so by the same token they must accept that she also then has the capacity to change her mind once she's there and come out again!

The hospital can't have it both ways. But you and your gran might be able to !

Like I say, just a thought. (Might be not good of course)

[Tracey_170312]

That thought has crossed my mind to be honest....
She's agreed to go into respite 3 times and hated it!
If she does change her mind I'm aware that she has a 12 week cooling off period, they can't say that she hasn't got the capacity as they know I have POA.
(Think the problem is the 'powers that be' hate the thought that families have had hindsight and sorted the POA for health & welfare since most go for the financial option!).
My problem is I hate bullies and have always been taught to stand up to them.... no matter how big they think they are

[jenny lucas]

You could write to the hospital saying that in the circumstances you give temporary permission for your nan to 'try out' residential care with a view to assessing whether it is suitable for her and whether she prefers it to being at home with a care package, but that if she decides not to stay, she will be coming back home again.

I daresay you know, that the hospital are stunned that you actually DON'T want your gran to go into care, as I suspect most of the time relatives are abjectly relieved that the time has come when they can say to their elderly carees that, sadly, the time has come for residential care.

I also expect that consultants (AKA 'CMG' - Call Me God!) aren't used to being 'challenged' by anyone other than a more senior consultant!

[bowlingbun]

Just make sure you get the Continuing Healthcare Checklist done before ANY decisions are made. They will try to avoid doing this, but it's really important. If successful, and it is a postcode lottery, it would mean that all care is paid for, whether provided at home or in residential care. Hospitals are not supposed to ask about a patient's financial situation, but often do.

[Dancedintherain]

Sorry you are struggling with this.
Best Interest meetings are focused on the patient/client.....just like it says on the box!
In the case of you and the NHS and/or the Local Authority Adult Social Care being unable to agree I believe the Court of Protection has the power to make decisions in her Best Interest.
Which can include removal of deputies or attorneys if need be. (And the option of appointing the Local Authority to act as Deputy).

SO.......if you as current holder of PoA and the Authorities fail to reach agreement the matter can/must be handed to the Court of Protection.
Whether You ask the Court to intervene or whether the NHS and/or LA (local authority) do so may or may NOT be important to you or indeed may be very important. There will be financial implications either way no doubt.

In your position, I suggest you contact the Court for advice. A simple phone call initially might be very helpful for you, helping you to find a way forward. Most people find them very very helpful.

There is a lot of misunderstanding in general about Power of Attorney. There are other Decision Makers such as consultants who also have legal responsibilities and duties to the patient. Another example for you of the Range of powers......... The Court of Protection cannot give attorneys the power to demand specific forms of medical treatment that Health Care Staff like Consultants do not believe are necessary or appropriate. NOt that this example is of interest to you at the moment.

But why trust me, a random person on a forum?!! Why not check it out with Citizens Advice or a solicitor? Or Age Uk or Independentage,org uk? Or try the Carers UK advice line? Just beware any websites which don't have .org at the end. Many of the .com or co.uk companies pretend to be something they are not. After the preliminary freebies to bait(!) you they they offer other chargeable services. Working only JUST within the law lol

Anyway, just want you to know I feel empathy for you I know it's a worryingly no situation.


I hope agreement can soon be reached in her Best Interest and I hope too that the outcome will sit well with you.

[Dancedintherain]

My goodness is That the time??? ! Good night.