power of attorney

Discussion in 'Legal and financial issues' started by elaineo2, Apr 16, 2008.

  1. elaineo2

    elaineo2 Registered User

    Jul 6, 2007
    945
    leigh lancashire
    Hi everyone,i have a question i need an answer for for tomorrow.just to prove a point with my manager.i have searched the net and think i am right in what i say.A residents daughter has decided on a dnr for her mother.The manager has documented it and had her daughter sign it.My query is,the daughter has power of attorney,which i understand to concern financial areas.i read that LPA gives the right to decide on medical welfare,which the daughter hasn't got.am i right in saying that the dnr is invalid at this point?thanks elainex
     
  2. CYN

    CYN Registered User

    Jan 4, 2008
    702
    east sussex
    D N R

    Elaine, I was asked buy two homes that my husband was in if i agreed to D N R on his notes. I agreed in both cases as he had no quality of life by this stage. i had enduring powers of attorney at the time

    Cynthia x x
     
  3. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Hi Elaine,

    That is a good question. I think legally, you can only give DNR instructions for yourself unless you give specific permission to allow someone to deal with your medical affairs on your behalf (e.g. a letter saying as much to a GP while you are capable or as part of a living will).

    I think the new LPA would also needs to specifically state that the attorney has powers to make such a decision on your behalf. There is some flexibility on the powers that you can give to attorneys with an LPA.

    However, I think DNR is treated on an individual basis and relatives are often advised by the medical profession when a DNR is appropriate. That is when it would be marked on the records that both the doctor and next of kin have discussed DNR.

    Really good question and I hope someone more informed than me comes up with the correct answer. Don't forget to read my signature ;-).

    If not, phone the alz helpline and let us know what they say.

    Kind Regards
    Craig
     
  4. elaineo2

    elaineo2 Registered User

    Jul 6, 2007
    945
    leigh lancashire
    Thank you bot,i think you have both reiterated my concerns
    on this.i am in work tomorrow and will get the matter sorted.not for the staff,for the redisdent.thanks
     
  5. citybythesea

    citybythesea Registered User

    Mar 23, 2008
    632
    coast of texas
    IN the US

    IN the United States there are to forms of Power of Attorney. In order to even discuss medical over here you must have Medical Power of Attorney as the Durable Power of Attorney does not even discuss medical issues. If you do have the medical you have the right to discuss the DNR issues but donot have the right to advance directive issues.(an example would be with holding food thru a feeding tube if the patient were healthy but not able to swallow....advance stages of AD can really test the medical power of attorneys limit and your patience).

    I know that this may not help you over there but I thought it was worth adding since some of your counterparts are here in the U.S. I'm also going to say that this is how it has been allowed an explained to me by proffessionals in the medical field over here.
     
  6. Sandy

    Sandy Registered User

    Mar 23, 2005
    6,847
    Hi Elaine,

    My first thought in reading this question was that it is a very serious subject and really needs expert opinions.

    My next thought was that any responsible health care organisation would have already sought out those opinions and formulated a code of practice for staff/patients/relatives so that everyone would be aware of how the system operates.

    I did a quick search on Google and found the type of comprehensive document that I would expect from, as it happens, a hospital in this case. The document (in PDF format) is here:

    http://www.sunderland.nhs.uk/chs/about_us/governors/2008/jan/docs/Item%206.pdf

    The bit that you're interested in is on page 5 of the PDF file (numbered 3 in the document itself)- point 3.4 specifically.

    I think the document makes a good point in saying that with out an LPA, a friend or family member cannot legally determine the course of medical treatment, but they can also be a source of valuable information in the decision-making process - where the final decision is made by the medical team.

    Take care,

    Sandy
     
  7. Helena

    Helena Registered User

    May 24, 2006
    715
    The consultant asked me if I wanted DNR on my Mothers notes

    She knew I had Power of Attorney and that my Mother would have vehemently not wanted to be dragged back into the state she was in

    I think you will find that if Medically the patient has no real hope of any quality of life etc and are already very ill that doctors /consultants will indeed accept a daughter/sons/wifes/husbands POA and DNR request
     
  8. daughter

    daughter Registered User

    Mar 16, 2005
    824
    #8 daughter, Apr 17, 2008
    Last edited: Apr 17, 2008
    Hi Elaine,

    A very difficult question. I can only speak from personal experience in emergency situations in hospital.

    When both my Dad and my Mum were rushed to hospital the doctors asked what we thought our parent would want to happen. We found it difficult to answer both times but I was a) relieved that the consultant went on to say it was not our ultimate decision and b) later I was pleased to have been given the chance to think about it and to be involved.

    Best wishes,
     
  9. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    I suspect that the intention is simply to record the wishes of a relative, but that the decision would not be made on those wishes alone.

    There would be circumstances where a relative might be present when the medical staff could physically resuscitate but where they believed it would not be good for the patient, owing to their condition. In such a situation they would consult the relative and act in the knowledge of their wishes, as well as on their own professional judgement.

    All the signed paperwork does is to give them the knowledge of the relative's recommendation, in the absence of the relative.

    Doesn't mean they have to act on it, but gives them information to inform their decision at the time.
     
  10. needsomecake

    needsomecake Registered User

    Apr 12, 2008
    10
    My understanding of DNR is that it is not a decision that a relative can make - it is a medical decision. The docs should take into account the wishes of relatives (hence having them noted down), and make sure the matter is discussed with them, but they are not bound to abide by them. I'm not sure how the new style LPAs work here but certainly the old style EPAs are not relevant as I think they only deal with financial matters (I'm no expert though!).

    My experience of this is when my dad had his stroke eight years ago, I was informed by the docs he was DNR and that was that. I'm not sure if I could have had it removed from his notes if I'd wanted to but I was so distressed I didn't question it.
     
  11. Mameeskye

    Mameeskye Registered User

    Aug 9, 2007
    1,669
    NZ
    I have a vague recollection of Mum's solicitor in Scotland advising us as to the differing POAs at the time she started her faster slide in 2002-3. Mum had an unregistered POA in place from 1993 when she had sorted out her will. The solicitor advised, when I contacted him to discuss it that if Mum was fit and seemed to understand what was being said that we draft a new POA as the legislation had changed. This I think was phrased as being a "Welfare Power of Attorney" which gave my brother and I the rights to discuss her medical treatment, nursing home care and up to and including putting a DNR on her notes when it became appropriate, which some of you may remember we did at the start of this year.

    I know that the situation does differ north and south of the border.

    I assume Elaine that you are concerned for the resident and feel that it may be premature. If it helps the GP said to me, when I discussed it with him, that more often than not, in a patient with dementia, CPR techniques failed, that they were not the miracle cure often shown on TV programmes. I was relieved, but mostly becuase I did not want Mum's last few minutes, should they happen, to be frantic and noisy, but instead to be peaceful and quiet, as they were.

    Mameeskye
     
  12. sue38

    sue38 Registered User

    Mar 6, 2007
    10,854
    Wigan, Lancs
    Sorry Elaine, just catching up and this may be too late.

    The old EPA only deals with financial matters, but the medical people don't always seem to grasp this.

    My mum, sister and I as solicitors have EPA for a number of people who we only 'know' from their bank statements. A couple of years ago my sister received a call from a hospital asking her permission to recusitate a lady for whom she had EPA. I think they literally had the heart paddles suspended waiting for my sister to give the go ahead. :eek: She pointed out she had no authority and luckily the lady pulled through.

    Just today my Mum was speaking to a GP about a lady for whom she has EPA and when she mentioned she had EPA the GP seemed to think she could take my mum's authority for personal care. My poor Mum, as though she hasn't enough to deal with caring for my Dad... still all good practice. Together they have found a good EMI home for the lady, which may be a possibility for my Dad if we ever need it. Just around the corner from me. :):eek:;)
     
  13. elaineo2

    elaineo2 Registered User

    Jul 6, 2007
    945
    leigh lancashire
    Thankyou all for your posts.although it leaves me a little confused.I read that having LPA gives power to decide on medical treatment?if this is so then is there a document needed from the GP to reiterate it?again i was led to believe that if a patient was suffering from an incurable disease or illness then dnr would be discussed with the gp,consultant and relatives.is a person deemed as well,entitled to have a dnr?
    thanks elainex
     
  14. christine_batch

    christine_batch Registered User

    Jul 31, 2007
    3,388
    Buckinghamshire
    When my husband was first diagnoised with AD, we both made our wills and EPA. Along with this my husband stipulated that he did not want to be resusitated, organ donation and brain to Alzheimer's Research.
    I gave copies to Care Home and to his Doctor.
    As Peter needs a hernia operation and is in the last stages, I have to go to see the Surgeon next week to decide, do I want Peter to have the op.
    On all Peter's notes are DNR.
    I am so glad he decided himself what he wanted as I would hate to make that decision.
    Christine
     

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