Isobel was an elderly lady who ended up living alone.  She had no children but did have nieces and a nephew.  She was wealthy in that she owned a substantial property on the coast and had a significant amount of savings, shares and investments.  Her estate was to be left to the nieces and nephews.  A nephew was made Power of Attorney for Health and Finance. 

 

Isobel developed dementia.  She wanted to stay in her house, be cared for and die there, she could well afford it.  This was not recorded anywhere although the nephew and nieces knew this and so did the full time carer.   A full time carer had been hired which the estate could easily afford and had worked with Isobel for at least two years.  As the dementia progressed the carer learned Isobel would only eat certain foods otherwise she would not eat and become distressed.  She would only do certain things to move around, for which she needed help, otherwise she did not move around.  Isobel liked to go outside when she could in the grounds of her wonderful house by the sea.  The nephew lived overseas so was not around to know the day to day care of his aunt.  Every now and then the nephew (with the Powers of Attorney) would visit the house but did not go into the room of his Aunt to see her any more.  The same full time carer remained looking after Isobel.  The full time carer became ill and had to go into hospital for three of four days.  She organised replacement cover with full instructions to care for Isobel until she returned a few days later.

 

During the carer’s absence the nephew went to his solicitor to exercise his right as Power of Attorney and within those three days had organised putting Isobel into a care home.  He wrote to the carer telling her that the family had decided that it was best Isobel went into a care home and that she was no longer needed.  The nephew no longer needed to wait for Isobel to die.  The house was sold, the estate liquidated and most of the assets distributed pre-death.  She remained in the care home for a further three years refusing to eat most of the food she was given, hardly ever moving out of her bed and reliant solely on seeing the care home staff. 

 

To the carer, it did not matter Isobel had dementia.  It was still Isobel, who would only eat her favourite food and who liked to be taken outside and follow a particular daily routine.  The estate could easily afford to keep Isobel’s care running at home and her needs were not specialised at the time such as to require specialist nursing care.   The caregiver was keen to ensure that she attended to Isobel’s wishes for as long as possible, ones that made her content during her end of life period but this was taken away from her and Isobel.   Anyone dealing with dementia patients will know how difficult it can be to learn about the patient and handle their behaviour and keep them calm and content.  In the end, Isobel may have needed specialist care, but it turned out this was not the case.  This carer asked if there was anything that could be done to help people like Isobel in future.

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We have developed the Right to Die at Home plan, Isobel's Conditions, the Advanced Care Plan and better use of the Letter of Wishes as needed.  Our planning and forethought on behalf of our clients has been extensive.  We believe in our work and the meaning of the word professional.