If your parent or relative is living with dementia, and they or you are worried about the prospect of them becoming unable to make decisions, there are useful things you can put in place to give you, or someone else they trust, the legal power to make decisions on their behalf if and when the time comes. This includes setting up a Power of Attorney for an elderly parent with dementia, setting up an Advance Decision, and a DNR (Do Not Resuscitate order).
As ‘grown-ups’ we generally take for granted the ability to make our own decisions about our own health and welfare, money and property. But what happens if we can’t? Without being too alarmist think about situations such as frozen bank accounts and no access to funds; inability to sell a house should care need to be paid for; decisions around care options being made by a (qualified) stranger in a court.
Find out everything you need to know about setting up power of attorney for a parent with dementia below.
Why is Power of Attorney useful for someone with dementia?
Dementia can make decision-making difficult when a person becomes very forgetful or confused. This is not about putting the housekeys in the fridge, but informed decisions about things that are very important – such as health or finances. A Power of Attorney gives someone else the legal power to make decisions on behalf of someone who is no longer able.
If you are concerned about a relative reaching this point, then first of all they need to be diagnosed with Dementia by a Doctor.
Ordinary Power of Attorney for a person with dementia
Ordinary Power of Attorney enables your parent to assign somebody else temporary powers over some finances. This could be useful, for example, during a stint in hospital which will ensure that bills can continue to be paid etc.
However, setting up a Lasting Power of Attorney tends to be more useful for a person with dementia, because there will be an inevitable decline in mental capacity over time.
Lasting Power of Attorney for a person with dementia
Lasting Power of Attorney (LPA) goes further in that it continues to be valid indefinitely if your parent loses their mental capacity and is no longer able to make their own decisions. It is a good way for a person with dementia to give someone they trust the legal authority to make decisions that they one day may not be able to make themselves.
There are two types of Lasting Power of Attorney:
- Property and Financial Affairs LPA to cover decisions including: selling a home, paying the mortgage, investing money, paying bills and arranging repairs to the property.
- Personal Welfare LPA covers healthcare and personal welfare decisions including: where your parents should live, their medical care, what they should eat, who they should have contact with and what kind of social activities they should take part in.
An LPA is only valid if your parents have the mental capacity to set it up and haven’t been put under any pressure to create it. The LPA must be signed by a certificate provider, someone they know such as a doctor, social worker or solicitor and it can only be used once it is registered with the Office of the Public Guardian.
How to get Lasting Power of Attorney for an elderly parent with dementia
Setting up a Power of Attorney can be a long process, and there are a lot of forms that need to be filled in.
Ideally, you want to start setting up a Power of Attorney for someone with dementia as soon as possible, as they are likely to find it more difficult as they progress through the stages of dementia.
Take legal advice when setting up a Power of Attorney after dementia diagnosis, as there are some boxes that should be ticked for particular situations.
For example should your parent become very forgetful and appear to be cashing cheques or spending money erratically, but they do not have a diagnosis of dementia, then they will still be deemed able to make their own decisions by the banks.
What happens if someone with dementia hasn't set up a Power of Attorney?
If someone with dementia is deemed incapable of making a particular decision at a particular time, and they haven’t made an LPA, the matter can be referred to the Court of Protection. The court may either choose to make the decision itself on the person’s behalf, or choose someone else, known as a “deputy”, to make the decision for them.
Where the court appoints a deputy to manage someone’s financial and property affairs on an ongoing basis, the deputy usually has to keep accounts, enter into a security bond, and report to the Office of the Public Guardian. The Court of Protection charges an application fee, and the Office of the Public Guardian charges a yearly fee to cover the cost of supervising the deputy’s work. As well as the additonal cost, effectively a stranger will be making decisions about your parents finances and care. Two very important reasons to set up a LPA as soon as you have an official dementia diagnosis.
While you are getting legal affairs in order, why not write your Will? It can take as little as 10 minutes, and all be done online. Read our guide to 10 of the best online will-writing services.
Advance Decisions for people with dementia
An Advance Decision (also known as a Living Will) is a legal way for someone to decide ahead of time what life-sustaining/life-saving medical treatment they would NOT want in the future.
Someone wishing to make an Advance Decision needs to write it down, sign it and have it witnessed. It is legally binding as long as it complies with the Mental Capacity Act, in other words, as long as you have the mental capacity to write and sign the Advance Decision in the full knowledge of its implications.
The document must explain clearly what treatments are to be refused and under what circumstances. For example, if you want to refuse treatment that might result in death, then this needs to be stated clearly. If the Advance Decision is legally binding it takes the place of decisions made in the best interests of the patient by other people, such as doctors or relatives.
Order to refuse CPR for people with dementia
All people have the right to refuse CPR if they do not want it, using a DNACPR. This stands for Do Not Attempt Cardiopulmonary Resuscitation, and it can be included within an Advance Decision form.
DNACPR means if someone’s heart or breathing stops, the healthcare professionals will not perform CPR on them. A DNACPR decision is made by the individual AND/OR by the healthcare professionals looking after them.
Having a written document outlining whether or not your parent with dementia would like to receive CPR in such a situation will make it easier for the decision that they want to be made.
The LPA + AD + DNACPR formula
If you stick with the LPA + AD + DNPACPR formula, it should hopefully be reasonably straightforward. Seek legal advice, fill the forms in correctly, and give copies to the right people. It will make life easier should you find yourself having to care for and make difficult decisions for a parent or elderly relative with dementia.