IN Worcestershire it is estimated there are more than 8,600 people living with dementia and this is estimated to rise to around 10,400 by 2020, according to the county council.

One of the contributing factors to this is our ageing population and Worcestershire has a noticeably higher number of older people compared to the national figure. According to the last census 19 per cent of the Worcestershire population was aged 65 or over compared with 16 per cent in England as a whole.

Dementia is not confined to the elderly and with the growing evidence that more of us will end up living with the condition, which gets progressively worse, it is more important than ever that adults put in place official measures to protect their health and welfare for the years to come.

Once a person loses their mental capacity, they have lost the opportunity to officially state their wishes.

Specialist in adult health and welfare issues and associate solicitor at Harrison Clark Rickerbys Catherine Hitchman, who is based in Worcester, said it is extremely important individuals complete and register a Lasting Power of Attorney (LPA) for health and welfare.

“Most people know about the property and financial LPA but a lot of people do not know about the health and welfare one.

“A lot of people think the old Enduring Power of Attorney covers health and welfare but it does not and people are shocked that it does not cover what care people have when they lose capacity and in what environment - nursing home, at home, residential home.”

Loss of capacity can result from a number of issues such as a stroke, brain tumours or acquired head injury – not just dementia.

Mrs Hitchman, who worked for Worcestershire County Council for 10 years advising on adult social care functions, said she has seen the consequences when a person loses their capacity to make decisions and there is no LPA in place relating to their health and welfare.

She said a person could have a stroke and the local authority and health services are looking at discharge planning and the family want them to go home but the authorities feel there are risks and it is in their best interests to go into a residential home.

“If the local authority decision is not accepted by the family or there is no decision because of a dispute, the council would have to refer the case to the Court of Protection,” she said. These sort of cases can be very complicated, costly, long-winded and distressing to family members and the patient, she added. There can also be cases where family members do not agree with each other as well as with the authorities and the patient has died before it is resolved.

“You are going into a whole legal minefield. There are no winners in that situation,” said Mrs Hitchman. If the Court of Protection deals with the case each party involved has to pay their own costs, including the patient who is normally represented by the Official Solicitor, and when this involves solicitors and barristers the fees escalate quickly.

Mrs Hitchman said: “The total costs for these proceedings can run into tens of thousands of pounds. Family frustrations can erupt into violence in some cases. It must have an impact on people’s mental health - for whatever reason you think you are doing the right thing and someone else is disagreeing with it.

“There have been cases of a parent being taken from the care home or their own home by a member of the family and I have known some particular proceedings where the patient has passed away before the proceedings are finished.”

She pointed out that these cases tend to take at least 12 months to resolve but can go on for two or three years and the court will make an interim ruling about the patient’s care until a final decision is made.

“There is the emotional strain as well as the financial strain and that feeling of being quite powerless for the members of the family particularly if they don’t have access to their own legal advice. The family can feel this is a decision they should be making.

“By making an LPA you are taking these decisions at that time of your life when you have the capacity to think about them and make informed decisions about what you want to happen if you were to lose the capacity to make your own decisions in the future.

“The LPA eliminates all the problems. The key is that you are making the decisions at the time you have got capacity to make your own decisions and express your wishes and you name someone you trust to be your attorney. The health and welfare LPA only comes into effect when you lose capacity and that is measured by a standard test.

“The attorney is required to act in the best interests of the patient. Once we have had the registered LPA back from the Office of the Public Guardian, it is stored in the strong room and not released until there is evidence and we are sure the person has lost mental capacity.

“Having seen it from both sides and what happens when things go wrong, it is really important to put an LPA in place and not put it off. Do it sooner rather than later.

“At the end of the day, you do not know what is round the corner. You could get struck down with a life limiting illness. It is a good thing to do and it is protection. There is a way to avoid the problems and ensure your wishes are respected.”

LPA forms can be completed with the help of a solicitor and are available to download from the government website by visiting https://www.gov.uk/government/publications/make-a-lasting-power-of-attorney. The forms do need careful consideration and to be correctly completed and help from a legal expert is recommended in many cases.

Worcester-based Onside Advocacy offers impartial guidance to vulnerable adults wanting to complete and register an LPA. Nicola Reece, Onside marketing manager, said: “In some cases they are living on their own or have the early onset of dementia. The people we support are probably the most in need of an LPA.”

For information about Onside visit http://www.onside-advocacy.org.uk/ or ring 01905 27525.