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Problems with capacity

Discussion in 'Legal and financial issues' started by Exning, Sep 7, 2018.

  1. Exning

    Exning Registered User

    Aug 26, 2018
    22
    POA Welfare for my 89 mother in law stipulates need for 2 doctors to confirm incapacity. One of which has to be mental health specialist. Problem is she is in remote north Scotland and the only NHS psychiatrist is unavailable for 6 weeks. Any idea of a way round this or must we just wait?
    Would strongly advise avoiding using this to confirm incapacity in POA if you are in remote area.
     
  2. Shedrech

    Shedrech Volunteer Moderator

    Dec 15, 2012
    6,528
    Yorkshire
    hi @Exning
    I wonder whether you will be able to deal with your mother's affairs without having to prove her lack of capacity, especially as you only mention Health & Welfare - medics generally consult with family on health issues
    I assume if your mother has an LPA in place for Property & Finance that it doesn't have the same stipulation, so you are able to manage her financial affairs; I hope so
     
  3. Exning

    Exning Registered User

    Aug 26, 2018
    22
     
  4. Exning

    Exning Registered User

    Aug 26, 2018
    22
    Unfortunately not as Hospital will not discharge until Welfare POA in place and properly activated. Her own wish has always been to stay in own home. As hospital have concluded she lacks capacity the only way to override is activating POA. Bit of a catch The hospital act on their own assessment of capacity but insist I meet higher standard laid down in POA documentation.
    Trying to get assessment done remotely by video link.As long as Psychiatrist signs the incapacity documentation I will be...at a significant cost..happy
     
  5. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,553
    Salford
    But the question is where do they discharge her to? If they determine she has no capacity then they can't send her home alone even if that's what she wants and without a POA you can't tell them to. Even with a POA if the hospital held a best interests meeting they could override your POA anyway.
    My mother ended up in A&E after passing out a couple of times, the hospital said they wouldn't let her go home alone, however, if I took her home to live with me then that was OK, I don't remember being asked if I had a POA but I didn't and it wasn't a problem.
    If I'd told them to send her home alone then maybe they would have told me the same as they told you, they have a duty of care to her and can't sent her somewhere if they believe she may be at risk so they really don't have a choice but to keep her as a "bed blocker" so it's as much in the NHS's interest to get the assessment done as soon as possible as it is in yours and hers.
    The NHS won't want her tying up a bed for the next 6 weeks but if they can't do better than 6 weeks to get an assessment done then they won't be liking it either.
    Depending on how the POA is worded could you use an Independent Mental Capacity Advisor (IMCA), some are doctors if that's the way the POA is worded others aren't but they're the people who do hold a professional qualification to assess mental capacity unlike social workers and solicitors who are allowed to assess capacity by virtue of their professional qualifications not a specific ability to assess capacity.
    If it's worded that it has to be a doctor or a psych then it's a problem but if says a "qualified person" then an IMCA might be an option.
    Usually it's solicitors who put clauses in like this and to be fair it does give the donor of the LPA a level of protection from unscrupulous relative putting someone in a home and pillaging their wealth, not that I'm implying that's what your doing in any way, but difficult for you and costly for the NHS you can see why some people are advised to do this as a safeguard.
    I don't see why the hospital can't section her if they can't safely let her out, that way they could have a best interest meeting and put her into care with or without you having an LPA.
    A best interests meeting can do this against the LPA donor's and holder's wishes if they want to it seems odd that the NHS are happy to keep her for 6 weeks at great cost instead of either sectioning or getting one of their psychs up there a bit quicker.
    If you want her to be sent back home and the hospital and social services don't, then even if, or when you get the POA activated they can still do what they think is in her best interests and over ride any input you have as a POA anyway.
    It sounds like you're dealing with this from a distance which to be honest just makes it harder for both you and the NHS/SS, they're the ones on the ground having to deal with it not you, sorry if I've got that wrong but dealing with people remotely isn't the NHS/SS way of doing things so having or not having a POA may well not help you as much as you may think, more than likely it's just a tactic they're using.
    Sorry to sound a bit negative but I feel the decisions will be made by them and they're just stalling for time to consider the position then tell you what's going to happen.
    K
     
  6. Louise7

    Louise7 Registered User

    Mar 25, 2016
    552
    #6 Louise7, Sep 8, 2018
    Last edited: Sep 8, 2018
    Looking at the OP's other thread I think the issue is that Mother is not safe to go home so the OP is working with a social worker to get her into a residential home. It looks like the problem is that she wants to go home and is currently deemed to have mental capacity so the best thing is for the hospital to keep her there under those circumstances. I would agree that trying to find an IMCA might be the best way to speed things.

    Edit: Has a period of respite in a home been considered? Maybe your Mother would be more inclined to go there if the doctors told her it was to recuperate? That way she would be somewhere safe but out of hospital whilst the mental capacity issue was sorted.
     
  7. Exning

    Exning Registered User

    Aug 26, 2018
    22
    Thanks for the replies. Maybe haven't set out problem as clear as I should.
    We are talking remote part of Scotland. Normal rules and logic not always around. We are a 10 hour drive away and are nearest family.
    Respite care a non started as no homes in area . Bed blocking not seen as current issue. Think only a dozen patients,at most, in whole hospital.Average age probably 80. Think old cottage hospital with GPs providing Doctor cover.
    Hospital and Social Work team are integrated in Scotland and work together. Sounds good but does not necessary get things moving. If the video link doesn't work will think again.
     
  8. canary

    canary Registered User

    Feb 25, 2014
    7,346
    Female
    South coast
    I think Im a bit lost. Who wants your mother to go where?
    I appreciate that your mother wants to go home, but as you feel there are problems with not having a health POA I assumed that you and the doctors want different outcomes. If there are no problems with her being a bed-blocker, why the urgency if you dont want her to go home (or do you want her to go there?)
     
  9. Exning

    Exning Registered User

    Aug 26, 2018
    22
    All on track for assessment on incapacity to be carried out by video link.
    Appreciate comments and understand points made. My motive has always been to be able to get MIL in a residential home asap. Yes she could have stayed in hospital until it was all sorted out but a hospital is not a homely environment for anyone. There is no hidden agenda by anyone just a bureaucratic logjam that meant that no action.would be taken until activation of POA was achieved.
     
  10. marionq

    marionq Registered User

    Apr 24, 2013
    4,879
    Female
    Scotland
    Although you are a long way away remember that civilisation still continues in the far north. She will get good care until it is decided where she will end up. The beauty of these areas is that staff tend to be local so accents and in the case of west Highlands, Gaelic, are still fairly familiar. She won’t be out of her depth.

    I have had relatives in care after an illness in places like Tain and Ullapool which are pretty far north and I’m not aware of problems. They will sort this out.
     

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