This page is about a situation most households eventually meet: a parent, a partner or a neighbour who is no longer coping with the practical side of life, and a family unsure what they are allowed to do.
The instinct is to take over. The law, and good practice, both start somewhere else: with the presumption that the person can decide for themselves, and with the obligation to help them do so.
This is not legal advice
Capacity is not a switch
The starting point is that a person has capacity, and that has to be displaced by evidence rather than assumed away.
Capacity is decision-specific and time-specific:
- Specific to the decision. Somebody may be unable to understand a pension transfer and entirely able to decide what to eat, what to wear, whether to have a visitor, or where they want to live.
- Specific to the moment. Many conditions fluctuate. Somebody may be clear in the morning and confused by evening, or clear between infections.
- An unwise decision is not incapacity. People are entitled to make choices others think are foolish. That is not, on its own, evidence of anything.
Which means the right question is never "does Mum still have capacity". It is "can she make this particular decision, today, with the right support".
Taking over more than is necessary causes harm. Loss of control accelerates decline, damages dignity and breeds resentment, and it is the commonest mistake families make with the best intentions.
Check the reversible things first
A sudden change in somebody's ability to cope is frequently a medical problem rather than a permanent decline, and several of the causes are entirely treatable.
Sudden confusion is a medical emergency, not a stage. Get a GP the same day. See recognising sepsis, where confusion is a red flag, and carbon monoxide poisoning, where it is the classic missed cause in somebody with a poorly ventilated heater.
Get the hearing and the eyes checked. An enormous amount of apparent confusion is somebody who cannot hear the question.
Supporting a decision
Before concluding somebody cannot decide, the obligation is to help them.
- Plain language, short sentences, one thing at a time.
- The best time of day, which for many people is the morning.
- Somewhere quiet and familiar, with no audience and no rush.
- Written down, or in pictures, if that helps.
- Hearing aids in, glasses on, room well lit.
- Come back to it. A decision does not have to be made in one conversation.
- Ask them what they want, rather than presenting a conclusion.
- Involve an advocate if there is nobody independent. Local authorities can arrange advocacy, and it is free.
Record what they say while they can still say it. Wishes about where they live, what care they would accept, what matters to them. That record is what guides everybody later, and it is a kindness to whoever has to decide.
The ladder of authority
From least to most intrusive. Use the lowest rung that works.
A power of attorney can only be made while capacity remains, which is why the moment somebody is beginning to struggle is the moment to raise it, not later. See wills and powers of attorney.
Find out whether one already exists. Ask, and look in the document file. Many people have made one and told nobody.
If there is no attorney and capacity is going, get advice urgently. The window closes.
Joint accounts are not a substitute and carry their own problems, including the fact that the whole balance may be treated as belonging to the survivor, and that either party can empty it.
Practical help that needs no authority
A great deal can be done without any legal step at all, and it is usually enough for a long time.
- Sort the post together once a week. Unopened post is the commonest early sign that things are slipping.
- Set up direct debits for regular bills, with their agreement, so nothing depends on remembering.
- Reduce the number of accounts and providers. Simplifying is worth more than managing.
- Register with the Priority Services Register for energy and water, which is free and gives extra support in a supply interruption.
- Arrange a nominated third party with utilities and banks, so somebody else can be contacted.
- Set up online accounts together, with their knowledge, and keep a written note of what exists.
- Redirect nuisance mail and register with the Mailing Preference Service and the Telephone Preference Service, which reduces the volume of scam approaches considerably.
- Check they are getting what they are entitled to. Attendance Allowance, Pension Credit, Council Tax reductions and Carer's Allowance are all substantially under-claimed. A benefits check from Age UK or Citizens Advice is free and frequently finds money.
- Sort out a care needs assessment from the local authority, which anybody can request and which is free.
Financial abuse
Scams are the other half of this. Older and isolated people are targeted persistently by phone, post and doorstep. Agreeing a household rule helps: nobody makes a financial decision on the day it is proposed, and everything gets discussed with a named person first. That single rule stops most of it.
Looking after the carer
The person doing all of this is usually one family member, and they are frequently the one nobody asks about.
- Carers are entitled to their own assessment from the local authority, separately from the person they care for. It is free and it is very widely unclaimed.
- Carer's Allowance and Carer's Credit exist and are under-claimed.
- Respite is not a luxury. Burnout is what causes a placement to break down, and it happens to competent, devoted people.
- Share it out. One sibling doing everything while others visit occasionally is the commonest and most corrosive pattern. Say so early and specifically, and ask for particular jobs rather than for help in general.
- Carers UK, Age UK and local carers centres provide practical advice and, importantly, contact with people in the same position.
- Look after your own health. A carer who becomes ill is two problems.