Care home confidentiality and untrusted family members

[Baxter2004]

Happy New Year all!

Thank you for letting me join your wonderful forum. A little background:

My mother passed away in October and by awful coincidence my elderly father sustained a bleed on his brain following a fall. Though he has not been diagnosed with dementia many of his symptoms mirror those associated with dementia. He has little short term memory, is confused and often doesn’t recognise family members. He is now in a good care home and being looked after.

I am currently in the process of applying to the court of Protection to have my sister and I appointed as deputies for his financial and welfare needs. So far so good as I know it can be a very long process.

My problem is this: I live away from the home and am only able to visit every couple of weeks. My sister is able to visit more often which is great. My relationship with my sister is reasonably good however my relationship with her husband is not. My parents thought him untrustworthy and manipulative and motivated largely by money. I share their concerns and I know that he “borrowed” a number of sums of money and never repaid them as well as using the threat of restricting my parents contact with their grandchildren as leverage.

I am becoming increasingly concerned that my father’s care home is sharing information with my brother in law about my father’s care as well as taking instruction and direction from him. Unfortunately my sister is dominated by him and tends to do whatever he tells her to. I spoke to the home briefly last week and requested that I be given regular updates on my father’s progress as I am concerned that my sister is not providing timely and detailed information to me. I learned that my father has had a number of falls and has also sustained a hernia. I had no knowledge of this until the home informed me.

I later received a text message from my sister telling me not to speak to the home and that she will relay any relevant information to me. I am not satisfied with this and knowing my family dynamic I know full well that this is her husband’s doing.

my question is this: surely the care home should not be sharing confidential information with anyone outside of immediate family let alone taking instruction from them. It may be that my sister has advised the home that she is happy for details of my father’s care to be shared with him but I have not given my consent for this and nor would I. If my sister is not available for any reason to answer questions or discuss any issue then surely I should be the next point of contact and not my sister’s husband? Just to be clear there is no LPOA in place hence my application to the court for joint deputyship.

Any advice gratefully received! Thank you!

 

[Louise7]

Welcome to the forum. A difficult position but at the moment although you suspect that the care home staff are sharing information with your brother in law you have no evidence of this. Did your sister say why she had not informed you about the falls & hernia?

If your sister has also given the home permission to provide information to her husband then I'm not sure why the home would need your consent to do so - have you asked your sister if she has done this? Does the care home have your contact details? If not, next time you visit the home could you give them your details and ask them to contact you with any issues if your sister is unavailable? If the problem is that your sister is not sharing information with you (for whatever reason) then I can't see that the care home is at fault. I can see that the family dynamic is a problem but as you have a reasonably good relationship with your sister maybe could you discuss these things with her to find out exactly what is going on. Sorry that this isn't much help but I'm not sure why all this is the fault of the care home.

 

[Jessbow]

Care home will have requested a 'first point of contact'. That naturally appears to be your sister.

The dynamic between your sister and you ( +/- B in law) will not come into the equasions. That is a problem that you two will have to resolve between you.

Even with POA/COP I doubt things will change if you share it with her.It is unrealistic to expect the care home to make two calls each time. Sorry, that wont be what you wanted to hear.

 

[Baxter2004]

Hi Louise

Thank you for the response. No, I’m not blaming the home as such it’s really more of a concern that they may be under the impression that my sister and I are both happy for my father’s care to be discussed with him. If the home are not in breach of any GDPR legislation in doing so then there is little I can do I suppose. It seems odd to me that they can have open discussions with him around my dad’s medical care simply on her say so given that she does not have power of attorney and my father is unable to consent. I work in financial services and am legally prevented from discussing any aspect of a client’s financial situation with any family member including a spouse without their written consent or copy of POA. The home now has my contact details and I have asked them to speak with me if my sister is not available.

 

[Baxter2004]

Hi Jess. Thank you. Yes I actually have no issue with my sister being first point of contact at all and I wouldn’t expect the home to use their valuable time making two calls. I am however concerned that my in law maybe making decisions in her absence so perhaps I need to make it clear to the home that I’m to be contacted if she is not available

 

[canary]

A tangent, Im afraid, but considering that you feel that your sister is under your BILs thumb and he is not trustworthy, is it actually a good idea for you both the have CoP deputyship? I know that you have to submit a detailed annual account of where the money has gone (right down to literally the last penny), but if the Court of Protection is not happy then they are liable to remove both of you from deputyship and appoint a panel deputy (usually a solicitor) in your place.

BTW, dont bother to apply for Health & Welfare deputyship as the court very seldom grants it, but you wont get the money back

 

[theunknown]

I reiterate what canary says, as I had deputyship. Although PoA normally involves financial and health/welfare authorisation when applied for, it's very rare for deputyship to be granted for health/welfare. There needs to be exceptional circumstances.

The care home thing is a separate issue. In my case the care home only contacted me even though I have a twin. This was probably because my sister didn't want to have any responsibility at all for my mum in any way, other than visiting from time to time when we gave her a lift. So they didn't have her contact details. Because of this I don't know how the confidentiality issue works with a care home. However, my husband was on their records as a second point of contact if I was unavailable. Over five years they only spoke to him once over the phone but it was important to me that the option was there so, if need be, when I wasn't able to be contacted I would have got any important information as soon as possible.

 

[Baxter2004]

Thanks Canary and unknown. It is important to me that my sister is involved and with joint deputyship neither of us will be able to make a financial decision without the agreement of the other so that gives me some comfort

Interesting point regarding health and welfare. Makes you wonder why it exists if they seldom grant it!!

 

[nitram]

Interesting point regarding health and welfare. Makes you wonder why it exists if they seldom grant it!!

It appears that the court prefer to consider each event separately rather than deputise carte blanche authority.

There is a local solicitor who recommends against H&W LPAs.
His view is that for day to day use it is not required and that if contention arises it will end up with a court application.

 

[Baxter2004]

Interesting. Thank you!

 

[theunknown]

Maybe the difference is that with PoA you're acting on behalf of the donor, but with deputyship you're acting on behalf of the court, ie you're the court's deputy, not the person with dementia. In order to agree to PoA the person who authorises this on their behalf has to be, at least in the moment, able to understand what they're signing up to. When you apply for deputyship the person you have it for has gone beyond this. In my case my mum had been placed on a Section 3 under the Mental Health Act. This involves 'deprivation of liberty', ie a locked secure unit. There are very stringent rules in place for what happens after that in order to safeguard the sectioned person. In practise, as named NoK, I was always asked by the care home about what I wanted to do in regards to anything they needed to consult me on about my mum's health.

After all, the person who has a court appointed deputy has never given permission for anybody to have the power to make decisions over health/welfare outcomes for them. So I actually think it's a good thing. Because of what happened with my mum my husband and I made sure we drew up PoAs for finance and health/welfare

 

[Splashing About]

@BrianSalisbury what exactly do you fear with your BIL being given information from the care home (btw in my experience it’s hard to get too much this way anyway!) I am asking not to be provocative but try and establish what you fears are. The care home will act in his best interests medically so he’s not at risk from your BIL. What risk do you perceive to finances? Or is it more about the feeling of being usurped in favour of a man you don’t trust? I can imagine this is painful. I’d say try and avoid placing responsibility for the care home to manage that.

I’m the local contact for our family and recently had my distant sister get shirty with me for not sharing a detail with her. This was one detail in hundreds of details....hours and hours of my time spent doing menial tasks, wiping bottoms, fetching shopping but she never thanked me for that but sniped over my failure to update her. I then spent each evening mailing her a resume of my day’s involvement (I work full time as well as care after out of hours and meetings during my working day). She then questioned my version of events and showed distrust in my decisions without actual knowledge because she wasn’t as involved as me. I spend a considerable part of my free time, weekends and evenings looking after her relatives and feel really attacked. I doubt I’ll get over that feeling as it hit me at a very low point. Your situation is probably very different and I’m only sharing to add another perspective. Try and nail what your feelings are around and what your parent would want in this situation and act with in that in mind

 

[Ruth1974]

@BrianSalisbury what exactly do you fear with your BIL being given information from the care home (btw in my experience it’s hard to get too much this way anyway!) I am asking not to be provocative but try and establish what you fears are. The care home will act in his best interests medically so he’s not at risk from your BIL. What risk do you perceive to finances? Or is it more about the feeling of being usurped in favour of a man you don’t trust? I can imagine this is painful. I’d say try and avoid placing responsibility for the care home to manage that.

I’m the local contact for our family and recently had my distant sister get shirty with me for not sharing a detail with her. This was one detail in hundreds of details....hours and hours of my time spent doing menial tasks, wiping bottoms, fetching shopping but she never thanked me for that but sniped over my failure to update her. I then spent each evening mailing her a resume of my day’s involvement (I work full time as well as care after out of hours and meetings during my working day). She then questioned my version of events and showed distrust in my decisions without actual knowledge because she wasn’t as involved as me. I spend a considerable part of my free time, weekends and evenings looking after her relatives and feel really attacked. I doubt I’ll get over that feeling as it hit me at a very low point. Your situation is probably very different and I’m only sharing to add another perspective. Try and nail what your feelings are around and what your parent would want in this situation and act with in that in mind

 

[Ruth1974]

The PWD has the right to choose who information is shared with. If they lack capacity (and that is clinically defined, you can't just decide) then the person/people who have been given POA have the right to decide who information is shared with. The care home is trying to do the best they can. If you are the legal guardian, maybe stipulate in eriting what info should be dhared with whom in what circs.
Check GDPR regulations for clarity but be sure who is legally responsible for your pwd firsy

 

[Palerider]

There is a local solicitor who recommends against H&W LPAs.
His view is that for day to day use it is not required and that if contention arises it will end up with a court application.

This is certainly a possibility, where parties disagree on the best course of action or omission to serve best interests. Simply stating someones wishes is not the same as reasoning out the best way forward when there is a conundrum. I wonder if advice mum took from her solicitor is why she did not instruct for H&W LPA?

@BrianSalisbury sometimes you do have to be bullish and raise your voice and make it clear you are to be involved. I think sometimes our trust in people to do what we expect can be misplaced re your sister and hubby, though this may not have been intentional by them. Seems you have done the right thing, but it sounds as if you need to have a chat with your sister and hubby and sort things out between you so there is a clear understanding.

 

[Baxter2004]

@BrianSalisbury what exactly do you fear with your BIL being given information from the care home (btw in my experience it’s hard to get too much this way anyway!) I am asking not to be provocative but try and establish what you fears are. The care home will act in his best interests medically so he’s not at risk from your BIL. What risk do you perceive to finances? Or is it more about the feeling of being usurped in favour of a man you don’t trust? I can imagine this is painful. I’d say try and avoid placing responsibility for the care home to manage that.

I’m the local contact for our family and recently had my distant sister get shirty with me for not sharing a detail with her. This was one detail in hundreds of details....hours and hours of my time spent doing menial tasks, wiping bottoms, fetching shopping but she never thanked me for that but sniped over my failure to update her. I then spent each evening mailing her a resume of my day’s involvement (I work full time as well as care after out of hours and meetings during my working day). She then questioned my version of events and showed distrust in my decisions without actual knowledge because she wasn’t as involved as me. I spend a considerable part of my free time, weekends and evenings looking after her relatives and feel really attacked. I doubt I’ll get over that feeling as it hit me at a very low point. Your situation is probably very different and I’m only sharing to add another perspective. Try and nail what your feelings are around and what your parent would want in this situation and act with in that in mind

Hi and thank you for the reply. Without being too specific, my BIL will attempt to freeze out anyone who he cannot manipulate. I don’t doubt the home will act in my dad’s best interests but information is being deliberately held from me. I have learned that my father had several falls has sustained a hernia and is experiencing hallucinations and I have not been informed of any of this. The home acted surprised and assumed that my sister would automatically inform me and she has not. A large sum of cash (several thousand pounds) has been removed from my parent’s house and my BIL had told me he has taken it and placed it in a bank account in his and my sister’s name for “safe keeping” yet he will not supply me with evidence. It’s not that I’m concerned about the care home sharing information but more that they are taking instructions from him and having detailed discussions with him about my dad and this information is not being passed to me. Not the care home’s fault of course but distressing for me nonetheless.

 

[Splashing About]

Hi and thank you for the reply. Without being too specific, my BIL will attempt to freeze out anyone who he cannot manipulate. I don’t doubt the home will act in my dad’s best interests but information is being deliberately held from me. I have learned that my father had several falls has sustained a hernia and is experiencing hallucinations and I have not been informed of any of this. The home acted surprised and assumed that my sister would automatically inform me and she has not. A large sum of cash (several thousand pounds) has been removed from my parent’s house and my BIL had told me he has taken it and placed it in a bank account in his and my sister’s name for “safe keeping” yet he will not supply me with evidence. It’s not that I’m concerned about the care home sharing information but more that they are taking instructions from him and having detailed discussions with him about my dad and this information is not being passed to me. Not the care home’s fault of course but distressing for me nonetheless.

I can only imagine how that must feel. What does your sister say when you tell her your feelings about it?

 

[Baxter2004]

I can only imagine how that must feel. What does your sister say when you tell her your feelings about it?

In all honesty I rarely get a chance to talk with her about it. He is always present and talks over her and for her. Even on the telephone he stands in the background and shouts at her and tells her what to say

 

[Splashing About]

In all honesty I rarely get a chance to talk with her about it. He is always present and talks over her and for her. Even on the telephone he stands in the background and shouts at her and tells her what to say

He sounds vile

 

[Louise7]

I think it's unlikely that joint financial deputyship with your sister is going to run smoothly under the circumstances - how likely are you to agree on financial decisions if your brother in law is involved in these? Perhaps it would be better for someone independent such as a solicitor to take on the role?