POA: 'Best Inerest' vs loved one's wishes

helenm250

Registered User
Jul 22, 2015
9
Having complied a rather long message in my head, instead I'll cut to the chase.

Does anyone have any experience with regard to being challenged on a decision they've made under an LPA?

The situation in brief:

MIL has always been financially incompetent (she hasn't opened a bank statement for at least 10 years).

Financial LPA executed last year (hubs and his sister). Registered by hubs and in action.

Applying now for H&W LPA (although it may be too late, we'll see what MIL's solicitor has to say).

MIL lived in her house for 30 years. Utterly refused any help, even a cleaner. Totally dependent on others to get her out of the house, even to do food shopping. For the last few years in the house, increasingly nervous of using the cooker (she probably hasn't actually cooked a meal for three years or more and stopped even heating soup over a year ago). She went from a size 16 to size 12 in two years.

Won't use the washing machine unless there's someone else in the house. Increasingly unable to use the central heating thermostat. For several months, would try any ruse to stop people fro leaving after a visit.

She has never had any hobbies; never learned to drive, never reads, even a paper, doesn't do crosswords or other puzzles, has no interest in socialising, converses pretty much solely with family plus a few people like her visiting hairdresser and long term chap who did the garden (also did odd jobs, and has been ripping her off for years). Constantly worried about her vast selection of long term medications (most of which she's been taking for 20 years since her husband died). Spent most of the time sitting in her chair doing nothing, then spending hours making repeated phone calls to her sister ('I haven't spoken to anyone all day and I've only eaten banana sandwich') the hairdresser (who stopped taking her calls and wants nothing more to do with her) the neighbours (they stopped taking any calls in the evening in case it was her) us and her daughter. Clearly frequently distressed, and adamantly refusing any assistance in relieving the distress. Unfortunately, she is also very self-centred, very stubborn and incapable of consequential thought. If there is a conversation that doesn't suit her, she will change the subject. This is not the dementia, simply her character.

Her replacement hip broke last July. She was in hospital for 6 weeks and we had to fight the consultant to ensure she got a replacement (she's 81 and healthy apart from dementia). She's now fully mobile but has become psychologically dependent on using a 3-wheeled walker, an because she hasn't regained much strength, needs a wheelchair if we take her for much of a walk.

She went for 'respite' to a lovely care home in September - absolutely without question the best place for her. She's well fed, has company, doesn't have to worry about her medication, is warm, doesn't have to do her own washing.

There is absolutely no doubt in the minds of anyone who cares for her that she is better in herself, infinitely better nourished, and in better spirits that she had been for at least a couple of years before the fall.

But she wants to go home.

Financially, and she is self-funding, her savings will last for about another year. So the house has to be sold, and the process has to begin fairly soon to ensure continuity of available funds. What we cannot do is wait any longer, because if for any reason she does go home, then there will have to be sufficient funds available to keep her going for as long as possible thereafter, unless a mortgage is taken on the house - not ideal.

She absolutely refuses to sell the house (the implications of the LPA have never really registered, and wouldn't have done even before the dementia).

Hubs takes extremely seriously the requirement under LPA not to dismiss the wishes of his mother simply on the basis of her decision being different to his, and being, in his opinion, the 'wrong' decision. In reality there is no-one who would challenge him if he simply told his mum she's not going home and he's selling the house. But it feels so damned harsh!!!!!!!

As far as we can see, there is no legal definition of 'best interest'. We have started the process of telling MIL firmly that she won' t be able to cope at home (her previous network has broken down due to the fact that her sister is in ill health, and the previously friendly neighbours have a serious health problem within their own family and are totally out of the picture). We have moved from London to Lincoln to be closer to her, but have commitments that take us away for weeks at a time. This would mean she would not be able to get any shopping, go out for a coffee, do any form of shopping apart from when her daughter comes to visit, which is once every three weeks.

Despite numerous attempts to discuss the matter, she cannot put together any kind of realistically strategy (how would you get your shopping in - you didn't manage on your own before the fall?' 'Well I'd manage, I'd HAVE to manage'....but no ideas on how!). However she informed her sister yesterday that she was going to sell the house and move to a bungalow. This is the house that she'll NEVER sell, and from a woman who hasn't been able to use her cash card for over two years, because she can't remember the number.

Oh dear, it's turned into a rant, hasn't it? Sorry. Point is, even with LPA, how do you stop someone from going home, without explicitly going against their wishes, which is equally explicitly against the terms of the POA? The care home suggests that we take her home and leave her there for a couple of days, but we feel that's a little cruel, as she really couldn't cope and all her fears would come back.....plus we'd be willing her to fail. Plus the fact that once she does return, we would have no chance of getting her to return to the home, because no matter how unhappy/anxious/lonely she was, she really is very stubborn.

Anyway, hopefully the question is reasonably clear, in amongst all this waffle! Any thoughts/experiences/advice gratefully received. Thank you xx
 

Beate

Registered User
May 21, 2014
11,830
London
To be honest, I believe you're overthinking this. Stop agonising, you know in your heart she is best off in the care home. Once she is mentally incapable of weighing up the pros and cons of a decision, the attorney has to take over and act in her best interest. The best interest is clearly the care home. Everyone wishes to be in their own home but I believe you have to exercise tough love now. Stop endlessly discussing this with her, just go ahead and do it. You'll only distress her by keeping her in the loop. It would be much kinder to use love lies along the lines of her recuperating a little longer in the home on doctor's orders. As for taking her home for just a few days - don't even go there. It'll confuse her no end. The thing is you know all this already, right? Time to act on your instincts. It's commendable not to want to dismiss someone's wishes but stop feeling guilty - she doesn't seem to be capable of living on her own anymore.
 

helenm250

Registered User
Jul 22, 2015
9
To be honest, I believe you're overthinking this. Stop agonising, you know in your heart she is best off in the care home. Once she is mentally incapable of weighing up the pros and cons of a decision, the attorney has to take over and act in her best interest. The best interest is clearly the care home. Everyone wishes to be in their own home but I believe you have to exercise tough love now. Stop endlessly discussing this with her, just go ahead and do it. You'll only distress her by keeping her in the loop. It would be much kinder to use love lies along the lines of her recuperating a little longer in the home on doctor's orders. As for taking her home for just a few days - don't even go there. It'll confuse her no end. The thing is you know all this already, right? Time to act on your instincts. It's commendable not to want to dismiss someone's wishes but stop feeling guilty - she doesn't seem to be capable of living on her own anymore.
Beate....nail....head....thank you. Hx
 

lori107

Registered User
Nov 4, 2014
45
Best interests, but whose?

Hi helenm250

I really can relate to your situation.

We have the same problem with fil. He is also registered blind, has dementia and recovering from a broken hip last October. We found a lovely care home for him which he is still in but all he goes on about is going back to his flat where he lived on his own with carers 1hr in the morning and 1hr in the evening.
In the home he has everything done for him, no frantic calls about the washing machine not working etc which is what we had to deal with on a daily basis. He has entertainment and a gardening club there, all of which he enjoys but he doesn't stop going on about going home. Hubby has both poas and we decided to get him assessed by ss even though he is self funded to put a stop to him going home. He is in so much danger going back to the flat, he doesn't know how to turn the oven on or off but when the SW came to assess him he told he cooks his own food, and needs only a little help. In the care home he needs help going to toilet, he doesn't know to remove his clothing when he wants to go but again he told the SW that he didn't need any help with any of this. He also told her was never diagnosed with dementia (he was, 2015) or that he doesn't have much trouble with his eyes and she has believed every word. She told us he had capacity to decide where he wanted to live (even though he denies that he has anything with him) Hubby Has disputed this and a best interests meeting is arranged for 15th March. We are furious as everyone knows he could not manage living on his own (he also told the SW that he had ladies waiting at home for him to come back so they could look after him, which is complete rubbish ) SW did mental capacity test on her own with him with no other carers or specialist people there to corroborate. She also did not ask for any information from the care home manager. He wouldn't even be able to get to his front door as there are 3 steps down to it. Hubby took him back to the flat a few weeks ago but I didn't think it was a particularly good idea and it wasn't.
My advice, stick to your guns with social services, write notes about everything she cannot do on her own, what is a danger to her in the house that at she has no awareness of, that's what we're doing for Tuesday. Also tell them she is a vulnerable elderly lady and that you will not be involved in setting up any care in order for her to return home. It's tough love, but so necessary. I wish you good luck, Lori x
 

Chemmy

Registered User
Nov 7, 2011
7,592
Yorkshire
Wanting to 'go home' is very common, but it's clear that this would not be in your MIL's best interest.

So I agree with what Beate has suggested. Stop discussing it with her and use 'love lies' if necessary. Never say never, but just redirect the conversation if it arises.

It reminded me of my son's first day at a new school, aged 7. I asked him how he got on. OK, he said, but I don't think I'll go back tomorrow. Needless to say, he was overruled too :)
 

Shedrech

Volunteer Moderator
Dec 15, 2012
8,442
Yorkshire
Hi helenm250

I think you have written this post to simply get things straight in your mind. You now know the answer; and here's the key:
She went for 'respite' to a lovely care home in September - absolutely without question the best place for her. She's well fed, has company, doesn't have to worry about her medication, is warm, doesn't have to do her own washing.

There is absolutely no doubt in the minds of anyone who cares for her that she is better in herself, infinitely better nourished, and in better spirits that she had been for at least a couple of years before the fall.
and yes I am ignoring the 'but' that came next because, with all due respect, it is not pertinent.
Your MIL cannot go home - it's that simple.
She may want 'to go home', however you and more significantly, your husband both know that she can't cope and you are probably aware that she isn't really asking to go back to that house or any real house - what she wants is to go back to WHEN she was able to cope at home

Please show your husband your post - his duty as Attorney is to do what is best for his mother (never mind any legal definitions) - notice the section of the quotation I've bolded - if there is 'no doubt' then what he must do is enable her to stay in her care home
that means selling her house (it's no longer her home) and not bothering her with any further discussions so she can fret less - if she brings up the subject just answer neutrally and change the subject
if there is 'no doubt', then no-one will even consider challenging this decision.

my dad is in a care home - he has at times yelled to go home, said he'd walk there if I won't take him in my car - home has been his childhood home and also just somewhere, he'll find it "when 'they' let me out" - and when he was at home with me there he'd ask where he was - I've no doubt no-one will challenge my decision

it's a horrible position to be in but basically the decision is made, your MIL is safe, your husband has to let go of any other thought than that he's doing what is best, and then get on with it

I wish you all well

PS my gosh so many other responses whilst I was typing - question answered
 
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Delphie

Registered User
Dec 14, 2011
1,269
Once someone has lost capacity to make the right decisions to keep themselves safe, someone else has to make those decisions for them. Very few people, once dementia takes hold, agree that they need help or that residential care is just the ticket. They feel they're coping, they feel that they're fine, they can't remember all the times they've run into problems they can't solve. So when someone is no longer safe at home, it's in their best interest to be looked after, to be in care. It may not reflect their wishes but their wishes have no roots in reality.

Their wishes, even previous wishes must still be considered when they can be of course. I'm a Deputy for my mum and an aunt-in-law and if at all possible I do what they would have wanted. My mum, for example, has a number of properties. One in particular was always very special to her and she said that she'd never sell it, that it must go to family after she dies. I have structured her finances in such a way that this property will never be sold on my watch. I did it because, although I've had a fair bit of hassle, I could and know that this is what she would have wanted. She is, however, in residential care, and I know that it's something that she never would have agreed to, but she wasn't safe at home and wouldn't accept any help, so that's one wish I couldn't accommodate.

It's a balancing act, but some decisions simply aren't negotiable.
 

Bod

Registered User
Aug 30, 2013
1,210
"I'm fine."
"I can manage perfectly well!"
"I do all my own shopping/cooking."
"There's nothing wrong with my memory, I well remember the day war broke out. Now where's my glasses?"

Hands up all those who have had this conversation, whilst looking around at the actual situation.
There comes a time when the best care we can give, is not at home, but in a Home.
We may not like it, they certainly won't agree to it.
But after settling in, it was a move for the best, for everyone.

Bod
Whose hand is up.

Above is a copy of a post I made a while back, in response to a similar thread.
Your position is not uncommon.
 

canary

Registered User
Feb 25, 2014
11,278
South coast
If you have POA/CoP deputyship then, yes, it is important to consider the wishes of the person you hold this for, but that does not mean that you have to do everything that they want. You do things that they want as far as is possible. The deciding on Best Interest is like dealing with a small child. Yes they can have an ice-cream and they can choose which shoes they would like, but no, they cant go to the park on their own as its not safe.
It doesnt sound as though its not safe for your MIL to be at home anymore, so what would be in her best interest would be to be looked after in a care home.
Moving someone into a CH is a big step, however, and usually accompanied by a (unjustified) feeling of guilt and I wonder if your husband is having trouble coming to terms with this and maybe he is worrying about the wording of the POA in an effort to put off the decision?
 
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Bessieb

Registered User
Jun 2, 2014
108
Hi there,
I have also been there agonising about a decision - knowing it's in the best interests of the person (or in my case people - my parents) you are making it for but knowing it is against their wishes.

To help me making the decision I asked the GP to do some capacity assessments and document them so that I was reassured I was doing the right thing and if I was ever challenged on the decision I would have something to go back to. In reality I was never going to be challenged on the decision - all of family were supportive - and there was no way my parents could go back home from the CH. But I needed to see it written down by a professional.

The capacity assessment formally wrote down that my parents were not able to weigh up the implications of a return home and so the attorney (ie me) needed to take a best interests decision.

This is what you and your OH need to do...I had all of the 'I'll manage' 'We'll be OK' conversations but in reality when people can't manage, they can't manage and may not be in a position to recognise this themselves.

Good luck with it...but I think you know what the right thing to do is