12A Dementia and the Need for a Will and Other Documents [Update 10 - 22.12.13]

A person with dementia in the end of life (EOL) phase should be receiving appropriate care, in an appropriate place, and in accord with his or her wishes. Hopefully, he or she would have made arrangements to be in place so as to cover important decisions about their care, place, and their finances and property. If the individual is young the decisions may affect a young spouse or partner and any children. The decisions can only be known and acted upon in law by the family, carer, doctors, health and care workers if there is a Will, and powers of attorney, etc covering property, finances and, in particular, health and welfare (care) matters.

The above and other pre-EOL matters which might be listed. [see Post 12B]. They include:

• Will
• Lasting power of attorney for a) property and finance, and  b) health and care 
• Decisions on refusal of treatment
• Funeral arrangements 
• Donations of organs and pacemaker, etc
• Family records and history for future generations
• Messages for family members and friends 
• Decisions about distribution of sentimental items
• Declutting of papers, records and chattels
• Trusts and other arrangements for vulnerable members of the family, eg children, vulnerable adults.

A lawyer who specialises in family law, estate planning and the like might be expected to give advice on the likes of the following documents:

• Will
• Lasting powers of attorney for financial and property affairs (see a later Post)
• Lasting powers of attorney for health and welfare (see a later Post)
•  

Will

It is surprising how many individuals do not have a Will (or "mirror" Wills in the case of a couple). 

A Will is a formal legal document which states the wishes of an individual (testator) as to the likes of the following:

• distribution of his or her estate after death 
• provisions for a spouse or partner and any children 
• gifts to other persons, etc. 

Formal Preparation of a Will

When preparing a Will certain formal conditions are required by law, including

• the testator must have mental capacity to make a Will 
• provision for one or more executors who will administer the estate in due course
• a signing of the Will by the testator
• the witnessing of the act of signing by two persons.

A Will is normally prepared by a solicitor or legal executive after an explanation of the testator's intentions - where necessary, with guidance on how the law affects the intentions. 

Absence of a Will 

Unless an individual has made a Will his or her intentions for his or her estate would most probablty not be met.   This is likely in the following kinds of circumstances:

• no Will was made 
• the Will is void as a result of re-marriage taking place after it was made
• the testator did not have mental capacity at the time the Will was signed 
• the Will is otherwise invalid, eg it is defective in form, eg not witnessed. 

In any of these circumstances the deceased's Estate will pass under the Rules of Intestacy.

Finally, even if a Will has been made, it may be disputed and contested in law because, for instance, no provision was made for the deceased spouse or children who are minors. Here one or more aggrieved parties may seek a deed of variation.  

Solicitors for the Elderly
Many solicitors may advise or act on these matters but in the 1990s a national body was set up, Solicitors for the Elderley. It authorises individual solicitors, barristers and legal executives requiring of them the following:

• to have a specified number of years of advising seniors
• to pass a qualifying examination on the relevant areas of law
• to comply with the SFE Code of Practice.

More details are available on the following website: http://www.solicitorsfortheelderly.com/

Footnote: This mention of Will Aid - see www.willaid.org.uk/ which, I understand, runs in November every year, and allows individuals or couples to obtain a Will or mirror Wills respectively at relatively low prices.

Profile 1A Dementia Services at Darent Valley Hospital (DVH) [Update 1 - 28.10.13]

See also Profile No1[25.10.13] for a brief description of Darenth Valley Hospital (DVH).

The prevalence of dementia in the area of the NHS Dartford, Gravesham and Swanley Clinical Commissioning Group (CCG) is now about 51% - some 49% of those living with dementia are, therefore, not currently diagnosed.  In line with national diagnosis standards the CCG has commissioned services so that the rate is targetted to rise to about 66% by 2015.

All this is important since those living with dementia who may be expected to go to DVH are likely to increase in the immediately foreseable future. They will be going fort the following reasons:

• a non-dementia related crisis in their health 
• a routine consultations with a consultant on health matters which are non-dementia related
• a person with memory problems who may be referred to the hospital's memory clinic after assessment by say, their GP
• after an event where a person has been found lost, they may be taken to the memory clinic at the hospital 
• after an event where a person has been found lost - wandering - they may be taken to the memory clinic at the hospital or, temporarily, to the secure unit for an assessment, etc 

In addition it may be noted that any patient over the age of 75 who is admitted for more than 72 hours will normally be assessed for memory problems. If the possibility of dementia should be indicated, he or she will be referred for diagnosis.

[The Dementia Buddy programme of volunteers at DVH is an important developoment which is being rolled out to other hospitals in Kent (see Post 13) when published shortly)].  

Profile 1 Darent Valley Hospital - Dementia Care Settings, Services and Staff [Update 1 - 18/11/13]

Related Posts
Profile 1A for dementia-related matters for admittance at Darent Valley Hospital (DVH).
Profile 1B  for the volunteer Buddy Scheme at DVH.

Introduction
DVH is the principal hospital within the area of Dartford, Gravesham Swanley Clinical Commissioning Group (DGSCCG). Most of the population living in Swanley are likely to be admitted there.

Numbers
The number of people with diagnosed dementia in the area of the DSGCCG is 1256 (July 2013), which means there are likely to be another 1200 or so who are not diagnosed. (The latter are more likely to require admission to DVH as a result of a crisis.)

Patients with dementia who are admitted to hospital with non-related conditions, eg a stroke, or following a severe injury in dementia- related crisis, eg a fall, will be cared for in the specialist ward for the illness or a dementia ward.

Accommodation
DVH has specialist units for dementia, including:

• several  dementia wards
• a memory clinic for those with memory problem - providing assessment, diagnosis and, if appropriate, treatment 
• a secure unit temporary admission for those who may harm themselves or other treatment.

The dementia wards and other care facilitities have been or are being redesigned and redecorated to make them more dementia friendly. This initiative is in line with policy and funding under the national Dementia Declaration (see Post No 5).

Key Staff

In the last few years personnel concerned with the treatment and care of those living with dementia at DVH have been appointed, or further trained and developed. The key staff for dementia include:

• consultants
• nurses, at least one of whom is a specialist dementia nurse 
• a group of volunteers known as "Dementia Buddies"
• NHS who have become Dementia Champions (seemingly a different role to that of Dementia Friends Champions) .

DGSCCG (July 2013) Dementia - The forgotten disease, DGSCCG