It’s called Lasting Power of Attorney – LPA in the UK; but does the same response occur in the US?

I was amazed at what happened to me today. The Care Manager of the team looking after my mam questioned the validity of the LPA I have for my mam’s Health and Welfare when I produced it. He was questioning whether my mam was fully aware of the gravity/authority of the document she had signed. This is strange to me – since the document does not become active until my mam is deemed incapacitated in her ability to make sound decisions. And since they are giving her a full bill of health in that department; handing back full financial control from the Department of Works and Pension to her - for example; they should not be concerned about the LPA.

The Care Manager – questions the LPA process – since my mam now denies having been informed fully of the weight of the document she was given to sign. This was after 6 months from the time of her signing. Five to four months before her signing, the symptoms of her current deterioration began showing. A friend of mine asked whether I have an LPA in place – in case it is Dementia she is developing. So I looked into it, with my mam fully in the know. I don’t like doing things that affect her – without her knowing; it’s a kinda child-mum thing that I feel I owe her an explanation for anything I do that’s serious. So she signed the document, it got validated two months later by the Office of the Public Guardian - UK. It all looked legit to me.

IMO the Care Manager is from the school of ethics that places more weight on the person’s current opinions, feelings or current wishes – over what they have previously decided or agreed on. I do agree that a person should not be tied to their previous expressed opinions – such as those they expressed when they were teenagers Vs to how they now feel as adults. Similarly, a person should be able to change their Last Will and Testament – if they so wish. However, when it comes to Mental Health – LPAs effectively restrict the person’s choices and tie them to their previously expressed will; it holds them to their word. That’s essentially what a legal document does; record what people have agreed to and compel them to stick to what they say.

The LPA becomes a “guardian” by law; and that Law is not open to interpretation by those who are not party to the initial signing of the document. There is no opinion or feelings required in order for the LPA to be validated after the signing; it’s simply a matter of law.

IMO - the Care Manager – sees this as a potential problem – for his team’s caring assignment. In their ethical framework – the most current opinion or ideas of their patient is paramount. They must give priority to the feelings of the patient; any request they make is held sacrosanct. It really is a very attractive ethical framework to live and operate by; giving the patient all the support they want; acting on every desire they express (within safety limits of course) – is just oh so “caring” – you could stick a bushy tail on it and call it a bunny rabbit; it’s delightfully attractive and kinda cute. But the long-term interest for those caring for their mums and dads – are relegated to the side line and essentially ignored.

This is a warning to those who believe the Law is above personal feelings. If you have an DPOA in mind, and you proceed to give all those concerned in the medical circles a copy – I would suggest be prepared to meet up with some resistance from those who adhere to this “care” ethics. There is a term banded about for it – but the results are less justice for society in the long term.

They are so focused on “caring” for their patients – they will resist any rule that will hinder their ability to facilitate bringing about the patient’s wishes. It’s all about mum’s and dad’s feelings first; your feelings are irrelevant. The DPAO allows you to have a large say in what happens to mum and dad – that may not be to their liking; so don’t expect those in charge (if they hold to this ethical frame) to be happy with that doc.