Dementia Support Line
Planning ahead: Making legal arrangements despite coronavirus
Advice about how the pandemic affects setting up powers of attorney and advance decisions to refuse treatment.
Question:
‘My husband has dementia and we’ve decided to sort out powers of attorney and advance decisions to refuse treatment. Can we do this without going against advice about coronavirus?’
Answer:
The pandemic has made many of us think about advance care planning – preparing for times in the future when we can’t make certain decisions for ourselves.
Lockdown restrictions and coronavirus advice have affected how some of this is done, but they shouldn’t stop you or your husband from making powers of attorney or advance decisions.
Getting advice
Speaking to your GP about your future health needs and treatment can give you a better idea of what you want to plan for.
Many GPs now offer appointments by phone or video call, so you can get their advice without going in to see them.
You don’t need a solicitor to make a power of attorney or advance decision, but if you’d like their advice, this could be by phone or video call too.
Signatures on documents
Making a power of attorney involves signing and witnessing documents, as does making an advance decision to refuse life-sustaining treatment. At present, signatures need to be witnessed by someone who’s there in person, which has been a challenge during lockdown.
The Office of the Public Guardian has produced guidance on making and registering an LPA during the coronavirus outbreak.
If you’re using a solicitor, ask them how they deal with this. If you’re doing it without a solicitor, think about what could work for your situation. For example, some people have signed documents with a witness looking through a window.
Maintain hygiene by making sure everyone’s hands are clean when handling documents and not sharing pens.
However you’re able to adapt the process, you still need to follow the precise rules on who signs and witnesses which bit of each document.
Our LPA digital assistance service can help people with dementia in England and Wales to set up powers of attorney – call 0333 150 3456 for details.
Making documents count
Powers of attorney usually need to be registered before they can be used, and letting people know about advance care plans makes them more effective.
For example, giving a copy of an advance decision to your GP means it can be lodged on your medical records.
If you’ve set up powers of attorney or advance decisions, it’s important not to let the pandemic stop you from getting them registered and lodged on medical or care records.
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Pamela Soane
saysCan my husband with late dementia come out of a nursing home and have a package of 24 hour care at home he had a 117 and now is in bed But is hoisted into a chair ,he reaches out to me and needs my love and care,he is still a living sole and l want him home till he leaves this world
Hi Pamela,
Thanks for your comment. Sorry to hear it's been a difficult time for you and your husband.
In terms of the legal decision to move him;
- if your husband has the mental capacity to make this decision for himself, it should be his decision to make (even if this is considered unwise by others)
- if he lacks mental capacity to make this decision but you or someone else has Lasting Power of Attorney (LPA) for Health and Welfare, the decision should lie with the attorney
- if he lacks mental capacity and no one has LPA then the decision lies with the Local Authority and Clinical Commissioning Group as 117 aftercare is usually jointly arranged and funded.
Whoever the decision maker is here needs to remember that the overarching concern is whether his assessed needs can be met at home. The purpose of 117 aftercare is to meet care needs relating to the reason he was previously admitted but also to reduce the risk of deterioration and prevent further admissions – you may be asked to try and explain how you could ensure this at home.
There is also the issue of funding and whether they will fund what will undoubtably be an increase in his care costs to meet his needs at home, when his needs can be met in a nursing home for cheaper. If there are needs you feel he has which aren’t being met by the nursing home which could be met with 24 hour care at home, you should raise these.
You should discuss any potential changes with his Care Coordinator. If they feel homecare is an option, you could explore whether a personal health budget could work for your husband.
You can find out more about the Mental Health Act and S117 aftercare on our website:
https://www.alzheimers.org.uk/get-support/legal-and-financial/which-sec…
‘Rethink Mental Illness’ also have a useful factsheet on Section 117 aftercare here:
https://www.rethink.org/advice-and-information/rights-restrictions/ment…
Please remember that you can also speak to one of our trained dementia advisers by calling the Dementia Connect support line on 0333 150 3456. One of our advisers will be able to learn more about your situation and provide information, advice and support: https://www.alzheimers.org.uk/dementia-connect-support-line
Hope this helps, Pamela.
Alzheimer's Society blog team