Confused by POA and deputy stuff

[Katrine]

I thought I had a reasonable grasp of the issue until I started to read the factsheets, Directgov stuff etc. in relation to our specific circumstances. Please can someone give me a steer as I am so confused.

OH has for many years had financial EPA for his mum but it has not been registered yet [with OPG, is that right?] He's seeing her solicitor soon to move that forward and get it registered. Last year MIL's solicitor said save your pennies until you feel she really lacks capacity to make financial decisions. Well she has for some while really but her affairs are straightforward and provided she has her shopping money she doesn't need to do anything else - OH has set up DDs and checks her accounts online. Other family members organise repairs, and do larger purchases at her request, and send OH details of funds to be reimbursed, and he keeps the receipts.

MIL is awaiting assessment by a social worker in hospital that should then link her to a Community Care assessment by regular SS. Stop me if I've got that wrong, but I think that's what will happen. Hospital staff are concerned about her level of confusion, have talked to her children and are keeping her in because of family concerns over her safety living alone. OK, that's great, everyone is helping us to fast-track getting her known by SS as a client or potential client. But, we worry about them trying to take over rather than just offering help or direct payments. Hence the need to get the EPA registered soon so they can't apply to get hold of her money.

What about welfare? There is no welfare EPA so what happens to get the deputyship and would it be wise to have more than one deputy so the process cannot fall down due to potential future incapacity of the deputy? If the financial EPA gets registered does this mean the same person is likely to be easily granted deputyship for welfare? Will MIL need to have a formal assessment of her mental state for this? We think the financial EPA can just get registered without someone having to tell her that she is officially bonkers, but maybe not?

This is all really basic stuff I know but I'm struggling to grasp it. OH relies on me to be the Talking Point junkie so I want to help him prepare for the meeting with the solicitor. We're not daft but find these people waffle on so much that it is hard to formulate a strategy during the meeting and then when you leave you have to try and explain the potted version to the rest of the family!

 

[bunnies]

[
Hi Katrine,
It's a pain how complex these things can look. In reality it seems to be simpler than it looks - at least that is what I have always thought.

Your MIL is being assessed in hospital. I don't know your precise situation, but just to repeat something that I and others have mentioned here before...if your MIL would be self-funding, once she is in hospital SS seem to have the goal to get the person into a home whether it is necessary or not. So be prepared to resist this suggestion unless you are absolutely convinced it is the right one. I had to fight really hard to get my relative home at this stage. I haven't experienced EPA only LPA, but at the stage you are now with your MIL I didn't have either, and I was still able to make sure she came home and take control of that, but with a fight. As I understand it the EPA can function at an earlier stage, so if anything your situation should be a strong one even if it isn't registered yet.

As I understand it, in the English system at least, you shouldn't need to have a deputy at all - that would be if you had no EPA or LPA prepared (which you do). Most people seem to manage without a welfare EPA/LPA. This is an area I don't really know about. I don't have one, and I haven't encountered that as an issue. (Also, it seems that the LPA does confer some rights in this area, even if it shouldn't.)

As I understand it, you don't need to have your MIL assessed to get the EPA registered - but as I have only personally dealt with the LPA I hope someone else can comment on this. (If it were an LPA you would only need to do that if the person had specified it on the LPA form.)

 

[jenniferpa]

Katrine, I'm going to assume that your MIL is in England rather than Scotland.

To answer your questions in no particular order.

You will have to notify your MIL that the EPA is being registered. This doesn't have to be particularly formal, especially if there is no one likely to object, but it does have to be done. "Mum, I'm going to send off that form you signed to make it easier for me to pay your bills when needed" is perfectly adequate as notification in most situations. If it really will upset her, though, the option exists to get a dispensation (they don't call it that, but you get the gist) from the OPG on the basis that notifying her will seriously impact her mental well-being. You need something signed by a doctor I believe, but the info is all in the EPA registration pack.

Becoming a welfare deputy. Well you could try. However, my understanding is that the court is very unwilling to appoint welfare (as opposed to financial) deputies. They prefer welfare decisions to be made under the guidelines of the 2005 Act, with applications to the court when there are specific issues that are contentious.

Whether social service would "take over" or not will depend a lot on whether your MIL is self-funding or not. Does she have much in the way of assets? If that's the case, there may not be much help forthcoming, sadly.

In normal circumstances the way this situation will play out is the EPA will be registered, social services will assess her and say she needs this, this and this. They will do a financial assessment that will indicate what she would need to pay (if anything) and then, assuming they decide that they will pay for at least some of the care, you will be given the option to use their contracted carers or get direct payments to employ your own. That last bit can be a bit iffy though - some LAs are much more inclined to force you into one path or the other. It may not be wrong for your MIL but you should be on your guard if, for example, you feel strongly that you would prefer direct payments but are being pushed into another option (and there are a couple of other options - that personal budget system for example). Not all LAs offer a choice however.

To be honest, apart from the EPA registration, and the unlikelihood of getting a welfare deputyship, I'm not sure that the solicitor will be a source of information vis a vis care.

Oh - the other thing with regard to the EPA registration. Various classes of relative need to be notified. Depending on how may siblings your husband has, that might be enough, but he probably should take names and addresses of such family members with him. When you notify one member of a "class" (say a child) you need to notify all members of that class, even if one of them you haven't seen for 20 years, unless you really have no idea of their location and no way to find out.

 

[Katrine]

Much enlightened!

Thank you both so much, that was really helpful. Yes MIL is in England. She has modest means but does own her own home and has small but adequate pensions so would be self-funding for CH, if and when.

We are awaiting a summons to attend her assessment in hospital by hospital SW. She was ready for discharge days ago but they are keeping her for this assessment to take place because they say it will take much longer if she goes home and doesn't have the direct hospital SW referral. I don't think they have ulterior motives; everyone has been very kind and seem concerned to help MIL manage at home with less stress and anxiety. That of course might also reduce the number of times she goes to hospital, so it would indirectly benefit their resources.

When this assessment takes place we won't talk about her money situation as it should be an assessment of her potential need for care support. It is useful to be forewarned of this rather than just blithely chatting on in what might seem to be a cosy and informal conversation with a skilled SW. As you say Jennifer, the filling in of forms regarding finances comes at the stage where they have dedided that she is eligible for some support.

I am aware of reluctance to offer direct payments. In my case it was for my mother in Scotland and they gave me the run around for months until I had to complain to the Director of SS, quoting Scottish legislation and care funding guidance and threatening a letter to her MSP.

For my OH and his siblings, direct payments is likely to be the most useful thing. MIL is sprightly and does not need help with personal care or household tasks, although checking her med compliance is an issue and she needs help when she goes outside her home. If we had strangers popping in every day she would just tell them politely to leave her alone, as she does with everyone official, charitable or just friendly who comes to see her.

We are also hoping that once she is registered as a service user then should her needs escalate it will be easier to gain access to services. This happens with my mother. She doesn't see her SW from one year to the next but I occasionally benefit from advice and support when I request it. And they help pay her care costs, living in her own home.

Thank you once again, Katrine

 

[jenniferpa]

Just to make sure I was clear - if she would be self-funded for a care home, she may be self-funded for social services care in her own home. It's going to vary depending on where she is, and how much help she needs, but sadly in most areas you don't get LA assistance unless you have few assets (excluding the home) and very modest income. Of course when it comes to a care home, her home comes into play as an assets which it won't in the current situation.

Some LA's have calculators on their websites that give you a rough idea of charges.

 

[Katrine]

Self funding

Thanks Jennifer, Yes that doesn't surprise me. One family member thinks that 'they' will provide funding and/or free services because MIL deserves it - because of her age, her fragile health and her previous contribution to the NHS as an employee. Hmmm. Still, we will probably be able to get lower rate AA once we've had a formal assessment of needs.

And lest anyone, including my OH, think I am paranoid about SS from reading too many horror stories on TP, I was talking to an elderly neighbour today and he said "Make sure the welfare don't try to get hold of your MIL's money." When his lady friend went into a CH he had a visit from SS demanding the deeds of her house. They told him they had powers to seize her assets to pay for her care. He said "No you don't, I have POA." They departed and the matter was never mentioned again.

 

[jenniferpa]

I think it's wise to be cautious, but I also think that in the vast majority of situations the system works as it's supposed to (with minor hiccups). You tend to hear about the bad stories and not so much the good. It's like the newspapers, you don't often get headlines like "No earthquake today. 6000 people did not die".

Regarding your elderly neighbour - a lot would depend on if anyone was still living in the house. Also, some LAs take the path of least resistance - they put a lien on the house so that when it is eventually sold they can recoup their money that way. That can be done without any agreement if it's not a disregarded asset.

 

[FifiMo]

Can I just make a point here that might be getting overlooked. It is good that you have financial power of attorney and that you are going to register it soon. What you do need to research is welfare power of attorney and I see that Jennifer is saying that it is not always necessary to have this. There are however considerations that you will have to be aware of if and when your relative is adjudged to no longer have the capacity to manage their own affairs, for example:

If your relative is in hospital and is judged to no longer have capacity to manage their own affairs then someone (either you or the state) will have to take over responsibility for this as there is a duty of care obligation that then kicks in. This then means that someone will have to apply to the courts for authority to make welfare decisions, such as where the person should reside, what medications or health treatments they should have, that kind of thing. This is different from it being a financial obligation and whether the person is self funding or not. This is a duty of care obligation that arises out of someone having decided the person in question can no longer make these welfare decisions for themselves.

If you are happy that the local authority applies to the courts as and when this scenario applies then fine. PLEASE however bear this in mind...for either party to need at that time to go to the courts for a decision (even on a one off basis) takes time and until someone is appointed by the courts to assume responsibility for the welfare of the individual or they apply for a one off decision to be made, the person will end up having to stay in hospital. This can, potentially, take months. What you might also find is that, if the LA applies for deputyship and that in doing so they say that they have to assume responsibility for the finances too.

Bear in mind that this is to do with duty of care obligations that the Local Authority have for the indivual, if no one else holds welfare power of attorney - nothing to do with if they are self funding or not.

It is worth looking into this now and making sure that you know what potential situations can arise in the future.

Fiona
x

 

[KIM62]

Poa & epa

Just thought I would put my experience of these two forms of administration.

When my SIL went into full time with her dementia, she wanted my husband (her brother) to be her POA.
The family G.P came to assess her that this would be required in all eventuality. He signed the papers and off the papers went. The Office of Guardianship in London, would not accept the forms as the G.P did not tick the box stating the client (SIL) was over 18, even though her date of birth was clearly on the form.
So, more forms were sent and this time the solicitor was visited for him to assist to complete the forms. The Office of Guardianship in London once again rejected the application for POA due to inconsistency on the form. This time the solicitor made a visit to my SIL in the nursing home, by this time my SIL condition had declined a little in the 9 month this had started. And because she had some confusion in trying to get the right sentence out and she was shaking, until the right meds applied. The Office in London would no longer accept the application of POA, and therefore my husband was granted 'Deputyship'. What this meant for him was he could no longer go to do on-line banking with SIL bank account, the bank automatically closed it down. And for my husband who is a pensioner and disabled it was an hindrance. Every time he had to deal with financial matters he had to go to the bank, and explain what his role was and take forms down to prove this. He still has the legal right to sell SIL property when time comes. There is no real difference to handling financial affairs. But the total failures between the solicitors and the G.P were just unbelieveable. Finally, when the Office of Guardianship finally allow the Deputyship or POA, there is an insurance premium to pay annually, this I believe is based on the clients finances, for which the client has to pay. And, a little bit of very basic book keeping has to be done annually, just to make sure the clients finances are being met and kept. So, please remember fill in those bank stubs, keep those receipts and if possible get direct debits set up to keep those bank statements as proof of payment.
Best wishes
Kim

 

[Katrine]

It's wise to be cautious

Yes I agree, but better to be cautious than risk circumstances that would devastate MIL and end her independent life.

Know what you mean about the media. Today I was reading her Daily M**l and it was entirely composed of stories that could be captioned "Ooo, isn't it awful!" I suppose it's the same appeal that the Victorian penny dreadful papers had - how shocking - how disgraceful - everyone with power is corrupt - vulnerable people are a whisker away from disaster - on and on. Goodness knows what affect it has on MIL's view of the world reading that every day.

 

[jenniferpa]

Actually I don't think I said a welfare LPA wasn't necessary. If I did I didn't mean to. In an ideal world Katrine's MIL would have one of those as well. What I said was that it is unlikely that the courts would grant a welfare deputyship (because they don't often). From Katrine's first post that everyone seemed feel that it was past time to register the EPA. I took from that the probability that she would no longer have capacity to grant a welfare LPA. I think it might be a good idea for your husband to raise this possibility with the solicitor, unless you are sure there is no way she could understand about a welfare LPA. If it might be possible to get one you'd obviously have to put off registering the EPA.

In fact there is normally no need for anyone (LA or family member) to apply to the courts for a decision about where a person can live unless there is some level of disagreement, and even then a registered EPA, although just for financial matters, has been considered by the courts to be a strong indicator of the wishes of the donor. If that was to happen, it would almost certainly not be a deputyship but a one off decision.

I am unaware of situations where people have been kept in hospital for months due to a lack of a valid welfare LPA. I'm not saying it doesn't happen but people are far more likely to be pushed into any old home because of the issue of bed-blocking. And you're lucky if you can get a social worker if you're self-funded, anyway.

 

[Katrine]

Update

OH met with the solicitor and it turns out that things are less complicated than we thought. The existing EPA covers welfare as well as finance and is deemed to be active due to OH's involvement in finance and welfare management. Solicitor said SS could not just take over. We are now planning to register it with Court of Protection but that will take 5-6 months due to court backlog. Solicitor says EPA was much better but now LPAs have automatically to be registered this is causing the backlog and we will have to wait our turn.

MIL (the donor) will need to be notified in writing so we will have to deal with this sensitively. By the winter she will take another downturn so we need to get the process started to give OH the necessary authority should residential (or respite) care be needed. In practice he would not take any action without full consultation with his mother and his siblings; it is more to give a point of reference for the authorities.

Other close family members will need to be notified also. This includes MIL's older sister to whom she is not especially close and who has no involvement in her care and welfare. Also her children (no problem) but also all her grandchildren, including minors! Why her youngest grandchildren, who are 12 and 15, should need to be officially notified is a mystery, but apparently if anyone in a class of relative is notified then all have to be notified.

We have not been impressed by the attitude of the hospital social worker; we felt he was primarily a salesman for care services that we felt were not currently appropriate. He got irritated when I told him we were not going to discuss her finances at this point because it was 'cart before the horse' to decide on whether she could pay for services when her needs had not been assessed. And, even if we proceed with a carer's assessment, which makes good sense, only OH, her attorney, will discuss her finances.

Fortunately she has now been transferred to our local hospital and probably a different social worker will deal with her assessment, so we feel more in control. Her GPs are very supportive and will be able to assist us better now she is back on home territory.

SS Carer's Assessment will involve the whole family 'team' of carers, and will involve an emergency care plan for when our team cannot meet her needs. This seems very sensible. I am generally the first port of call, but with care responsibilities for my own mother 500 miles away I might not be available in a crisis. Therefore emergency support from SS might be needed. The social worker's view was that MIL's care needs were currently being met by the family but that without our considerable input she could not live alone unassisted. So it made sense to assess her current level of care support. I may not be expressing this very well, but what he said was that they wanted to assess the carers as a matter of urgency, rather than the client.

 

[jenniferpa]

How many children does she have? If she has two, including your husband, then you could just notify those two, plus her sister. That makes the 3 required.

As to the EPA covering welfare - well in practice it may well, at the code of practice says that a person who is an attorney under and EPA should be consulted but it's not a must which would be better.

And a further thought: I was just going through the code of practice (which as an attorney under an EPA is more in the nature of a guide rather than rule book) and the information about being a decision maker, which is what your husband needs to be considered. It makes the point that while an EPA hold is a decision maker, they are a decision maker for those decisions that are within the scope of their authority, and there is no doubt that an EPA is solely for financial matters. This is the primary reason that people who are still competent are now encouraged to draw up a welfare LPA even if they have already drawn up an EPA. Now your husband may be the decision maker for his mother for most day to day decisions by virtue of being her primary carer, but if for example it came down to paying a carer, then that carer could end up being the day to day decision maker. The code makes clear that you can end up with a lot of different decision makers. I urge you (if you haven't already) to read section 5.8 -5.12 of the code. I'm very hopeful that you, Katrine will have no problem in this area, but I'm posting this in case in the future someone reads this thread and thinks - "oh no need to get a welfare LPA then" which would I feel be the wrong message.

 

[Katrine]

Her EPA covers both finance and welfare

It is quite clear from the wording of MIL's EPA that it covers both finance and welfare - this is explicit. Might have been an idea for OH to read it before I posted here, I kinda thought he had done!

The solicitor advises that at least 5 people must be notified, not three. And also, that if anyone in a class of relative should be notified, then all should. Since she has two other children and a sister (only 3 people) then grandchildren have to be brought into the picture.

 

[JPG1]

Katrine,

I really do think you must check again with the solicitor because I suspect he may be wrong. The EPA will only cover finance. If it's of any consolation, a friend of mine was also told by his solicitor that the EPA covered both finance and welfare, but when he asked the solicitor to confirm that in writing to him, as he was doubtful about it, the solicitor changed his mind.

His EPA said "finance and affairs" and the solicitor took that to mean health and welfare, but the solicitor was wrong and apologised for his mistake.

PS. If the grandchildre are under the age of 18. or anyone is mentally incapacitated, you don't need to notify them. But other than that, you will have to work your way through the family 'class' structure, if you get my meaning!

 

[jenniferpa]

Oh carp. And this hasn't been registered yet? Look I really, really do not want to worry you but I'm not sure that the OPG will register it as it sounds as if it is fundamentally flawed: EPAs could not make directions with regard to welfare, since there was no law in England to allow such a direction. I would strongly suggest calling the OPG helpline about this.

Look - it may be that they will register it for finance and I hope so. Or they will do after you take it to court. This is one of those occasions where I would be more than delighted for you to come back in 5 months and say "you were wrong" but I wouldn't be being honest if I didn't say that I think this EPA may fall into the 10% of instruments that are fatally flawed and cannot be registered.

On looking at the justice.gov.uk site, it would appear that the court will sever restrictions such as this. Whether it will be necessary for you to go to court is unclear but at least it is likely that after doing so, you will have a valid EPA for finances.

Have a look here

http://www.justice.gov.uk/guidance/...nduring-powers-of-attorney.htm#restrictincomp

You'll see that all of these reference welfare decisions.

Has your husband thought of showing this EPA to another solicitor? Assuming this was the solicitor that drew this up I think a second opinion would be warranted.

And the solicitor is wrong about the 5 people, it's 3. There has been intermittent issues with regard to whether the attorney counts (I had to get guidance about that myself). I suppose it's possible that the EPA was written in such a way to require 5 but that's not what the base line requirements say. He's right about the "every member of a class" thing though. If it doesn't say it on the EPA though, it's 3.

 

[Katrine]

Property and affairs

"I .... appoint .... to be my attorney for the purpose of the Enduring Powers of Attorney Act 1985 with general authority to act on my behalf in relation to all my property and affairs."

The solicitor says that there was not a separate welfare EPA at the time this was signed (2004). There was potential provision for the donor to limit the scope of the powers, giving specific details of this, but the donor in this case did not limit the powers. Therefore welfare matters are included.

 

[Katrine]

Consulting OPG

Thanks Jennifer and JPG1, I agree that advice from OPG is needed. The court rulings on the link you gave me make it clear that the court does not see EPA as intended to include welfare and in practice has explicitly severed such provisions where they have been added to individual EPA documents. I'll keep you posted when we know more.

 

[jenniferpa]

I'm sorry Katrine but the solicitor is wrong about this. Please, speak to another solicitor about this if you don't believe JPG1 and I.

Now if the instrument uses the phrasing you quote then you might well get it registered as it says "property and affairs" . This is because the terminology is close enough to property and financial affairs to slide through, but that's all it means. No EPA has ever given authority over welfare - that's one of the reasons the new LPAs were created.

As to the 5 people - I'm wondering if the solicitor is confusing the EPA provisions with those of LPAs?

P.S. Sorry, cross posted with you. Glad you're looking into it further.

 

[russellgww]

Isn't it funny (ie odd) that there is so much confusion on this subject here, on this forum especially, despite the apparent wealth of information on the subject? I hope someone from AS is monitoring this and some action will be forthcoming to correct all the misconceptions in a clear and digestible format. As a reasonably intelligent person I would offer to write a draft verion if only I could feel confident that I understand it myself!

FiL was diagnosed with Alzheimers 2 years ago and has been on Aricept since then, which we believe has helped minimise the delusional episodes he had been experiencing as well as bringing about a small improvement in his cognitive skills, or at least slowed their deterioration. In truth he has been exhibiting classic signs for several years but as he is a very private and independent man (widowed 19 years) we backed off rather longer than perhaps was wise.

His house is full of unwanted items bought via home shopping over the TV and through telephone and mail solicitations, especially those which carry a prize draw element (when we asked what he would do if he ever won a cash prize he responded "I would give it to you.") As a pensioner he was making charitable donations by DD and SO to the tune of £350 a month, rapidly diminishing his limited savings. Bills were remaining unpaid, he would write out the same cheque several times but neglect to post it, and we discovered that his credit card account was subject to a late payment charge every month last year. He has no clue where his money comes from or what he has in his account even when the statement is in front of him.

And yet if we ever tried to help he would stamp his feet and get angry and say "How do you think I got to be this age?" (91) and "I used to work in the borough treasurer's office, I am very methodical and I know what I am doing!" Finally we had to take over his finances in January before he got into real trouble and he even signed a LPA for financial affairs, although mostly for now we are just operating his account for him via internet banking.

It is not problem-free, however. He insists on carrying absurdly large amounts of cash around with him, typically £500 plus spread throughout all his pockets and when he goes to pay for something in a shop notes fly everywhere - he would be a mugger's paradise. Our local AS have suggested putting limits on the cash he can draw but we are worried that would distress him too much - although he hasn't paid a bill in more than 8 months now and it is abundantly obvious we are doing all that for him he prefers to forget that he is not fully in control.

We decided that we didn't need a solicitor to complete the LPA and I still would say that most competent people should be able to do it themselves. Despite proof-reading it several times, however, I was still notified by the OPG that I have entered FiL's date of birth incorrectly on the application. How on earth could I make such a stupid and basic mistake??? I put it down to stress, which is affecting everything at the moment.

This notification came some months after applying to register it and we were told that either we could provide evidence of the correct dob and they would proceed to register it but with the warning that it might be open to challenge, or we would have to recommence the whole process from scratch and pay another fee as well as wait several more months for registration. We have opted for the former but will ask FiL to sign another application now while he is still competent and only register it if we have a challenge to the existing LPA.

So, a lesson learned there, as well as an embarrassing admission. Having sort of muddled through this one, we are now worrying about the Health & Welfare LPA. FiL is generally fit and healthy and has refused any kind of home help. We live 330 miles away and I am visiting every 10 days to restock the freezer, sort out problems and lift his mood, which inevitably declines when he is on his own. He has agreed to come and live with or near us and is in theory making preparations, but has been doing so for 3 years now so unless or until a crisis occurs it is hard to see how we can effect the move.

Which is what worries us and why an LPA for H&W is on our minds. FiL has recently had dentures fitted to his lower jaw after proudly boasting about having his own teeth for years. Sadly, although we had thought he was fastidious in his personal care, this was not the case and the dentist has confirmed that poor hygiene was the cause. At the moment he is staying with us because a week after his extractions he still cannot manage to fit or remove his dentures without help. They are a good fit and once in there are remarkably few problems, but he forgets they are there, which teeth are real, what to do with them once they are out etc etc.

So far we have had relatively little contact with SS as FiL refuses to even consider any kind of support. I have no reason to believe there would be a problem with them but the fear remains if he ever had to go into hospital that he would not be allowed home and could find himself forced into a care home against his will (he owns his own house so would be self-funding). The only reason we are likely to feel that an LPA is necessary is to safeguard against that possibility, however remote it may be. If there could be some clarity brought to the discussion as to how real this risk is it would be a great help to many people, I feel.

The trouble is that, despite FiL reluctantly signing a LPA for finance and property (reluctant not because of mistrust but because it was in his mind an admission of something he didn't want to admit) he is drawing the line at signing the one for H&W. The form itself is not helpful - the separate section on decisions to be taken in the event of life prolonging treatment etc is rather stark and difficult to discuss in abstract for someone with limited cognitive skills.

We have explained carefully and patiently that unlike the form he has already signed, this one will actually not come into force unless and until he is deemed to be incapable of making decisions himself and only then his daughter would make decisions for him. His response is that of course he would much rather his daughter made decisions for him under such circumstances but he cannot believe that the law would ever allow anything else to occur. The problem is that while he can rationalise things perfectly well right here and now he has little or no ability to plan anything for the future - the concept of things changing is just absent.

FiL has a fantastic GP who has also tried also to explain this but so far without success. Our dilemma now is whether to try and push ahead with this while FiL is still competent to make the decision, or whether we risk upsetting and distressing him over something that isn't really needed.

Sorry this is such a long post but I hope that it might lead to some answers that would help not just us with our predicament but a great many others as well.