I guess I'm stuck in a time warp. It doesn't seem possible that my father is nearly 70. It shocked me to realise that, but then I'm lucky because he's always kept himself mentally agile, even when caring for my mother. He's still working as a technical editor and website designer, because he enjoys it. Its now been proved that we all have to keep our brains as active as our bodies in order to fight the progression of dementia.

Once you stop learning or having new experiences you begin to mentally age - which is a frightening thought really.

One of my clients had a dementia or Alzheimers assessment not so long ago by her community nurses, assessing her suitability for Aricept. One of the things which we discussed was in fact not how much (work) I was doing looking after my client, but  how little I should be doing. Now this is a double edged sword, because obviously in my capacity as carer I was supposed to be doing all kinds of jobs about the home as well as her day to day care, but then I had been advised to encourage her to do as much as possible for herself. It was very difficult to try and achieve this without seeming to become somewhat uncooperative. Thankfully we muddled along, and with her improvement on Aricept she beagn to take more of an interest and wanted to do more for herself. The trouble is that with her Alzheimers she became less and less able to read as her concentration levels dropped. She also ceased to take an interest in the (terrestrial) television, probably quite rightly so! 

To keep someone stimulated is sometimes quite difficult.  I found the following book quite helpful, as was this one, as the activities are organised by general categories such as music, exercise, horticulture, pets, humour, and social events. The largest section deals with communication and includes word games that help people to make the most of their remaining verbal skills.

One of the problems experienced by overseas carers, or indeed by short terms new carers is that all too often they are unfamiliar with your local area.  It is normally required as part of their caring duties to attend hospital or doctors appointments with their client or even do simple shopping tasks. All too often this can become a nightmare, particularly contending with an Alzheimer's client, heavy traffic and new roads. These are some practical suggestions. 

• Try an make sure that appointments are not within 24 hours of the new carer arriving from the care agency.  Allow a settling in period and time to adjust to the client, the car and read a map.


• Satellite Navigation systems. A wonderful little invention that takes all the stress out of getting from A to B and facing unexpected diversions, or taking the wrong exit off the motorway!  Costing about a £100 and giving clear voice instructions you can find most hospitals, railway stations, addresses by postcodes etc. The clear instructions dispel any doubts from anxious clients. I know from experience that a former client was utterly convinced she could direct me to a given point.  She ended up getting us hopelessly lost, in an area I didn't know, where upon she panicked and became very distressed, she tried getting out of the moving car. I learnt very tactfully never to trust her judgement again, if only because the roads have changed so much since she was last driving.


• Get postcodes with every address, along with telephone numbers, so worse case scenario your carer can always get some helpful advise en-route.


• Full road recovery.  Absolutely essential when travelling with clients. Make sure the card or the contact information is left in the glove compartment, never with the client.


• Emergency supplies.  Keep a first aid kit when travelling. Also a glucose drink or bottled water and a blanket, map and a fully charged torch. 


• Have regular servicing of the vehicle. I was once in a vehicle breakdown with my client, and although considered a priority rescue, it was nearly two hours before we were taken home. As this was during the winter, it could have been a very serious incident for a relatively minor breakdown.


• Make sure your carer always has a fully charged mobile phone when travelling and has family emergency contact numbers.


• Have you got a disabled parking badge? If not it may be worth applying for one from your local county council if you think its appropriate.


• For the less active or mobile - try a swivel seat . I found the stress of getting one of my gentlemen in and out of the car almost too much for him, both he and I began to dread car journeys.

It should always be remembered that using  Law is best (and usually cheaper) as a preventative course of action, and that certain events should always be avoided.  However it is very much human nature to avoid talking about unpleasant facts - one's death or incapacity, being one of them. Having trained in UK Law, and with a daughter practising in Australia, it saddens me to see families resort to desperate legal remedies when these events could have been so easily avoided with a bit of forethought, and discussion. There is truly nothing worse than being faced with the loss of a loved one and then having to go through the Intestacy process.

You can't leave such matters too late, particularly if you think there is likely to be a diagnosis of Alzheimer's, or any other condition that might leave you (or your parents) without the mental capacity (this is both a medical and legal definition) to know your own mind, and exactly what you are signing.  Any legal document signed after this point can, and most likely will, be challenged and may be invalid. 

 

Everyone with dependants or assets should make a Will. UK Probate Law is very complex but this is a basic guide of how the UK's Intestacy Law currently works.

Where the deceased leaves a spouse but no children, the spouse receives: 

• All the personal effects such as a car, furniture, clothes and jewellery


• A legacy of £200,000 and one half of the balance outright


• The remaining balance then passes to various relatives; first to the deceased's parents if either are still alive but if not then equally amongst brothers and sisters

Where there is a spouse and children, the spouse receives:

• All the personal effects


• A legacy of £125,000 and the income from one half of the balance


• The rest passes to the children on reaching 18

All this can leave the spouse and the children with a financial nightmare, typical problems may include:

• If the matrimonial home is in the deceased spouse's sole name, this may often have to be sold to satisfy the various family claims

• Where there are children they are likely to receive very little, unless the estate is worth several hundred thousand pounds


• Inheritance tax may be due if the value of the estate passing to the beneficiaries, apart from the spouse, is worth more than £300,000 (2007/2008 tax year)

I found a great website which allows users to fill in their own fully legal UK Will online. Their legal team has devised all the questions they need to answer to make a fully legal Will, without the hassle of using third parties such as a solicitor. The Will is then checked for errors and professionally bound. All this is carried out by a registered, qualified UK Will writing expert and returned to the user within 48hrs. This service is quick cheap and reliable and gives you the peace of mind that your Will is fully legal. DIY (over the counter) Wills have the problem that they may be invalid, but the chances are you won't find out until its too late! Even worse is when, more commonly now, couples, aren't married, but do have children. In this case you should also consider a Parental Responsibility Agreement. Dont delay!

 

Another document to consider is a Power of Attorney which enables someone to administer your financial affairs should you be unable to do so.  We were very grateful this was a matter my Mother had considered whilst she was still well enough, and it made things a lot easier for my Father when he had so much to cope with.

 

I personally chose to make a Living Will , (having watched my Mother be unable to communicate her own wishes) a copy of which my daughter has, which documents my personal decisions on medical intervention. I would like to save my children from having to make the final decision about when its OK to cease medical support.

 

Disclaimer: This material is produced and published on this website or the receipt of any information from Independent Care or its website is not intended to create nor does it create a solicitor-client relationship between you and Independent Care and / or its employees.  This website is intended to provide general information in summary form on relevant legal topics, current at the time of first publication. The contents do not constitute legal advice and should not be relied upon as such. Formal legal advice from a solicitor or legal advisor should be sought in particular matters.

We were exceptionally fortunate, in that my Mother was able to contribute in the decisions of choosing her own Carers. These carers stayed with us, living with our family for over 10 years. We used a local firm of accountants to administer the payroll, so we had little paperwork.  It gave us total control of my Mother's care plan, and the decision making. 

Using a Care Agency

Although using an agency is usually more expensive than recruiting care yourself, it has the advantages of:

interviewing potential candidates & taking care of the paperwork.

dealing with an employee's National Insurance and tax.

checking references.

providing a back-up if an employee is ill or unsatisfactory.

Social services should be able to tell you about care agencies in your area, or check the listings in your phone directory.

Recruiting a Carer

If you decide to recruit help directly rather than use an agency, you should be aware of the responsibilities this gives you as an employer or existing caregiver. For example, you will need to:

check out your employee's references carefully. Do a verbal reference check as well as looking at the written references.

pay statutory sick pay if an employee is ill and provide cover, possibly respite care.

pay towards your employee's National Insurance contributions.

sort out your employee's income tax. There are many small accountancy firms who will offer a payroll service for a minmum fee, or there are payroll software solutions available.

take out adequate public liability insurance to cover any accidents an employee might have in your home. You will often find this included in normal household contents cover. You will be liable for injury and/or loss to the carer under the Occupiers Liability Act 1957 (as amended).

You may also be liable to pay compensation if you dismiss an employee unfairly or make the position redundant. Furthermore if they have been living with you for a long period (with or withour a contract of employment) they may have established tenacy rights.

You should always seek independent legal advice before terminating employment. It is always adviseable to have a written contract of employment in effect, otherwise a verbal one is assumed in law. 

Furthermore, if you have chosen a non-British employee you must first establish their right to work in the UK. They must complete a P86 regardless of their country of origin. You must also establish if they require a valid visa and when it expires. This is of course the carer's legal responsibility. 

I found the following government website particularly helpful.

Disclaimer: This material is produced and published on this website or the receipt of any information from Independent Care or its website is not intended to create nor does it create a solicitor-client relationship between you and Independent Care and / or its employees.  This website is intended to provide general information in summary form on relevant legal topics, current at the time of first publication. The contents do not constitute legal advice and should not be relied upon as such. Formal legal advice from a solicitor or legal advisor should be sought in particular matters.