NHS Next of Kin -

[Blue123]

My mum was taken to hospital recently, she has dementia - I am one of five children, one of my sisters has never been to see my mum for several years, even though she is close-by - absolutely nothing, she has had personal issues in her family but shunned us all, changed her number etc etc. She knew our mum was getting worse, but has never bothered, just a birthday card through the letterbox. However 10 years ago she did take mum to hospital for a few appointments and unbeknown to us became her next of kin.
My other sister has been doing some housework and personal care but not nearly enough leaving my wife to go in to feed her in the morning and evening for the past year almost every day and spend a lot of time with her. Not to do that would lead to a decline in my mums health. This sister did get Power of Attorney 5 years ago.
My wife is briliant with my mum, and looks after her so well - she carefully organised a care company for my mum, got her assessed by them and social services, would discuss her medication with her GP as clearly the daughter was doing nothing ( though she was told it was happening) my sister was not happy and was refusing to let any of us access to the bank account to know what savings she would have or her current balance. The care package was all in place, mum needed extra care - everyone that knows her agrees it could only benefit her.
Clearly the sisters began communication again, and just the past 2 months has the first sister begun coming around for just an ''hour'' a week to assist in bathing my mum.
So now with mum in hospital, my wife was visiting daily at the evening meal times ( sometimes with me) to ensure she is fed well, yet when she noticed issues with her condition and asked questions she was told she was not allowed to discuss anything with the nursing staff on instruction of the Next of Kin. She was also being watched by the nursing staff making her feel she was going to abuse my mother. EVerything my wife did has been questioned by the sisters - sadly whilst I was away, my mum developed Covid, the sister sent a message to my wife and said ''my mum has covid '' Immediate family only'' ( suggesting my wife cannot visit her now) Question - what is ''immediate family'' classed as in the NHS? who should the NHS be listening to ? Should they be taking instructions from a NOK (when they have been absent for so long - mum was very well mentally when the sister did get NOK) and when a Power of Attorney is already in place? I know it is difficult for the NHS but they may not know the real circumstances

[dslippy]

The power of attorney is not a direct substitute, but usually trumps all.
Exactly what kind of power is it? They differ hugely.

[Blue123]

there are 2 types here - Lasting Power of Attorney in - Health and wellbeing and Property and Financial Affairs

[Manxman]

[Edit: Cross-posted with the OP}

The term "Next of Kin" has no legal meaning or significance whatsoever. It is simply shorthand for the NHS to know who to contact in the event that they need to contact the patient's family, or the person closest to them. (It may not even be a family member).

If your mum is in a NHS hospital, is the hospital not aware that another one of your sisters (not the "NoK") has a valid power of attorney?

There are two types of power of attorney. One relates to property and financial affairs, the other is concerned with health and welfare issues. If your sister has a health and welfare power in respect of your mother, the hospital really ought to be informed as this sister should supersede the "NoK". The sister holding the PoA should be consulted with by the hospital in respect of any matters concerning your mother's helath and welfare, and she might be asked to make decisions about your mother's treatment.

Make, register or end a lasting power of attorney: Overview - GOV.UK (www.gov.uk)

In my view (I'm a retired NHS manager) the hospital should be taking account of the wishes of your mother (insofar as she can still express them) and those of your sister who holds the PoA, not the supposed "NoK" sister.

While I'm sure that it must be very distressing for both you and your wife to feel that your wife is being prevented from visiting your mother, I'm not sure what you can do about it without risking a lot of ill-feeling with your siblings. And you can't really expect NHS staff to act as arbitrators in a family dispute or difference of opinion.

I'd have thought the most appropriate course of action would be for you to discuss this with your sister* who holds the PoA, and "to sort it out" between you. Then make sure that hospital staff are made aware of whatever arrangements you and your sister* have made. But make sure those arrangements are simple to understand and for NHS staff to put into effect. You can't expect them to referee a family fight.over who can and cannot visit your mother.

And of course you don't want to upset your mother unnecessarily.

*Ideally, of course, you would discuss this with - and reach an agreement with - all of your siblings, but it's the one with the PoA who is arguably the most important one

[Manxman]

Blue123 - further to my earlier post I may have a more practical and more useful suggestion. As well as my earlier advice you could also try contacting the hospital's Patients' Advice and Liaison Service (PALS) and explain the situation to them. As it says on the tin, they are there to provide advice and support to patients and to their families, and they are often these days also on the front line in sorting out complaints against hospitals.

Obviously in this case you are not making a complaint against the hospital - you simply want assistance in getting hospital staff looking after your mother to understand the situation better. If the hospital is providing dementia care then all its staff (and PALS) should be experienced in dealing with families and powers of attorney.

To recap my earlier post, having been named as "Next of Kin" doesn't mean anything - it doesn't give any legal rights or powers above those of you and your other siblings. Your sister who is next of kin has no more right to say who can and cannot visit your mother than you do. And that is the point you want to get tactfully across to the nursing staff caring for your mum and to PALS. But go easy on the hospital staff as they obviously should not be caught in the cross-fire of a family feud. their job is difficult enough and stressful enough as it is.

The only person who arguably has more say than you and your other siblings over your mother's care and as to who can visit her, is your sister with the power of attorney.

So ideally you want to get agreement between you and all your siblings, but failing that you need to get the one with the PoA on your side.

Good luck

[twohoots]

Well explained by Manxman. From personal experience see if all the siblings can get together so you all understand that one is POA (assuming she is sole POA) and that she is the one who all authorities (inc hospital, GP, social services, care home (if that’s the way this goes) have to speak to to liaise about your Mum. I would see if you can all do this asap.

This isn’t always possible with families as I know only too well but it really is the best way forward. As POA I arranged a meeting for us siblings to meet with my Mum and discuss her future care but one refused and has caused massive stress, upset and legal costs.

I am surprised that her GP has been discussing medication etc with your wife actually as they should only be talking to her POA which should be in her notes. I was the only one the hospital, GP, care agency, etc would liaise with. The hospital wouldn’t even take a phonecall from anyone else and I believe most hospitals are the same.

i do hope you can all work together to ensure your Mum gets the best care.

[Blue123]

Thank you so much for your guidance Manxman and Twohoots, I feel reassured now about the NOK and will go to the Hospital Liaison (if they will ever answer my call) but just to throw a spanner in the works is as well as my first sister having LPOA for health and wellbeing so does my brother though I don't think he really understand what it means. (nor did the sister) My brother is aware the NOK sister has come in trying to control everything, though of course unsure what has been divulged to the hospital. So I am wondering if brother can go to hospital with my wife and state as he has POA he wants her to be able to discuss my mothers condition with the medical staff in the same way as NOK sister is allowed to? Having a medical background also my wife has more ability to comprehend treatment plan and ability to converse along with her being so close and caring to my mum.

[Blue123]

All was not what it seemed - fast forward 6 mths, there was a reason why sister with POA did not want mum to have carers, as she had control of the bank account ( we all trusted her) but when asked for social services she would not let any of us have access to it refused to arrange statements, she cancelled the care my wife arranged for the second time ( unbeknown to us) thankfully mum ended up in hospital, and now a nursing home, it has been hell but at least mum is safe and cared for now and visited daily by my wife still - ...... needless to say we are experts now in this and owe it to mum to get justice.

[Manxman]

Ah. Sorry to hear that. I can see why your sister wanted to exclude your wife so she wouldn't discover what was happening with your mum's money. Your wife would have been a better daughter than your sister perhaps. We can't choose our relatives...

Hope your mum is getting cared for properly now