NOK for aunt - responsibilities

Flakie

In the last three years or so I have been back in contact by phone with an aunt that I haven’t actually seen for decades. She lives about 200 miles away from me. She is estranged from her son and daughter and has no one else. Until last weekend she lived in a flat with carers going in four times a day as she has multiple health issues. A few weeks ago we were talking about what would happen if something happened to her and I agreed to be named as NOK on her notes so I would be notified. She wants nothing to do with her children and has removed them from her will and left instructions that they are not to be contacted at all. Last weekend she was taken into hospital and it looks like she will be there for some time. The care team she was using had terminated their contract for her due to take effect in a few days due to her attitude towards them. It doesn’t look like she will be able to return to her flat so the SS are talking respite and then a care home at some point. When she was taken out of the flat the care team was with her and one of them said they would take her handbag and have it locked away in their office. She agreed to this in the heat of the moment but then told,me that there was between 2 and 3 thousand pounds in there in cash. The designated care manager from adult social services is looking into this as we speak. She had no money with her so I arranged with the hospital league of friends to pass on an initial £10 to her for essentials which I will pay back to them. My question is who takes responsibility for the bag and cash ( assuming it is there) and what responsibility and rights do I have as NOK? I can’t start travelling there unless it’s absolutely necessary due to my own commitments and can’t keep shelling out money if she is in hospital for some time. The SS lady said they have very little power to do anything. Surely this isn’t an unusual situation. Any advice or suggestions gratefully received! 

MovingForwards

No responsibility or rights.
If you want to help get your aunt to sort out a power of attorney.

MalMonroe

As MovingForwards said, no responsibility or rights. 

Now your aunt is in hospital they may allocate a social worker to her if she doesn't have any relatives who can help or visit. When you are in hospital you receive many 'official' type visitors such as social workers, occupational therapists, dietitians, you name it - and your aunt should be allocated someone to help her. (My daughter was in for a while just before covid struck and the scariest visitor she had was a vicar. He was lovely but she thought she was on her last legs! Why did they send a vicar, she asked. We still don't know.)

The social workers should ensure that any valuables are kept safe. 

Normally people who are assessed as being unable to care for themselves any more are allocated a care team, so your aunt should be all right. Also, during the pandemic, people weren't allowed to visit hospitals and it looks as if we may be headed that way again. I do hope everything works out for your aunt. It's just such a shame about her children. 

Flakie

Thank you both. I appreciate your thoughts on my situation. 

Savvy_Sue

Remember, just because she's named you as NoK, you don't have to take responsibility for her affairs, choose a care home etc, and you can't sort out payment for anything without power of attorney. You may have to repeatedly make that clear to people.

elsien

Hospitals like a “next of kin” so they have a named person to contact, rather than a variety of friends and family.
As already said it has no meaning in law and confers no rights whatsoever. 

The basic legal position is that if aunt has capacity she makes her own decisions. If she lacks capacity, any power of attorney or deputy  is the decision maker. If there’s no power of attorney then the relevant professional or team (depending on the decision) are are decision maker but they are obliged to consult with family/friends. If family/friends want to be consulted - some do not. 

I do wish hospitals would stop banging on about next of kin because it does muddy the waters an awful lot. 

If she can manage her finances then she needs to consider how to make sure bills etc are paid. If she lacks capacity around finances then no one except am LPA or deputy can access her bank account. If that is what is needed the LA can commission a paid service to take this on and act as appointee for pension etc. They may well ask you first. You can say no without giving a reason if that is more responsibility than you are willing/able to take on board. 

Albermarle

If she lacks capacity, any power of attorney or deputy  is the decision maker. If there’s no power of attorney then the relevant professional or team (depending on the decision) are are decision maker but they are obliged to consult with family/friends

In practice is it not the case that most decisions are not made by any specific person , even when there is a PoA, but that every interested party agrees what is in the person's best interest . The legalities of who makes the 'final decision' only comes into play when  it can not be agreed what is their best interest , which may never happen .

I am not that sure but I though that is how things normally worked in practice , although clearly disputes will crop up from time to time. 

elsien

Albermarle said:

If she lacks capacity, any power of attorney or deputy  is the decision maker. If there’s no power of attorney then the relevant professional or team (depending on the decision) are are decision maker but they are obliged to consult with family/friends

In practice is it not the case that most decisions are not made by any specific person , even when there is a PoA, but that every interested party agrees what is in the person's best interest . The legalities of who makes the 'final decision' only comes into play when  it can not be agreed what is their best interest , which may never happen .

I am not that sure but I though that is how things normally worked in practice , although clearly disputes will crop up from time to time. 

I attend best interests meetings regularly as part of my job and although there may be agreement amongst all concerned, there is still a decision maker (or occasionally a team) who confirms that lack of capacity has been properly assessed and after discussion what the decision is. It is also not uncommon for there to be disagreements about best interests and part of that process is the decision maker taking all the conflicting views into account when weighing up the pros and cons for each potential option.
It may feel like a consensual decision, and that is the best way, but there is still legally a decision maker because there has to someone to take responsibility and accountability for the decision that has been made. 

Albermarle

Thanks for that .
For adults who have never had capacity ( severe learning disability from birth for example ). In this case there can be no POA and the court of protection is unwilling in most circumstances to grant a Deputyship for Health & Welfare ( I think in the past they would but not anymore)
In this case there is no regular decision maker , so all decisions have to be made jointly with relevant parties /in best interest. So nobody taking direct responsibility as far as I can see. 
If there is a dispute , the court of protection can be brought in to make the decision, on a ad hoc basis, but that would not be something happening on a regular basis, if at all.

That is how I understand this situation anyway.

elsien

Day to day decisions would be made by the people supporting them. Medical decisions by the relevant health professional. Decisions about where they live by the local authority or health, depending on how they are funded. They are always best interests decisions, but there will still be a formal decision maker (although it may not feel like that if everyone is agreed.) 

MCA code of practice p69

Who can be a decision-maker?

5.8 Under the Act, many different people may be required to make decisions or act on behalf of someone who lacks capacity to make decisions for themselves. The person making the decision is referred to throughout this chapter, and in other parts of the Code, as the ‘decision-maker’, and it is the decision-maker’s responsibility to work out what would be in the best interests of the person who lacks capacity.

• For most day-to-day actions or decisions, the decision-maker will be the carer most directly involved with the person at the time.

• Where the decision involves the provision of medical treatment, the doctor or other member of healthcare staff responsible for carrying out the particular treatment or procedure is the decision-maker.

• Where nursing or paid care is provided, the nurse or paid carer will be the decision-maker.

• If a Lasting Power of Attorney (or Enduring Power of Attorney) has been made and registered, or a deputy has been appointed under a court order, the attorney or deputy will be the decision-maker, for decisions within the scope of their authority.

What this means is that a range of different decision-makers may be involved with a person who lacks capacity to make different decisions.

5.10 In some cases, the same person may make different types of decision for someone who lacks capacity to make decisions for themselves.

For instance, a family carer may carry out certain acts in caring for

the person on a day-to-day basis, but if they are also an attorney, appointed under a Lasting Power of Attorney (LPA), they may also make specific decisions concerning the person’s property and affairs or their personal welfare (depending on what decisions the LPA has been set up to cover).

5.11 There are also times when a joint decision might be made by a number of people. For example, when a care plan for a person who lacks capacity to make relevant decisions is being put together, different healthcare or social care staff might be involved in making decisions or recommendations about the person’s care package. Sometimes these decisions will be made by a team of healthcare or social care staff as a whole. At other times, the decision will be made by a specific individual within the team. A different member of the team may then implement that decision, based on what the team has worked out to be the person’s best interests.

Flakie

Just resurrecting this if that’s ok. Things have moved on a little with my situation. Aunt J is now in a nursing home on a months funding for assessments. The Continuing Healthcare Team are recommending 24 hour nursing care and have said she is eligible for nursing care funding (?). Her free funding stops on 2nd February but up to now the case manager hasn’t been able to speak directly with her to get her view on things due to Covid in the home and residents isolating and very poor phone signal in the home. It’s all going to the wire a bit. But something came up when I was chatting with a friend about me being NOK. I know you’ve all said that as NOK I have no legal responsibilities which is fine with me but as things progress is there any situation that might arise where I would be liable for any financial contribution or recompense? I know J doesn’t have much money and I’m not in a position where I could be paying out for anything. Thanks again.