The short answer
- While your parent can weigh the decision up, it is theirsThe law starts from the position that your parent can decide, and a choice you think is wrong is still their choice.
- Legal authority comes from a document, not from being next of kinIf your parent can no longer decide, the say sits with an attorney they appointed or a deputy appointed by the court.
- A council assessment gives everyone the same set of factsA care needs assessment is free, anyone can ask for one, and it puts an outsider’s written view in front of everybody.
- Write down the week, then price itCarers on PrimeCarers charge £18 to £25 an hour with our fee included, against £28 to £35 through an agency.
This page covers England and Wales. Scotland and Northern Ireland have their own, similar laws on capacity and on council assessments, so some detail will differ if your parent lives in either.
Whose decision it is
Who holds the decision, and who does not
Before the practical questions, it helps to know whose decision it is. That turns on whether your parent can weigh up the particular decision in front of them. Find the row that describes your parent, and the one beside it says what the rest of you can do.
Where your parent is
Whose decision it is
What that leaves the rest of you
Position one
Where your parent is
Position one
Your parent can understand the choice, hold it in mind long enough to weigh it up, and say what they want.
Whose decision it is
Your parent, on their own.
What that leaves the rest of you
All of you can give them information, tell them what worries you and disagree with each other. None of you can overrule them, and a choice you think is wrong is still theirs to make. The work here is persuasion rather than authority.
Position two
Where your parent is
Position two
Your parent cannot weigh up this particular decision, and made a health and welfare lasting power of attorney while they still could.
Whose decision it is
The attorney or attorneys named in it, deciding in your parent’s best interests.
What that leaves the rest of you
Attorneys appointed "jointly" have to agree with each other before anything can be decided. Appointed "jointly and severally", any one of them can decide alone. Either way, whoever decides has to take the views of anyone caring for your parent, or interested in their welfare, into account.
Position three
Where your parent is
Position three
Your parent cannot weigh up this particular decision and there is no lasting power of attorney and no deputy.
Whose decision it is
Whoever is making that decision at the time, usually the social worker, the GP or the hospital team.
What that leaves the rest of you
Every one of you has the right to be asked what you think, and none of you has a casting vote. Being the eldest, living nearest or being listed as next of kin does not carry legal authority on its own. Any of you can apply to the Court of Protection to be appointed as a deputy.
If it cannot be settled
Where your parent is
If it cannot be settled
Your parent cannot weigh up the decision, the family cannot agree, and the decision still has to be made.
Whose decision it is
The Court of Protection, on an application from any of you.
What that leaves the rest of you
The court can make a one-off ruling about where your parent lives or what care they receive, or appoint a deputy to make ongoing decisions. It is slow and it costs money, so it is worth trying mediation and a fresh assessment first.
The Mental Capacity Act 2005 assumes every adult can make their own decisions unless it is shown otherwise, and capacity is judged decision by decision rather than as a general verdict on a person. Your parent can be able to decide about a carer in the mornings and unable to weigh up a decision about surgery the same afternoon. A choice that worries you is not, on its own, evidence that they cannot decide. Can an elderly person be forced into care in the UK? goes through where that line sits.
Where a parent can no longer weigh a decision up, the authority to decide comes from one of two places and no others: an attorney your parent appointed while they still could, or a deputy appointed by the Court of Protection. Making decisions on behalf of someone sets out both routes, and if nobody knows whether your parent made a power of attorney you can search the register held by the Office of the Public Guardian.
Two details settle a lot of family arguments. Where attorneys were appointed "jointly", gov.uk's guidance on choosing attorneys is blunt: they must all agree or they cannot make the decision. And whoever makes a best interests decision has to take into account the views of anyone caring for your parent or interested in their welfare. A brother two hundred miles away and a sister who does the shopping both count.
Four decisions, not one
Separating the four things being argued about as one
Families argue about care as a single question, and it is four. They have different answers, and different people may be right about different ones. Split them up and you no longer have to agree about everything at once.
What help your parent needs
A question of fact
Where your parent lives
Your parent’s decision, while they can make it
Who pays, and out of whose money
Your parent’s money first
Who in the family does what
The hardest one to agree
The fourth question is the one that hurts, and it rarely improves while it is discussed in the abstract. A sibling near your parent carries small interruptions a sibling two hours away does not see, and a sibling further off may be carrying the money or a job they cannot leave. Writing out the week, task by task, gives you something to divide. How can I take care of my elderly parents remotely? has jobs a distant sibling can take on, and the challenges of caring for an elderly parent covers the pressure on whoever does most.
On where your parent lives, care at home or a care home sets both out side by side. On money, can my mum pay me to care for her? covers the tax and council rules where the family is considering paying one sibling for hours they already do.
An outside view
Getting the facts assessed by somebody outside the family
A disagreement between siblings is hard to settle from inside the family, because each of you is arguing from different observations. An assessor with no history with any of you replaces opinion with a written account. All of the following are free.
- 1
Ask the council for a care needs assessment
Free, and anyone can askA social worker or occupational therapist looks at how your parent manages washing, dressing, cooking and getting about, and writes down what help is needed. A sibling living elsewhere can ask for it. - 2
Ask for a carer’s assessment for whoever is doing the most
Separate, and also freeThis looks at the person doing the caring rather than the person cared for, and can lead to a break, practical help or a small budget. - 3
Ask the GP if capacity or a change in behaviour is the question
If it appliesRaise this only where something specific points to it, such as confusion, memory loss or a personality change, not because your parent is choosing something you disagree with. - 4
Find out whether a power of attorney already exists
Half an hourFamilies argue for months over decisions a registered power of attorney has already settled. The Office of the Public Guardian keeps a searchable register.
The council's duty to assess is in the Care Act 2014, and section 10 puts it plainly for carers: the duty applies regardless of the council's view of the level of need or of anyone's financial resources. So a family cannot be turned away because somebody assumes your parent has too much money to qualify. The NHS pages on getting a care needs assessment and on carer's assessments explain how to ask, and council funding for care at home and the carer's assessment cover what follows.
Agree one thing before the assessment: who will be there, and who will speak. Four siblings contradicting each other in front of the social worker gives your parent a difficult hour and produces a muddled record. One or two of you, with a written list from the others, is better.
Writing the plan down
Writing a plan the whole family can read
Once you know what your parent needs, put it on one page and send it to everybody. A written plan moves the argument from what each of you believes to what is on the page.
What to put on the page
0 of 8 ticked
The week
Who does what
How everyone knows what is happening
When the plan reaches the point where paid help is needed, you can search for carers near you and compare their rates, experience and reviews before anyone commits. Looking is free, and two or three real profiles with real prices can move a stuck conversation, because a named person and an hourly rate are easier to discuss than a vague idea of getting carers in. How many visits a week does my parent need? works the hours out from the tasks.
PrimeCarers is an introductory service rather than an agency, so the family chooses the carer and agrees the visits directly. Before a profile appears, a carer's identity and right to work are checked, an enhanced DBS on the Update Service is confirmed, and they are interviewed online. Training, qualifications and references sit on the profile for the family to check with them.
Paying for it
What paid care costs, and what each of you is agreeing to
Money arguments are hard while the numbers are hypothetical, and easier once they are real. Here is what each kind of care costs.
| What it covers | On PrimeCarers | Through an agency | |
|---|---|---|---|
| Hourly visits | Washing, dressing, medication, meals and the weekly jobs, on the days you choose | £18 to £25 an hour | £28 to £35 an hour |
| Overnight care | A carer in the house overnight, sleeping and there if needed | £130 to £145 a night | From £150 a night |
| Live-in care | A carer living in the house, covering the day and there at night | From £1,050 a week | About £1,400 a week |
Hourly visits
- What it covers
- Washing, dressing, medication, meals and the weekly jobs, on the days you choose
- On PrimeCarers
- £18 to £25 an hour
- Through an agency
- £28 to £35 an hour
Overnight care
- What it covers
- A carer in the house overnight, sleeping and there if needed
- On PrimeCarers
- £130 to £145 a night
- Through an agency
- From £150 a night
Live-in care
- What it covers
- A carer living in the house, covering the day and there at night
- On PrimeCarers
- From £1,050 a week
- Through an agency
- About £1,400 a week
PrimeCarers figures are what families pay, with our fee included. Companionship visits run from £15 to £20 an hour. A care home place averages £1,160 a week. Past about 35 hours a week, live-in care costs less than the same hours in visits.
Care is normally paid for out of your parent's own income and savings. In England the council carries out a financial assessment: capital above £23,250 means paying for their own care, capital below £14,250 is disregarded entirely in that calculation, and between the two the council contributes on a sliding scale. Attendance Allowance is worth checking whatever your parent's savings, because it is not means-tested. Attendance Allowance and the care cost calculator are the quickest ways to see where your family sits.
If one sibling is being asked to give up work or hours to cover the care, put a figure on that too. Lost pay, lost pension and the cost of replacing those hours belong in the same conversation. Cancelled and late visits covers what happens when a booked visit does not go ahead, and the guide to care plans covers what a fuller written plan contains.
If you are still stuck
What to do if the family still cannot agree
Some disagreements do not resolve with better information, because they carry twenty or thirty years of other things. The first useful move is to stop trying to win and start protecting your parent's care from the argument.
What tends to help
- Agreeing a short trial with a review date rather than settling the whole future at once
- Putting the decision back to your parent wherever they can still make it, and asking them in front of everyone
- Bringing in a neutral third person: a social worker, an advocate or a mediator
- Writing to the others afterwards with what you understood was agreed
What tends to make it worse
- Making arrangements and telling the others afterwards
- Using your parent to carry messages between the siblings
- Reading a refusal to help as proof of how somebody feels, when it may be money, health or shame
- Letting an argument about money delay care your parent needs now
A mediator is a realistic option before anything legal, and worth trying first because it is faster and cheaper than court, and easier to come back from. Mediation is paid for, and the Civil Mediation Council, a charity covering civil, community and family mediation in England and Wales, has a search for accredited mediators. For advice rather than mediation, Age UK has an advice line and local branches, Carers UK supports unpaid carers, and Citizens Advice covers looking after somebody. Age UK's factsheet on arranging for someone to make decisions on your behalf covers powers of attorney and deputyship in full.
If a sibling holding power of attorney is using it against your parent's interests, there is a specific route: report a concern about an attorney or deputy to the Office of the Public Guardian, which investigates. Where your parent lacks capacity and a decision cannot be agreed, the Court of Protection can rule on where they live or what care they receive, and applying to become a deputy is the other route. Both take months, so keep the care going while you use them.
Questions
Questions families ask when siblings disagree
Your parent does, for as long as they can understand and weigh up the particular decision in front of them. That is the starting position under the Mental Capacity Act 2005, and it holds even where the rest of the family is certain they are choosing badly. If your parent can no longer weigh a decision up, the say passes to an attorney under a health and welfare lasting power of attorney, or to a court-appointed deputy.
No. Being the eldest, living nearest or being recorded as next of kin carries no legal authority to decide on somebody else's behalf in England and Wales. Authority comes from a lasting power of attorney your parent made, or from a deputyship granted by the Court of Protection. Without either, decisions for a parent who lacks capacity are made by whoever is making that decision at the time, after consulting the family.
An attorney has to act in your parent's best interests, and that includes taking into account the views of anyone caring for your parent or interested in their welfare. Put your concerns to them in writing so there is a record. If you believe they are acting against your parent's interests, you can report a concern to the Office of the Public Guardian, which can investigate.
It depends how your parent appointed you. Attorneys appointed "jointly" must all agree, and gov.uk states that if they cannot agree they cannot make the decision. Attorneys appointed "jointly and severally" can each act alone. The lasting power of attorney document says which applies. If jointly appointed attorneys are deadlocked, the Court of Protection can decide the point.
Ask the council for a care needs assessment. It is free, anyone can ask for one, and it produces an outside written account of what your parent can and cannot manage, which is harder to argue with than any one sibling's version. Ask for a carer's assessment at the same time for whoever is doing the most.
Price it rather than debate it. Write down the tasks and days, then attach the cost: carers on PrimeCarers charge £18 to £25 an hour with our fee included, against £28 to £35 through an agency. Care is normally paid for out of your parent's own income and savings, so in many families it is not the siblings' money being spent.