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Is it time for care home?

Fiona P

Registered User
Dec 14, 2014
19
Hey - youre not moaning, actually what you are is: worried, concerned and feeling in limbo

I am just going through this now with my dad, he is very much loved and has a team of 4 of us doing all the necessary.
Dad had dementia 8 years, started respite last September 2 x 1 week stints

Masive decline since October steep decline since 28th Dec.

In the space of a month - and this is still a shock to us - he was assessed as no longer able to be at home
The Social worker here has been amazing. The decision wil ultimately be taken out of your hands and it is not you putting him there, the disease is . Talk to SS see what their assessment says. we need to ask ourselves, for dad's safety should he be at home? where is dad better off? in a CH with company or at home with a carer coming in for an hour max? All these things we have had to do in the last month ( less than)

talk to the family, SW and local Alzheimer co-ordinator as a team you will do the best. You are now about to for an alliance of professionals, you are the professional on your dad, SW is professional in care homes and support and Alz Co-ord will be invaluable and think of things you've not thought of yet.

Best of luck
 

sharonbrown

Registered User
Oct 20, 2011
26
Cambridgeshire
You know your father best

Someone who comes to see your dad for a short time every now and then will not know your dad as well as you and your family. I felt quite annoyed on your behalf when I read the community nurse comments. It's a good sign that you're feeling guilty - if you could put your dad into a home without any guilt then there would be something to worry about.

There was a BBC series last year (called Protecting our Parents I think) that was interesting. Most people are frightened of going into a care home - let's face it, the press are only interested in the horror stories, not the happy ones. But many of the elderly featured were so lonely in their own homes and often unsafe. One lady rang for an ambulance several times a day because she was bedridden and wanted to be moved but her husband couldn't do it. When admitted to hospital she was given tests and the specialist consultant said she should not be at home, one reason being that her reasoning skills were poor. The lady didn't realise she was phoning the ambulance so often. However when the social worker came in and asked her if she would be phoning the ambulance all the time if she went home the lady said no she wouldn't, so social worker overruled the expert and said she was OK to go home. As soon as she was at home the lady immediately started phoning for an ambulance again - what a surprise!!!!!!

You and your family know your dad best. You will definitely get to a point where there is no choice and it sounds like if you're not there already, you will soon be. Definitely visit care homes. Get as much info on them as you can from the CQC website but you can't beat an actual visit. Just turn up - don't make an appointment - but to be nice, avoid mealtimes when their staff will be extra busy.

Good luck.
 

marmarlade

Registered User
Jan 26, 2015
183
i have just put my husband into care it was a hard thing to do but i could no longer keep up looking after him all day and then he didnt sleep at nights he would wander round the house putting on all the lights and when he got really tired and wouldnt go to bed he would fall over.Putting him into care has taken all that worry away no i dont want him there but had no choice and you know when to do this. i have had a phone call from the care home this morning saying he had 2 falls in the night they have had the Doctor to him and every thing seems fine .BUT i would have had to get him to our Doctor thats if i could get an appointment so i know he,s safe and well looked after
 

AnneED

Registered User
Feb 19, 2012
80
East Yorkshire UK
Is it still safe for your loved one and are you completely able to cope?

I think that the answers to the two questions above give you the answer as to whether a relative needs to be in a care home or not. My mum has just had a week of respite care for the first time in a care home specialising in dementia near her. When I left her there I burst into tears and it was some time before I was able to sort myself out.

There are two parts to the equation:
1) Is your relative able to remain as safe and well at home, with the support they get, as someone in their situation who is physically and mentally well?

In my mum's case she is reducing how much she drinks and how much she moves about to the point where at some time not too far away she will not be able to stay healthy. She does not wander or leave things unlocked or switched on, but she does not recognise that you need to drink a reasonable amount and move around a certain amount in order to stay healthy. Carers can do very little about this when they call in briefly to provide her with meals.

2) Can you/other carers manage to provide care to keep the relative safe and well whilst remaining well yourself?

In our case there are only 2 of us, both living some way away and both with other responsibilities. I am on a career break at present and that has made me realise just how stressed and struggling to cope I was feeling. When I go back to work I will not be throwing myself back into those levels of stress, so when caring becomes too hard a care home will be under serious consideration as a full time option.

No-one says 'Yes, I'd love to go into a care home' but people do accept a stay away/a holiday/ a convalescence, and if it is the right environment for them then a permanent stay does not have to be described as 'moving into a care home'. I feel that you cannot force someone to go and live somewhere that they hate whether or not you have a P of A - unless they are sectioned. So the aim is to find the right place, to get some sort of agreement to visit for a stay, however that is achieved, and then make sure that you have done everything in your power to make it work - as others have said, checking CQC reports, checking out how friendly it seems, making sure your relative is well cared for there and that it suits their life.

It's really hard but the sooner you start looking into it, the greater the chances of doing the best job and making it work.
 

Roseylee

Registered User
Sep 24, 2014
25
Hi Lexie, we went through this with my Mum for the last 6 months of last year. Mum was not eating, then trying to eat raw ready meals and putting them back in the fridge half eaten. She had a fixation with keys - always checking she had them, then hiding them. We had a keybox fitted on the outside of her house, but the one time the carer needed to get in in a hurry, she couldn't because Mum had put a key in the inside of the door. We tried carers visiting but frankly, for the times they attended, it just wasn't enough and no one knew what she was getting up to for the rest of the time. My sister and I live 70 miles away, so we were dependent on neighbours, and the carers keeping things sorted on a day to day basis. It wasn't really any way to live for any of us. Things came to a head in November, where she went into hospital because she had a D&V bug, and she only weighed 6 stone. While she was in there, she had a UTI, a fall, and a bleed on the brain. Enough was enough. When we considered it, Mum's safety took over. We looked at care homes near my sister in Kent, and Mum moved there in January. She is warm, happy, well fed, well washed. She has company all day, there is a GP which visits. Ironically, she always never wanted to get old, she never wanted to end up in a care home, as that was for "old people". But due to the nature of the disease, we have found it quite easy to move her there. She has never asked I am in a care home, she just seems to enjoy everything about it, almost as if she knows now in her own little way she needn't worry about anything apart from enjoying her life. We got POA done (just financial) last year before things got bad and really glad we did as my sister and I have now got everyone dealing with us. Much easier - especially as we now need to sell her house to pay for the care. Good luck and it will get easier.
 

Aries

Registered User
Jan 13, 2014
6
Hi, Only a month ago my sister and I had to make the decision to keep my mum in the care home where she had gone for respite. It was such a difficult decision and one I felt more because I cared for my mum as much as I could while she lived at home. She had carers coming in every day but once they had gone she would be on the phone to me consistantly saying she wanted to go home, even though she was in her own home where she had lived for 60 years. That was not all there were a number of things including a nasty fall 18 months previous and other minor falls, and I was worried there might be the one time when she could fall in the middle of the night and be lying there until morning on her own. Mum had been going to day care at this home in the hope that she would remember it when the time came for her to stay permantly. But her memory is so short even today she still didn't know where she was and didn't understand why she was staying there, I struggle with this but have to keep telling myself it is better for her to be safe, warm and well looked after in a lovely residential care home which is a five minute drive from me instead of a good half an hour away where she used to live. I didn't want to wait for the disaster in the end and hope that one day she might be a bit happier to stay at the home but at the moment I still tell her she will be going home tomorrow. Good luck with your dad, I totally understand what you are going through.
 

Rosie56

Registered User
Oct 5, 2013
75
Hi Lexie, we went through this with my Mum for the last 6 months of last year. Mum was not eating, then trying to eat raw ready meals and putting them back in the fridge half eaten. She had a fixation with keys - always checking she had them, then hiding them. We had a keybox fitted on the outside of her house, but the one time the carer needed to get in in a hurry, she couldn't because Mum had put a key in the inside of the door. We tried carers visiting but frankly, for the times they attended, it just wasn't enough and no one knew what she was getting up to for the rest of the time. My sister and I live 70 miles away, so we were dependent on neighbours, and the carers keeping things sorted on a day to day basis. It wasn't really any way to live for any of us. Things came to a head in November, where she went into hospital because she had a D&V bug, and she only weighed 6 stone. While she was in there, she had a UTI, a fall, and a bleed on the brain. Enough was enough. When we considered it, Mum's safety took over. We looked at care homes near my sister in Kent, and Mum moved there in January. She is warm, happy, well fed, well washed. She has company all day, there is a GP which visits. Ironically, she always never wanted to get old, she never wanted to end up in a care home, as that was for "old people". But due to the nature of the disease, we have found it quite easy to move her there. She has never asked I am in a care home, she just seems to enjoy everything about it, almost as if she knows now in her own little way she needn't worry about anything apart from enjoying her life. We got POA done (just financial) last year before things got bad and really glad we did as my sister and I have now got everyone dealing with us. Much easier - especially as we now need to sell her house to pay for the care. Good luck and it will get easier.
Roseylee, how did you manage to get her to the home? Like you I live some distance away from my mum and have only financial POA and I'm getting frightened about this. I worry about scenes in which I'm trying to coax her into the car and she won't go, and I have no legal right to get her in there, and it just drags on and on. What actually happens when Social Services decide someone should only be released into f/t care? Do they arrange transport? I would like Mum to come near to me so that I can visit her and there is a really good dementia unit here but I know she won't be fooled by the idea of a 'holiday' or anything like that.
 

Solihull

Registered User
Oct 2, 2014
97
West Midlands
Hi Lexie, I think everyone on here is trying to tell you something. SS, GPS etc will not take over and make any decisions if the "good daughter/son/spouse" etc is eager to help. Believe in your judgement and take over. You will need to tell a few white lies but if you don't think your Dad is safe there is only one option. This all happened with me & mum and six months on she is happily settled in a care home. Yes, you will feel guilty but it really is the kindest thing to do for them
Take care.
Sue
 

horse

Registered User
Jun 24, 2012
2
I managed to set up care for my mother to enable her to stay in her own home, a sheltered housing flat. It involved constant badgering of the care providers to cater for my mum's own needs and keep her safe. I was determined she should stay at home for as long as possible even though I live 3 hours away from her. On News Years Eve I got a phone call from the police saying they had picked my mum up in the centre of Camberley at 1.30am wandering around. It was obvious that it was no longer safe for her to live on her own. I'm still in the process of trying to get some funding towards the cost of my chosen care home for home. It's not an easy process and I sympathise with you.
Good luck.
 

London girl

Registered User
Jan 2, 2015
3
Thank you for all your comments, they do help, especially when so many have had similar experiences.
I think me and my sister will start looking at care homes with a view that if things carry on deteriorating, we have options. One thing that worries me, we have PAO on money but not health, does that mean that if he refuses to go to care home we can't make him?
Re your question about not having a POA on health - I am not sure anyone with Dementia is really able to say when they are ready for a care home. We have to make those decisions for them. Do go and visit some care homes - you must meet with the manager of the home and talk through these issues. Talk to as many people as possible generally - there must be people at AGE UK and the Alzheimers Society who can help. I used to live 2 and half hours drive from my mum. If I had lived round the corner from her, I don't think I would have moved her to a care home when I did. I started looking at care homes over a year before she moved. I must have looked at 10 homes. Re your community nurse - my mum always presented very well to strangers. You are best placed to make these decisions taking into account all the facts and circumstances.
It's good you are using this forum - it can be a lonely time (but very time consuming) making all these decisions. I didn't have the issue of the POA so made the decision myself. My mum had no idea she was going into a care home. I even packed her case without her knowing and she thought she was just going out for the day. It's very difficult, I appreciate that.
 

Juliekaine

Registered User
Nov 24, 2012
2
Difficult decisions

and what wonderful advice, this forum is so uplifting in times of real dire needs.
I think you have to ask yourself the overriding question, is my Dad safe? If you honestly think not, it is time to act in your father's best interest as his children (now the parent) and as his PoA.
A period of respite might be put in place just for a week or so if you can find an appropriate place. When my dad found himself ina. Similar situation, we too arranged for 4 carers visits a day and me as 5th! Key safe, yes a good idea, Lifeline around neck but he took it off on a regular basis and was still driving at 85. At his request, we all sat down over a cuppa and discussed the situation fully, with respect and a cuppa. So easy to make decisions for someone not with someone, emotions are running very high I expect and you feel at your wits end.
So maybe a family discuss with your siblings and dad, you never know, he may in fact be relieved and less anxious. Good luck.
 

Carrie Anne

Registered User
Sep 7, 2011
67
Wiltshire
After Christmas my mother's condition deteriorated substantially. She was wandering off looking for for'home', phoning me several times an evening asking me to come and get her as she had been dumped in the middle of nowhere ( her front porch usually), she was hallucinating, imagining small children in the house who had been left with her. When I stayed over at night on the particularly bad days, she was wandering about,teetering on the top of the stairs with not a clue where she was.

I found that when we had reached that stage the system kicked in quite well. I phoned her doctor and told him mum needed to be in a care home and could he help me. I took her to see him for 'an annual check up' and he suggested to her that she herself was healthy but her memory was very poorly, she needed a rest to recharge her batteries. After phoning her CPN she came out to see mum the day after and was shocked at the way Mum had gone down hill, she insisted that she needed 24 hour care. I phoned social services for the first time who were very supportive even though mum, being self financing was not eligible for their hands on help. They certainly gave me confidence I needed to get through it all. That afternoon mum was assessed for my 'top of the list' care home. Sadly they came back to me first thing next morning and said that mum would not be suitable for their 'specialist dementia care home' (!). I phoned number 2 on my list which was an hours drive away, said it was an emergency and could I bring mum over for an assessment. They said they had a room, so I reminded my Mum what the doctor had suggested and said we were going to look at a place. By 3 that afternoon I left mum there eating a sandwich in the care of some lovely carer.

I don't feel particularly good about any of this, mum is not happy, but she was lonely, miserable and frightened at home alone. She has been there for 3 weeks so far. I never thought I would have the nerve to do this, having read about other families experiences but there comes a time when your options just run out.
 
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wisdomlearner

Registered User
Jul 1, 2014
1
Newe Zealand
I think that the answers to the two questions above give you the answer as to whether a relative needs to be in a care home or not. My mum has just had a week of respite care for the first time in a care home specialising in dementia near her. When I left her there I burst into tears and it was some time before I was able to sort myself out.

There are two parts to the equation:
1) Is your relative able to remain as safe and well at home, with the support they get, as someone in their situation who is physically and mentally well?

In my mum's case she is reducing how much she drinks and how much she moves about to the point where at some time not too far away she will not be able to stay healthy. She does not wander or leave things unlocked or switched on, but she does not recognise that you need to drink a reasonable amount and move around a certain amount in order to stay healthy. Carers can do very little about this when they call in briefly to provide her with meals.

2) Can you/other carers manage to provide care to keep the relative safe and well whilst remaining well yourself?

In our case there are only 2 of us, both living some way away and both with other responsibilities. I am on a career break at present and that has made me realise just how stressed and struggling to cope I was feeling. When I go back to work I will not be throwing myself back into those levels of stress, so when caring becomes too hard a care home will be under serious consideration as a full time option.

No-one says 'Yes, I'd love to go into a care home' but people do accept a stay away/a holiday/ a convalescence, and if it is the right environment for them then a permanent stay does not have to be described as 'moving into a care home'. I feel that you cannot force someone to go and live somewhere that they hate whether or not you have a P of A - unless they are sectioned. So the aim is to find the right place, to get some sort of agreement to visit for a stay, however that is achieved, and then make sure that you have done everything in your power to make it work - as others have said, checking CQC reports, checking out how friendly it seems, making sure your relative is well cared for there and that it suits their life.

It's really hard but the sooner you start looking into it, the greater the chances of doing the best job and making it work.

Thank you, AnneED,
This is my first attempt to write in this Forum after lurking gratefully for several months. I am caring for my husband of 41 years of which the last two have been challenging after a stroke and now vascular dementia.
He is reducing what he drinks, and even though I'm with him 24/7 (three two-hour breaks per week courtesy of the NZ Health system) I'm not sure he is doing as well as he might if he was with someone else/in care. So that is my response to your first point.
And that is related to the second point. I am very, very tired. I don't really know how long I can keep going with an increasingly complex and demanding life-style and responsibilities.

I have visited five care-places now. None of them is right, but some have less problems than others. I think this process will go on for a while and gradually (or maybe suddenly) it will become clear..

However, I'd like to thank you for making these two considerations so very clear...
 

clareglen

Registered User
Jul 9, 2013
318
Cumbria
The simple answer is Yes. We are all so horrified by the media reports of bad care homes it puts us on high alert, but if you find the right one it is marvelous. I looked round at 7 for my mum who was in hospital & causing mayhem & they couldn't keep her safe there either. I had her in respite 3 times at 2 different homes over the last year, but I wasn't keen on her being in either permanently. She was turned down by an EMI home for being too bad for them but I moved her from hospital (so no leaving home issue) to a lovely small care home, even though EMI home said she needed nursing home, and it's the best thing ever. There are good homes out there. Yes there is the guilt, but at least it shows we care. She has much better company even though she's never been a 'mixer'. Mum is self funding so I had a social worker to support me/sounding board, but I did it all on my own, as I had been doing everything for her 24/7 for years & didn't realise how bad she was. Mum has been there since October & the home are very proactive regarding medical issues etc & I've never had a bill yet. Owner keeps saying she'll get round to it. :)
 

Purplehelen

Registered User
Dec 28, 2013
1
Is it time? Guilt?

Totally agree with herbaltea. Look carefully at homes and try not to feel guilty. You will get your life back and be safe in the knowledge that your parent is secure and cared for. The guilt feeling is enormous but if you pick the home carefully, your parent will be happy in their own way and you will gradually come to accept that. It is not easy. Remember always that you have their safety and well-being at heart. Good luck!
 

Danelover

Registered User
May 2, 2013
14
Different situation , still brought me to my knees

Hi,
I lived 2 hours away and was like a rabbit in headlights after years of helping Auntie then mum. I didnt know mum had Dementia .
My lovely brother left his wife and moved in with mum....... things came to a head and cos she couldnt look after herself, full of hard stool, she had a rectal prolapse ( bottom fell down )and became doubly incontinent whilst being totally mobile (v tricky to deal with.)Needed 6 bottom washes a day.
Brother worked abroad, I booked a patchwork of live in carers and week blocks of respite care near me and wore my self out on all levels.
Begged her to go into nice care home she had had 4 separate weeks of respite , she couldnt see why, (I was a woman on the edge the anti depressants saved me 3 years later).
took her to 1st care home, needed to leave after 3 years as was going out in the night.
Moved to 2nd dementia home a year ago. Awful for both of us (hell for me )as I couldnt really prepare her. Many tears from both on the day. But..... she settled, doesnt remember the past few years at all. Yey, I have let go of the guilt and go to do all the daughtery things , the list is very long.... I'm Off the anti depressant pills for the time being. She is very upbeat. Many talks with excellent manager to wash clothes properly and more ( I wash her jumpers) I still get v angry with her (poor little soul) I hate being told to put a coat /gloves/hat on etc ...Grrr
The staff are amazing and I pop in 3 times a week. I constantly thank them and also chivvey them , I dont care if I am popular ( gone past that )but I let them know I understand their job is v v hard....they forgive me for nagging .
So....Advice , trust yourself. I was shocked I had the power to essentially put mum in a home before a real crisis , she lost keys once and needed operation once but I couldnt manage her at home any more, I was going down hill fast !
I guess people go to care homes either a little too early, just at the right time or a bit" late" as it were depending on circumstances.

but we got there.. phew , but I still wrestle with my anger (grief at my lovely mums decline ) at most trips out
 

lizzybo

Registered User
Jun 6, 2014
5
Time for care

My mum has Alzheimer's, we have thought a lot about ' when the time comes' and have been putting it to the back of our mind. Dad does very well looking after her,but he recently became ill, along with major surgery for myself, we decided to put mum into a care home for respite for 11 days. It was an extremely difficult decision for my dad in particular, but mum settled very well. The staff were excellent giving stimulation with music sessions and cookery clubs and general conversation. Dad recovered and mum was so much better when she came home, it was like a holiday for the pair of them. I know it is a very difficult decision, but when the time comes we will not be so scared of putting mum in a home as I truly believe she will be comfortable and well cared for, safe and as happy as she can be.Guilt is a very big part of carers feelings but when you know your loved one is well looked after it allows you to continue your life and that of your family's more freely and with a certain piece of mind.when you make the decision I believe everyone's quality of life improves as you are mentally able to contribute more positively to everything, which can only be a good thing.
 

Chris Lancs U.K

Registered User
May 18, 2013
5
Guilt

The biggest hurdle I had to overcome was my Mothers fear of Nursing/Care homes ,she used to say when I mentioned about going in one that you go there to die and shouted at me for mentioning it,this was when she was in the middle stages of Dementia when she was about 85,eventually after a fall and fracturing her hip I had to do just that after a stay in Hospital ,it was terrible, I lost her two years ago in February aged 89 and blame myself to a degree as she might of given up hope,she couldn,t talk or swallow her food in the end and was wheelchair bound and went very thin.
 

canary

Registered User
Feb 25, 2014
13,685
South coast
Hi Chris, nobody wants to go into a care home. I doubt that there was ever a person with dementia who, when asked if they wanted to go into one replied "oh yes, of course, it will make life so much easier for you and will keep me safe"

However, the plain fact of the matter is that eventually the care required is usually more than one person can give - however much they want to.
The things you describe - difficulty with swallowing, inability to speak, loss of mobility - are all symptoms of end stage dementia. I very much doubt that there was anything you could have done to change the outcome.

Be gentle with yourself.
 

Roseylee

Registered User
Sep 24, 2014
25
Roseylee, how did you manage to get her to the home? Like you I live some distance away from my mum and have only financial POA and I'm getting frightened about this. I worry about scenes in which I'm trying to coax her into the car and she won't go, and I have no legal right to get her in there, and it just drags on and on. What actually happens when Social Services decide someone should only be released into f/t care? Do they arrange transport? I would like Mum to come near to me so that I can visit her and there is a really good dementia unit here but I know she won't be fooled by the idea of a 'holiday' or anything like that.
Hi Rosie,
Mum spent 6 weeks in hospital last year, and was in there all over Christmas. We had spent many anxious hours on the phone late summer of last year taking phone calls from passers by, paramedics, neighbours as my Mother went from one issue to another, thinking she was having a heart attack, and on the third visit to hospital in 4 weeks she actually was, not eating properly, loosing weight, loosing things. Carers of 6 days had proved diabolical not making sure she was dressed, or watching her eat anything so that added to our cause as we had tried the carers at home route. Eventually she went in in November weighing 5st 13lbs with a D&V bug and her AD got worse while she was in there, only able to ask 3 questions on a continuous loop when we visited....1 How was your journey? 2. how are the children? 3. How was the traffic, before she went round them all again. It was draining....a 2 hour drive for an hours visit with the 3 same questions over and over again. When she became "stable", and I mean "stable" from a medical point of view (and even that was a small window as she had had a urine infection, a fall in hospital and a bleed on her brain) the hospital social people visited her. They knew they had to do something with her, and as a family we had made the ward staff very aware we didn't want her discharged home as we mentioned it every time we went in there. The SW assessed her as having "complex physical needs". We had already told the ward and her consultant that under NO circumstances should she be released back home, and frankly I think they saw that as she had been in 3 times August to September finally with a heart attack, then again November to just after Christmas, they knew if they sent her home, she would be back in again with weeks, and they didn't want that. We basically mentioned it every time we phoned the ward, every time we visited the ward and every time we spoke to her consultant. So we looked at homes near my sister, and found a nice one. We got a phone call from the Social Worker, (as she knew from the ward staff of our intentions) and did it all from there. In the end the ward tried to get rid of her very quickly, but we dug our heels in as we needed to get clothes into the hospital for her to make the journey in and so said NO, they would have to wait until we could get her a decent outfit to the hospital to travel in, or otherwise they would have just sent her off in the hospital gown. The SW was supportive of this. Also like you, we knew to put Mum in our car and to drive her to the home would be a no-go due to the stress it would cause everyone, and she trusted the medical staff, so we asked them to organise it. We thought she would go by private ambulance, but she actually went by hospital car. But even the night before she left the hospital we were phoned up and asked to pay for the private ambulance!!! We actually refused point blank and said you need the bed, you pay for it. And she was being moved from one NHS authority to another anyway, she wasn't a private patient. The SW said we shouldn't have been asked to pay. Even then when she turned up at the care home the hospital didn't even send her with any medication and the manager had to get the locum GP to organise an emergency prescription. So, long story short, it was easier for Mum not to go home from hospital but straight to the home, that way she just thought it was another branch of the same thing, and she had been institutionalised for so long in hospital, that made things slightly easier. I think you need to speak to the SW as it is in everyone's interest if she moves to a home near you, and they are the people who know how to make this happen especially if it is between local authorities. We didn't have the Welfare POA but this was never an issue because everyone at the hospital knew that full time care was the safest option for Mum. The solicitor said when we did the financial POA that it boiled down to the fact that if Mum was happy for medics to make decisions on her medical care, then there was no need for the Welfare one, and if as a family we were happy for the medics to make decisions that were in Mum's best interests then again the welfare one wouldn't be much use. It would only be useful if we had specific medical views (like on religious grounds that may conflict with a Dr's viewpoint). Mum had also done a DNR which they would take into account and the solicitor said that was good too as there would be no conflict of opinion should that come into play. Hope all that helps. :)