1. Marinajane

    Marinajane Registered User

    Feb 25, 2018
    54
    i have been told by the nursing home that because I don’t have lasting POA health and welfare I am not allowed by law to see his care plan. I feel heartbroken that I, his wife, who vowed 40 years ago to love and cherish him in sickness and health am now so powerless that I can’t even see his care plan. I do trust that he will be looked after according to a proper plan but it feels so hard to be so shut out by the law. Has anyone else had this? 10 years ago we thought we were being sensible and took out enduringPOA s but now they are not valid for this.
     
  2. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    2,685
    Nottinghamshire
    This doesn't sound right to me. I drew up my dad's care plan for his home care with the carers. How can it be so different in a home? Surely you are the one who knows him best and should be involved.

    I have the new POAs for dad but dad had the old one for mum and I don't remember him having any problems with the care home.

    Hopefully someone who knows the care home system will be along soon with some useful advice.
     
  3. love.dad.but..

    love.dad.but.. Registered User

    Jan 16, 2014
    4,364
    Kent
    #3 love.dad.but.., Jul 20, 2018
    Last edited: Jul 20, 2018
    I had poa health for dad in his NH but several wives of residents I got to know didn't have poa health and they were treated with the same respect in terms of inclusion and involvement as their spouse. This feels like an individual NH decision and taking their interpretation of the law too harshly and I would strongly challenge it with the manager...if your OH lacks mental capacity who do they think will speak for him? Did they take all the admission information from you in terms of his physical health etc? If so...to shut you out now doesn't make sense to me.
     
  4. Singing Friend

    Singing Friend Registered User

    Nov 5, 2014
    26
    London
    I have enduring POA for my mum - she did it years ago when we were discussing what might happen to the farm if she had a stroke or something. We didn't think about dementia! Anyway the care home was happy to accept it, and share her care plan not only with me (I'm the only person with POA) but also the rest of my siblings. It probably helped that my mum was able to say when she moved in that she is happy for all of us to know.

    Although it doesn't specifically cover health and welfare, it does say that I have the power to deal with "all finance, property and personal affairs". I would argue that where she lives, and how she is cared for is definitely a "personal affair".
     
  5. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,693
    Salford
    I've never had a problem seeing my wife's care plan without having a POA, I helped fill it in.
    Basically though it doesn't say very much apart from the obvious and if you read other people's care plan they all seem to say the same thing from what other visitors have told me.
    The home just state the obvious that they're going to look after her, be attentive to her needs and all that corporate rubbish, there is no "plan" as such, how can you plan for someone with AZ?
    Has anyone ever seen anything apart from a DNR or treatment of some specific issue in a care plan that anything other than a lot of platitudes?
    You can't plan what someone will be like tomorrow, next week or next year, the plan is "there is no plan" a good home adapts to the changing needs of someone with AZ rather than trying to manage someone who is basically unmanageable.
    Honestly I don't think you're missing anything not seeing it and if it's anything like the ones I've seen then they're probably too embarrassed to show you what a load of meaningless rubbish they are.
    Maybe other people have had a different experience but my wife's is mainly just background stuff on her life which I know anyway, her per-existing medical conditions which I know too and how the home are going to looks after her and adapt to her needs. There is some bits about how the nurses and the activities coordinator perceive the way she presents...tell me something I don't know.
    K
     
  6. try again

    try again Registered User

    Jun 21, 2018
    270
    What ever happened to next of kin?
     
  7. witts1973

    witts1973 Registered User

    Jun 20, 2018
    600
    Male
    Leamington Spa
    I worry about this being a problem in the future I care for my mother and have the property and affairs POA and the solicitor said at the time 10 years ago that we didn't need the health one
     
  8. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,693
    Salford
    There's a certain logic in that, in so far as a solicitor may charge hundreds of pounds for a financial POA which is massively important to deal with institutions, because without one they won't even talk to you, so to have any legal authority you have to have a legal and financial POA otherwise they literally won't talk to you.
    As tryagain says next of kin counts for as mush as an LPA for health and welfare, the NHS won't do anything without consulting the family and a clear cut relationship like being a spouse is pretty much as good as an LPA.
    Years ago my mum and I had to deal with her brother in law who got sectioned and for the NHS it was an issue, mum was only a sister in law and I was only a nephew so the relationship was "second hand" at best, but there were no closed family members so we did it as next of kin, we were asked about al the decisions to a point where my mum just wanted it to stop.
    Years later I managed my mums care without an LPA, when asked if I had one and I said "no" they went with me being the next of kin, no questions asked, you get told everything.
    Now my wife has been sectioned, six months in a secure unit and 2 years in an EMI nursing home, I can't ever recall being asked if I had an LPA let alone asked to prove it.
    If you have an LPA for health and welfare and the doctors make a decision that you don't agree with they can override you anyway, a H&W LPA can be overridden "in the patient's best interests" where a finance LPA gives you rights over institutions like a bank so you can tell them what happens where a H&W just gives you a voice, not the final say.
    K
     
  9. Jessbow

    Jessbow Registered User

    How utterly ridiculous.
    You should be fully involved in drawing up his care plan.

    You are his NOK, and his wife. You might like to point that out. You absolutely should be allowed to see his care plan! Do you have a SW on anyone on your side? Who pays the fees?
     
  10. Louise7

    Louise7 Registered User

    Mar 25, 2016
    991
    I think from previous posts that the OP's husband is getting full CHC funding, in which case I think the care plan can be decided without input from the NOK. Not sure that this should make a difference to whether the OP could see it or not though. I would ask whoever said that you are not allowed 'by law' to see the care plan which 'law' they are referring to as it could be that someone has got their wires crossed.

    From experience I'd change that to 'the NHS are not supposed to do anything without consulting the family'........
     
  11. Marinajane

    Marinajane Registered User

    Feb 25, 2018
    54
    Thank you to everyone for these replies. I think I am probably having a big emotional reaction to this as it made me feel like I was irrelevant and my marriage didn’t count for anything. Another loss as well as losing him to dementia. I agree that NHS would be likely to consult on any best interest decisions. I was next of kin to my brother and when he was on life support I had no POA was never asked about it and the consultants even showed me his brain scan etc to help me agree to removing life support. Same when my mother died. I think I have had an uncertain relationship with the nursing home which is only now improving a bit . We have no children or siblings so he is my world and I have been mega protective. I still think the law is an ass on this but maybe it’s not worth going to war with the home over it.
     
  12. Herewego

    Herewego Registered User

    Mar 9, 2017
    93
    Hi Marinajane

    My OH has dementia and we completed our LPA (Finance & Health) and registered it last year just as he was diagnosed (did it ourselves and I did one at the same time). I also helped friends do theirs, they did not use a solicitor, and in turn they have helped another couple. While they are lengthy documents, they are not difficult to do and unless you want to do something out of the ordinary, anyone can do them.

    Now in your case, I think you can still do one - I think it is a bit more complicated and you will need to involve a judge, but as you have completed the old forms I don't think any judge would refuse to give you the powers of a LPA - Health (& Finance). I will do a bit more research and post my findings.

    In the meantime, I have found a document that tells you what involvement you should have when there is no LPA. You can find it here https://compassionindying.org.uk/library/decisions-care-treatment/ and may help you when talking to the CH.

    I do think the CH is acting with far to much regard for 'sticking to the letter' - and I am not convinced that they are correct in their interpretation either......makes me wonder what their motives are in excluding you.
     
  13. Hazara8

    Hazara8 Registered User

    Apr 6, 2015
    354

    The key here is 'best interests'. As a wife, you will know your husband better than anyone else. That alone is a fundamental element of 'care' and its proper application - knowing a person's needs, dislikes, background et al. For many Care Homes it is simply common sense to be open with those who have cared for or are indeed so directly related to a loved one, unless there are reasons to do otherwise. It might be worth clarification from the Court of Protection or the CQC in order for you to feel confident enough to approach the nursing home and resolve this issue. Frankly, it seems rather strange to be left out of access to the care plan. I regularly referred to my late mother's as I did her medication chart. But yes, I DID hold LPA.
     
  14. Herewego

    Herewego Registered User

    Mar 9, 2017
    93
    Hi Marinanajane

    I have now done more research and you may still be able to complete an LPA - it will depend on how badly affected your OH is at this point in time. In the guidance notes it clearly says that having dementia does not automatically mean you do not have mental capacity to make an LPA.

    While looking after my MIL (for whom we did have an old style POA), she had dementia and was in hospital. She wasn't really verbal at the time (could talk just didn't), the NHS/SS had decided she was ready to be discharged but could not go home and had decided without involving us at all, that she would be transferred to a care home. They moved her without even telling us - very annoying. Anyway, we spoke to MIL while she was still in hospital and before they moved her about her options, going home, going into care or coming to live with us. In each case we (I) went enough detail so she knew what the option entailed. To the first two options there was no reaction at all and I wasn't even sure she was listening or taking it in. With the 3rd option, I explained we would have to sell her house and use her money to build on to our house to be able to bring her to live with us - her response was immediate, she looked up and grinned from ear to ear - the nicest smile I had seen on her face for some time! So we did just that, unfortunately in the meantime the SS had moved her to a care home near us that did not identify her incontinence, left her in wet clothes and let her lay in bed all day if she wanted to - the point of this story is to say that you could have assumed my MIL did not have mental capacity to make a decision about her care, yet when asked, it was obvious she did. Anyone watching and listening would have known what she wanted. (BTW she did come to us and lived for almost 2 years - even tho' the CH said she was very frail and would not live long, a few months at the most! I have also no doubt at all that her quality of life was much better too. My MIL was an easy person to have, my OH on the other hand may or may not stay at home as time goes on - he is quite different to his mother!)

    Info from the Age UK website:

    "An LPA will only be valid if you have the mental capacity to set it up and haven’t been put under any pressure to create it. It must be your decision and you must be able to trust your attorney [this can be anyone you choose], as you’re giving that person power to make decisions about your life."

    "Mental capacity is the ability to make a specific decision at the time it needs to be made. To have mental capacity you must understand the decision you need to make, why you need to make it, and the likely outcome of your decision. Some people will be able to make decisions about some things but not others. Mental capacity can change over time and someone may not be able to make a decision at one time, and then be able to make the same decision at another time. Someone with mental capacity is able to communicate decisions through speech, signs, gestures or in other ways. Taking time to understand or communicate may be mistaken for a lack of mental capacity, but having dementia, for example, doesn’t necessarily mean someone can’t make any decisions themselves. If someone is having difficulty communicating what sort of decision they want to make, an attempt should always be made to overcome that difficulty and help the person decide for themselves. Before someone can make a decision for you, they must assess whether you can make the decision yourself. The person making a decision for you must make sure they are acting in your best interests."

    "Have the LPA signed by a certificate provider. This is someone who confirms that you understand what the LPA is and haven’t been put under any pressure to sign it. They must be someone you know well or a professional such as a doctor, social worker or solicitor, but can’t be a family member."

    If you can not find a 'certificate provider' that will sign to say your OH understands as the paragraph above explains, then trying to get a LPA now will not work, however, if you do have someone you know (does not have to be a professional - just someone that knows your husband and not related) willing to sign as the 'certificate provider' then you can still do an LPA.

    Hope this helps - do let me know if you want any more info or help with this.
     
  15. witts1973

    witts1973 Registered User

    Jun 20, 2018
    600
    Male
    Leamington Spa
    Thanks that has made me feel happier about the situation
     
  16. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,306
    Female
    England
    My husband received CHC from the day he entered his nursing home to the day he passed away. They never asked me in the 4 years he was there whether I had a LPA ( I had both). I was part of making his care plan, I was consulted when they thought it needed changing and it , along with his daily records was there for me to read as it was for our son and daughter.

    It was the same when he was admitted to hospital for the last time. I was consulted about his treatment, the futility of continuing the treatment and where I wanted him to be. I wanted him back in his nursing home and they moved heaven and earth to get him back there. Again no one asked about a LPA .
     
  17. Duggies-girl

    Duggies-girl Registered User

    Sep 6, 2017
    1,456
    I have attended every appointment that dad has had since his first appointment with his GP over memory concerns. He has seen 3 consultants in recent months and had a lot of tests, I always go with him. His GP and the hospital have my number and they will and have phoned me because they know there is no point phoning dad. The memory clinic were great and the only time I had to leave the room was when dad has his test. They sent me a copy of his care plan by post.

    I do have LPA for Health and welfare but I have never been asked if I have it and I have never had to say that I have it.
     
  18. Marinajane

    Marinajane Registered User

    Feb 25, 2018
    54
    Thank you for doing all this research. Unfortunately a psychiatrist who saw my husband to assess mental capacity so that I could register the Enduring Power I already had for finance etc. Judged him to lack capacity. So I got the registration to handle his finances but he was judged not to have capacity to consent to an LPA health and welfare. Sickening as I know he would have wanted me to do it. It’s interesting to compare the NH response with what the DOLS says about my responsibility as his representative to monitor his care and also that I was given a full copy of the NHS decision tool for funding which details everything about him. I just can’t make sense of their view.
     

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