A Caregiver's Roadmap
Sarah, (46) and her mother, Mary, (79)
Sarah is a busy 46 year old currently balancing her own life responsibilities with the growing needs of her 79 year old mother, Mary.
Mary still lives alone in the family home and values her independence highly.
​Lately, Sarah has moved from casual checking-in to a state of low-grade anxiety. She has noticed her mother's forgetfulness once thought to be ‘senior moments’, Mary has now missed bills, has confusion about appointments and medication.
Sarah is concerned that her mum's living situation is becoming unsafe and worries about the stove, medication management and vulnerability to scams.
She feels the heavy weight of the role-reversal shifting onto her shoulders and is struggling with how to intervene protectively without stripping away her mother's dignity or causing conflict.
1. Identify ‘Mental Capacity’
Sarah was appointed her mother’s Power of Attorney (POA) when she was in hospital for a knee replacement. However, if Mary’s ability to remember things and her ability to make informed decisions worsens she may be assessed as having lost mental capacity. *Mary must have mental capacity at the time of signing an EPA.*
If an EPA is not registered and Mary does lose mental capacity Sarah may apply to the Office of Care and Protection for a Controllership, which is significantly more expensive and takes much longer.
Resources & Signposting
· NI Law Society Enduring Power of Attorney
· Your Life, Your Choices Booklet
· Age NI
2. In Case of Emergency’ (ICE) folder
Thinking and planning ahead, Mary and Sarah decide to gather important information. Placing all information in one place, that Sarah knows about, will help to minimise further stress in the case of an emergency.
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Gather important documents to create an ‘In Case of Emergency’ (ICE) folder containing:
· National Insurance number and NHS number.
· List of bank accounts and regular bills (Direct Debits).
· Contact details for her GP and any specialists.
· Mobile phone password.
· Email and social media passwords.
Resources & Signposting
3. The "Golden" Conversation
Sarah may want to talk with her mother about what matters the most to her, including the people and places she values. Mary can then record her thoughts, beliefs, and wishes to ensure her voice is clearly heard.
This conversation may prompt questions around where she would like to cared for, her feelings on resuscitation for example Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and artificial feeding.
These are tough, but doctors will look for these preferences if Mary can no longer speak.
Mary can record her wishes in a legally binding document called an Advance Decision to Refuse Treatment (ADRT) that healthcare professional must adhere to.
The Northern Ireland "Big Three" Documents
Unlike other parts of the UK, Northern Ireland does not have a ‘Health and Welfare’ Power of Attorney. Instead, planning is split into distinct categories:
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Enduring Power of Attorney (EPA) is a legally binding document that covers property and financial affairs ONLY, such as banking, bills, and managing a home. It must be registered to be fully effective.
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Advance Decision to Refuse Treatment (ADRT) is a legally binding document used to record the refusal of specific medical treatments.
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Statement of Wishes: This outlines preferences for daily care and quality of life. While not legally binding, it serves as vital "best interests" guidance for healthcare providers and families.
