Elderly Care / Power of Attorney / Private Testing

shields_supporter

shields_supporter

Winger
Dear All,

Hoping for a little direction/advice

Briefly, me and missus still in Hong Kong, but will be leaving permanently this coming August after 21 years. Lots of reason, one of which is the thread today.

Will also be landing in UK for 7-days this coming Saturday 15th with the hope of getting some elderly care things underway.

Father-in-law is coming up 89 - up until 4-weeks ago he was doing pretty well. could get himself around OK although no longer drives thankfully. 100% fully lucid and adept at making salty/Dad jokes.

Lives in rural Rutland, has a lady (you don't want to see) who 'Lodges' in his house. Used to be the cleaner/carer for his partner before she died. Works great as there's someone there morning and night to make sure he's alive - but she's out most of the day doing her rounds.

Has always had the odd fall over the past 10 years, doesn't help that he's a nosey fucker and will rush anywhere to see what's going on and to engage with anyone that looks like they have the ability of speech. Also has always had one of those head first/hip behind walking styles which gives him a terrible centre of gravity.

4-weeks ago, he started having more falls/collapses - some of which he was unable to tell if it was because of tripping or blackouts. Was found a few times in shower, kitchen floor and almost face-first in his wood fire!

Ambulances, nurses, doctors been out half-dozen times as he has one of those fall alarms. They have put it down to 'Old age' - their words.

Generally check him over for cuts, breaks and leave.

2-weeks ago, started falling/collapsing/slumping couple times a day and became very confused as if he was 3-5 years in with Alzheimers. No one, doctors, nurses, local GP would authorise any tests for mini-stroke, concussion, viral/bacterial infections which such sudden onset would suggest. We Facetime a couple hours a day whilst someone is there and he doesn't currently know where he is. Thinks he's in someone else's house.

We are lucky that we managed to get paid for private carers in 5 times a day for all meals, washing, sleeping. They have also used their 'Connections' to get Occupational Therapists in and have had special bed installed in dining room downstairs until we can get there and look at most sensible options. Carers have been brilliant.

A doctor has 'Reluctantly' put him on a week's worth of antibiotics for a water infection which have made a difference (today last day) but no where near enough. One carer just took a urine sample to the GP, handed it over and forced their hand.

My questions are:

* Anyone have experience of paying for private testing/scans etc to bypass the NHS? Happy to pay what it takes but he's not exactly mobile at the moment.

* We have power of attorney (finance and health) already but have no idea how it works with regards to getting access to his finances - carers are costing us around 1200 quid a week at moment and our business has been destroyed by HK's Covid response (and other legislature). He's not short of a bob or two and his 5-bed house not exactly appropriate for him. Anyone been through the process with the banks? Timescales etc?

* Really any other suggestions as missus is going mental and we're beholden to a Golden break contract (which we are breaking to an extent by coming) which severely restricts taking time away from our contracted work - anyone done similar from overseas or from afar?

Appreciate any help people can give. Will be bumping back into a fair few of you next season.
 


You need to register the power of attorney with your Dad's bank, they will then give you access to debit cards, phone banking and online/app banking. This may require a face to face and you may need to provide documentary evidence of identity. This was my experience with HBSC. This doesn't need to be in your father's branch. In time you may need to register the PoA with others such as phone companies etc.

The health PoA is a waste of time in reality. It only comes into play once it is determined he no longer has capacity to make decisions and you cannot demand health treatments, car home placements etc unless it is deemed in his best interests by a social worker / medic.

Been through this with my parents, give me a pm if you want to ask questions. I'm not an expert by any means though. Good luck
 
If you’ve got POA it’s normally just a case of sending off either an email or a printed copy to banks etc. straightforward. Call them and ask. Do it with mortgage, doctors/GP, care orgs, utilities etc.

If he’s got assets I can’t advise, get some estate planning advice. Oh and check his will in case his “lodger” has worked her way in.
 
I sympathise with your worries and concern.
When you’re in UK, you’ll need to provide proof of Power of Attorney (Finance) at any bank that your father in law has an account. Best to make an appointment and explain the circumstances, as banks usually have a long list of people waiting to be seen, face to face. With POA you will have access to determine how much he has in total to help you manage his needs.
I’d suggest putting a claim in for Atfendance Allowance ( if he is at home being cared for and has not already made a claim ) . You can access information on line and apply on his behalf.Dept Work and Pensions will send a claim form in the post. Sounds like he may qualify for the higher rate and it is paid from the date of applying ( back dated) with his State Pension. It is tax free. To help with his care.
I would make his GP aware of his situation and notify Social Services who can visit to assess the situation and possibly manage his needs and requirements , if you return abroad.
I hope this helps.
This information is from my own experience in the past. I’m not a professional.
It sounds like you’re going to be busy. I wish you all the best and hope your FILaw pulls through. Water infections can cause falls and confusion but once cleared there can be a big improvement.
It sounds like the carers are switched on.
The NHS is on its knees as you will likely discover.
 
shields_supporter said:
Dear All,

Hoping for a little direction/advice

Briefly, me and missus still in Hong Kong, but will be leaving permanently this coming August after 21 years. Lots of reason, one of which is the thread today.

Will also be landing in UK for 7-days this coming Saturday 15th with the hope of getting some elderly care things underway.

Father-in-law is coming up 89 - up until 4-weeks ago he was doing pretty well. could get himself around OK although no longer drives thankfully. 100% fully lucid and adept at making salty/Dad jokes.

Lives in rural Rutland, has a lady (you don't want to see) who 'Lodges' in his house. Used to be the cleaner/carer for his partner before she died. Works great as there's someone there morning and night to make sure he's alive - but she's out most of the day doing her rounds.

Has always had the odd fall over the past 10 years, doesn't help that he's a nosey fucker and will rush anywhere to see what's going on and to engage with anyone that looks like they have the ability of speech. Also has always had one of those head first/hip behind walking styles which gives him a terrible centre of gravity.

4-weeks ago, he started having more falls/collapses - some of which he was unable to tell if it was because of tripping or blackouts. Was found a few times in shower, kitchen floor and almost face-first in his wood fire!

Ambulances, nurses, doctors been out half-dozen times as he has one of those fall alarms. They have put it down to 'Old age' - their words.

Generally check him over for cuts, breaks and leave.

2-weeks ago, started falling/collapsing/slumping couple times a day and became very confused as if he was 3-5 years in with Alzheimers. No one, doctors, nurses, local GP would authorise any tests for mini-stroke, concussion, viral/bacterial infections which such sudden onset would suggest. We Facetime a couple hours a day whilst someone is there and he doesn't currently know where he is. Thinks he's in someone else's house.

We are lucky that we managed to get paid for private carers in 5 times a day for all meals, washing, sleeping. They have also used their 'Connections' to get Occupational Therapists in and have had special bed installed in dining room downstairs until we can get there and look at most sensible options. Carers have been brilliant.

A doctor has 'Reluctantly' put him on a week's worth of antibiotics for a water infection which have made a difference (today last day) but no where near enough. One carer just took a urine sample to the GP, handed it over and forced their hand.

My questions are:

* Anyone have experience of paying for private testing/scans etc to bypass the NHS? Happy to pay what it takes but he's not exactly mobile at the moment.

* We have power of attorney (finance and health) already but have no idea how it works with regards to getting access to his finances - carers are costing us around 1200 quid a week at moment and our business has been destroyed by HK's Covid response (and other legislature). He's not short of a bob or two and his 5-bed house not exactly appropriate for him. Anyone been through the process with the banks? Timescales etc?

* Really any other suggestions as missus is going mental and we're beholden to a Golden break contract (which we are breaking to an extent by coming) which severely restricts taking time away from our contracted work - anyone done similar from overseas or from afar?

Appreciate any help people can give. Will be bumping back into a fair few of you next season.
Click to expand...

I forgot to mention that Attendance Allowance is not means tested, against the amount of savings etc held by your FILaw.
 
We've just been through that with the ma in-law (based on dementia incapacity), different rules I think up here in Scotland so might not be much help but we got a certificate and a copy of the POA agreement once it was all signed off and agreed to. So far we've only had to send in a copy of the certificate to those we've needed to deal with and our own ID. Good luck though @shields_supporter, it's stressful mate - just keep leaning on the carers and OT's till you're back, they'll keep F-I-L right till you're back. Push for UTI testing via the carers and docs - that can send mild or early dementia into whole other level. M-I-L went from just occasional memory loss to full on delerium, crazy personality change and aggressive manner, couldn't remember what was discussed 30 minutes ago. Took weeks to be detected and the longer it goes on, the higher chance the old more normal capacity baseline is lost.
 
Quench said:
You need to register the power of attorney with your Dad's bank, they will then give you access to debit cards, phone banking and online/app banking. This may require a face to face and you may need to provide documentary evidence of identity. This was my experience with HBSC. This doesn't need to be in your father's branch. In time you may need to register the PoA with others such as phone companies etc.

The health PoA is a waste of time in reality. It only comes into play once it is determined he no longer has capacity to make decisions and you cannot demand health treatments, car home placements etc unless it is deemed in his best interests by a social worker / medic.

Been through this with my parents, give me a pm if you want to ask questions. I'm not an expert by any means though. Good luck
Click to expand...
Many thanks - have looked the PoA up online and because we live overseas we need to jump through a few more hoops as in getting all of our Hong Kong utilities, banks etc notarised (at 250 quid a document)
Goat Eyes said:
If you’ve got POA it’s normally just a case of sending off either an email or a printed copy to banks etc. straightforward. Call them and ask. Do it with mortgage, doctors/GP, care orgs, utilities etc.

If he’s got assets I can’t advise, get some estate planning advice. Oh and check his will in case his “lodger” has worked her way in.
Click to expand...
hahaha will do regards 'Lodger'
E Tenebris Lux said:
I sympathise with your worries and concern.
When you’re in UK, you’ll need to provide proof of Power of Attorney (Finance) at any bank that your father in law has an account. Best to make an appointment and explain the circumstances, as banks usually have a long list of people waiting to be seen, face to face. With POA you will have access to determine how much he has in total to help you manage his needs.
I’d suggest putting a claim in for Atfendance Allowance ( if he is at home being cared for and has not already made a claim ) . You can access information on line and apply on his behalf.Dept Work and Pensions will send a claim form in the post. Sounds like he may qualify for the higher rate and it is paid from the date of applying ( back dated) with his State Pension. It is tax free. To help with his care.
I would make his GP aware of his situation and notify Social Services who can visit to assess the situation and possibly manage his needs and requirements , if you return abroad.
I hope this helps.
This information is from my own experience in the past. I’m not a professional.
It sounds like you’re going to be busy. I wish you all the best and hope your FILaw pulls through. Water infections can cause falls and confusion but once cleared there can be a big improvement.
It sounds like the carers are switched on.
The NHS is on its knees as you will likely discover.
Click to expand...
Good advice regards 'Attendance allowance' will be looking at that. Been hard to co-ordinate with 7-hours time difference and public holidays. have found that if we provide a letter (from him) we can deal with his GP direct.
peachy said:
@shields_supporter

Good luck, wish you well and short queues.
Click to expand...
Thanks for the concern - much appreciated - at this moment, our main concern is short to medium term care
parttimer said:
We've just been through that with the ma in-law (based on dementia incapacity), different rules I think up here in Scotland so might not be much help but we got a certificate and a copy of the POA agreement once it was all signed off and agreed to. So far we've only had to send in a copy of the certificate to those we've needed to deal with and our own ID. Good luck though @shields_supporter, it's stressful mate - just keep leaning on the carers and OT's till you're back, they'll keep F-I-L right till you're back. Push for UTI testing via the carers and docs - that can send mild or early dementia into whole other level. M-I-L went from just occasional memory loss to full on delerium, crazy personality change and aggressive manner, couldn't remember what was discussed 30 minutes ago. Took weeks to be detected and the longer it goes on, the higher chance the old more normal capacity baseline is lost.
Click to expand...
Yes - we've been through Altzheimers with his partner years ago and even mild infections can set things off.

With regards to baseline, thats exactly what we are most worried about as he was very lucid
On a SAFC related side-note.

Although the FiL was born and raised in Plymouth, during the war he lived at 16 Roker Park Road South with his mam and dad as his dad was an Admiralty Shipwright.

He attended Redby Junior mixed which is of course no longer there.

Always laughs about how much they took the piss out of his accent.
 
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Agree with what @parttimer said about water infections, my wife's mam had them repeatedly and we think they contributed to her cognitive decline massively in the long term, as well as the delirium and falls when she had them. Nag them about testing on a regular basis/at first sign of any concerns and also on pretty much by-return prescription of anti-biotics, and testing after a course (we had a couple of occasions when she finished a course but then it reared its head again a day or two later)

Push hard with doctors on a scan. When my m-i-l had her second to last scan after a fall, they found evidence of two previous strokes that none of us knew about. She then went on to have a massive stroke.

Ditto the poster above on attendance allowance.

If you get really concerned that he's vulnerable and not getting the care he needs then rattle cages, phone adult social care and log a safeguarding concern.

Our experience over a year or so was that frankly, the system was broken, poor, disjointed, no one took ownership of her as a person and always passed the buck to someone else, and that if we hadn't been really assertive (politely, always) then things that needed to happen would not have happened. If he's now collapsing/going absent a couple of times a day and health professionals aren't even testing him for anything, then they're failing him, and you. Don't stand for it. We felt that (same as with wife's dad) there was a kind of baseline of deal with an emergency otherwise just let the elderly person decline and die.

Good luck, it's a horrible position to be in even if you're just up the road, let alone overseas.
 
The King of Um said:
Agree with what @parttimer said about water infections, my wife's mam had them repeatedly and we think they contributed to her cognitive decline massively in the long term, as well as the delirium and falls when she had them. Nag them about testing on a regular basis/at first sign of any concerns and also on pretty much by-return prescription of anti-biotics, and testing after a course (we had a couple of occasions when she finished a course but then it reared its head again a day or two later)

Push hard with doctors on a scan. When my m-i-l had her second to last scan after a fall, they found evidence of two previous strokes that none of us knew about. She then went on to have a massive stroke.

Ditto the poster above on attendance allowance.

If you get really concerned that he's vulnerable and not getting the care he needs then rattle cages, phone adult social care and log a safeguarding concern.

Our experience over a year or so was that frankly, the system was broken, poor, disjointed, no one took ownership of her as a person and always passed the buck to someone else, and that if we hadn't been really assertive (politely, always) then things that needed to happen would not have happened. If he's now collapsing/going absent a couple of times a day and health professionals aren't even testing him for anything, then they're failing him, and you. Don't stand for it. We felt that (same as with wife's dad) there was a kind of baseline of deal with an emergency otherwise just let the elderly person decline and die.

Good luck, it's a horrible position to be in even if you're just up the road, let alone overseas.
Click to expand...
Just to add to this. It would be worth a call to social services to see if he can be appointed a care manager. The one I had for my mam was great. Organised a social worker for her, sorted out benefits, put a care plan in place and generally gave good advice. I'd echo the above, unfortunately you need to chase everything with the NHS at the minute. We had to deal with it all during the height of lockdowns which I think added a layer of buggeration
 
Jesus, what a minefield these FinanciAl and medical power of attorney forms are!

Because of the rapid decline in my Mam’s health due to the frontal lobe dementia I’ve had to start pulling together the paperwork to act on her behalf.

I am very grateful that a family friend is a Solicitor who deals with this type of stuff on a day to day basis and she sat with me going through all the pages explaining them and how to fill the forms in.
 
you may be able to get a scan if done privately. I know people who have had medical issues and ended up going private and issues resolved.
My neighbour went to the doctors re a bad back. was referred for a scan and was told it would take weeks. called the hospital and was told it would be 4 months.
went private. able to get it done within a week. had the scan at 1.50pm and given the results at 2pm. cost him £400. but we both agree , worth every penny.
another friend had problems with her lower leg. at times she would be in tears with the pain. kept getting nowhere with her doctor. she went private for a scan and was told immediatley what the issue was. she needed a minor op. doctor himself he stated that another surgeon should do it, because of his expertise. done a week later and no problem since and that was 4 years ago. so well worth the money and the actual op was paid for by the nhs. just diagnostic had to be paid for.
 
You can contact Age Concern re lasting power of attorney. I’ve had to do this recently with a parent and it’s a bit of a wait for them to respond but it’s much cheaper than a solicitor
 
Nookie Bear said:
Agree , makes me wince when I see people paying hundreds if not thousands for solicitors to do the POA when it’s quite a straightforward form to download and complete
Click to expand...

This. Solicitors charges are ridiculous. I did mine myself for Health and Finances. Completed forms online, printed off, signed then sent off. Total cost £180.
 
I'm a GP and it pains me to see how broken the NHS is. He needs investigation to see why he has dipped so suddenly. Using old age as a reason for a decline is unacceptable without digging deeper into things.

I would try to get a private assessment from a Care if the elderly Physician and advice on scans/labs from them. If you have POA you may need a letter from a doctor stating he no longer has capacity to activate it.

Where in the UK is he? I am still on the UK doctor chat forums so could get a recommendation for you for an assessment
 
If antibiotics have improved things, then there's a high chance that you won't be able to get a baseline cognitive assessment for weeks after, at least not one that a psychiatrist will be willing to accept and make a diagnosis using. Delirium following a UTI can last for months, but usually weeks.

A referral to secondary care mental health services would likely be declined, unless there's obvious evidence of progressive decline over 6 months.

No reason why you can't go to the GP and get the ball rolling though, full bloods (FBC, LFT, U&E, TSH, glucose or HbA1c, B12, folate) repeated urinalysis and a physical exam at the very least. Some GPs, not many, will even request a CT head if they suspect a dementing illness

Rutland have Admiral nurses who can support and help co-ordinate things for people like your dad and keep an eye out when you've left. Might be worth speaking to your Dad's GP about it.
 

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