Don't know who to turn to ...

[Jo Sutton]

Long story short, I spent Wednesday afternoon in A&E with Mum and it turned out that she has a hairline fracture in her pelvis which is making it extremely difficult to put any weight on her left leg. A&E kept her in overnight to "get her pain medication right and assess her mobility".

On Thursday morning, I got a call from the hospital asking if I was prepared to have her home. "Only if she is able to walk," I said, and was assured that she could now walk with a frame.

When I got to the hospital to pick her up, there were no doctors in sight, a nurse with her back to me who waved her hand without turning round and said I could take her, and her pain medication was in the bag.

Mum was kicking off, refusing to take off her hospital gown and get into her clothes, insisting she could walk the length of the hospital corridors to the car park, and it was a real palaver getting her into a wheelchair, outside and into the car, and it took all my energy so I didn't question the hospital any further.

When I got home, I found that the 'pain medication' they had so carefully managed was paracetomol, which she takes anyway for her arthritis. She also takes other, stronger, painkillers, so I have no idea why they thought paracetomol would help, and I worry that they didn't read her medication list which I supplied.

I also found that, some of the time, she can't even stand, let alone walk, which means that if she needs to go to the lavatory, someone has to physically lift her from the bed / armchair into the wheelchair and out again onto the toilet. I have chronic back pain and fibromyalgia, so I am finding that near impossible to do.

My question is: who do I contact? This is not quite a failed discharge, as she hasn't had a further medical emergency, it's more a care issue. Do I take her back to A&E (I don't think I can manage another 5 hour wait in uncomfy chairs)? Or do I call the GP? The care service who supply the one carer a day? The SS START Team? SS themselves? Admiral Nurses (this isn't a dementia issue)?

I'm really at a loss to know who to turn to or whose responsibility this mess is. Please could you lovely people advise me?

Hugs

Jo xx

 

[2jays]

No idea

I think I would call 111 and would perhaps imply it’s a failed discharge from hospital

Because, in a way, that’s what it is

Your mum obviously, to me, is not a suitable candidate for being at home without proper pain medication and perhaps more input from OT and carers with extra aids and more care support - or even maybe she needs respite until she has healed more

Just my thoughts

 

[Beate]

Call an ambulance. If she cannot walk or stand she has been discharged too early, so yes, that is a failed discharge and it's the hospital's fault. But next time you have to insist on a proper discharge meeting meeting before you take her back, and have to insist to see the hospital worker to get an increased care package in place before you take her back. Medically she might have been fit to come home, but if you cannot look after her with her decreased mobility and your own medical problems, then it's down to the social worker to find a solution. You have every right to refuse to take her back and don't fret what the staff will think of you - you need to find the best solution for your Mum and yourself. Trust me, I've had that fight myself, and you might have to be very forceful and repeat yourself to everyone until it sinks in that you are not budging.

 

[Amy in the US]

I can only agree with Beate. And do insist on a proper care package being put in place, an OT assessment of the home, and so on, before you allow her to be discharged again.

At a minimum she clearly needs better pain control. I wonder if she perhaps needs some sort of respite or rehabilitation stay.

My only other thought is if you have a helpful GP. I've seen anecdotes here on TP where a GP has fast tracked a hospital admission so you don't have to wait around in A&E. I also don't know if the ambulance staff/paramedics can help flag you for admission before you get to hospital (they can here) so you can avoid the horrid waiting room.

I hope others have better advice and that you are able to get the help you need. Please don't risk your own health.

 

[DareDiffer]

Ask if the hospital carried out a continuing care assessment - point out you need equipment such as a hoist and would have to call paramedics out if she fell. And that can be a wait of 5 hrs or more. I coped for 20days and nights with no help - washing sheets at 2am and unable to leave to shop or even pay my own bills. It is too much for one person.

 

[PollyP.]

Hi Jo,
I really feel for you and your Mum, Last Saturday I spent NINE hours in A&E, In all of that time my Mum wasn't even offered a cuppa or even some water! I even had to ask for pain medication as the nurse who was supposed to be getting it had gone off duty!

My Mum had fractured her arm in a fall at her Care Home and was taken into hospital at 4:30am in an ambulance. It was about 2:30pm when we eventually got her back to her Care Home and to the safe arms of the Carers there.

They eventually (5 hours later) x-rayed her arm and the doctor prescribed co-codamol and some oral morphine (syrup), I'm surprised that all they gave your mum was paracetamol ! It makes your blood boil just thinking about it.

I agree with others, you must get her back to the hospital and insist on proper medication for her. I feel so sorry for ones who don't have any -one looking out for them.

Remember - the squeckiest door gets the most oil !!!

You need to be "Loud" to get things done for your poor little Mum, she must be in so much pain.

Hugs
Pauline
xx

 

[DareDiffer]

Unfortunately paracetamol Is common for elderly due to reacting to medications more as age. Dad broke his hip - home made him walk and stand for a fortnight despite my comments before finally sending for an X-ray. And yes paracetamol handed out....

 

[Prudence9]

Jo I agree with Amy, call your GP and cry if you have to - they can arrange to have your Mum admitted to a ward so although it may be a wait of a few hours while this is arranged, you will at least be in the comfort of your own home with tea and food to hand.

We have been through both types of admission several times and although you still have a shortish "registration" in A&E, it's much faster and an ambulance will be arranged for transport.

After waiting for 14 hours with my poor Mum on a trolley, trying to change her with a lovely but stressed junior Dr, and watching her in such pain and distress, I would never go via the straight to A&E route again if I could avoid it, it was pure hell. Also agree with Beate, it's a failed discharge.

I can't believe they've discharged her without an OT and SW assessment, make sure you're there when they see her!

So angry for you, good luck xxx

 

[Toony Oony]

My Mum fell 6 years ago when she lived on her own, and cracked her pelvis in 3 places. Mum hates hospital and so discharged herself without telling me. Her friend rang me in a panic. Mum could hardly move let alone look after herself. I hit the phone immediately and I have to say the service was amazing, even though I had to undo all that Mum had 'decided', without any POA. It took about 8 weeks to get Mum reasonably mobile again, but stairs were a problem and her mobility took a real bashing. This prompted me to move her into an assisted living flat. These pelvic fractures are nasty things. Make a fuss, as unfortunately this won't be a quick recovery for your poor Mum.
As for the paracetamol, I am surprised that they didn't give her at least a couple of doses of a stronger painkiller to start with. However, paracetamol seems to be a popular option for pain relief even for what might be considered major trauma. Co-codamol has dire effects in terms of 'going' - so I can see why that was not given - it does the trick, but it is grim.
Hope you get things sorted very quickly and your Mum feels much better soon.

 

[Spamar]

Even with a gp admittance to the emergency assessment unit, there was still a long wait before he got admitted to a ward. We got there at 14:00 and he got to ward at 00:30. No food or drink offered. I couldn’t even use machines as that would have left him alone, with all that might happen in a couple of minutes. When I flatly refused to drive home (an hour) the only place to sleep was the floor of the waiting room of the next door ward. Just what you want with arthritis! Chairs weren’t big enough to use. I went to see him in the am, he was OK. Went to stepdau s which was closer, for wash, change and food!

The vascular consultant asking me if I was sure he had dementia was the final straw!

 

[emmags]

Jo I agree with the others call your doctor or 111 and explain your health issues. My dad has recently been diagnosed with alcohol related dementia, his alcoholism and dementia have been fighting against each other, he has been in hospital nearly 6 weeks now but we stressed he can't go home to mum who has copd and only this year came if heart failure nurse. The adult mental health and social work who came to his best intentions meeting have been great and actually the social worker has now taken on my dad's case as we expressed concerns over the one who had his case wanting to send him home. The hospital last year put my mum in the same situation as you and asked her in front of my dad.

Sorry gone on and off track but you need to contact them ASAP, please don't leave it for after Christmas otherwise I can see you being in hospital as well.

Take care xx

 

[Lawson58]

A fractured pelvis is a matter of real concern in the elderly and can be quite dangerous. My sister (no dementia)
had a similar fracture and said it was very painful and that she needed help to get in and out of bed and to walk the short distance to the bathroom. She then needed three weeks in a rehabilitation unit gaining her strength and mobility with the help of a physiotherapist before she was released to go and stay with her son because she couldn't manage stairs for some time.

Your poor mum!

 

[DollyBird16]

Long story short, I spent Wednesday afternoon in A&E with Mum and it turned out that she has a hairline fracture in her pelvis which is making it extremely difficult to put any weight on her left leg. A&E kept her in overnight to "get her pain medication right and assess her mobility".

On Thursday morning, I got a call from the hospital asking if I was prepared to have her home. "Only if she is able to walk," I said, and was assured that she could now walk with a frame.

When I got to the hospital to pick her up, there were no doctors in sight, a nurse with her back to me who waved her hand without turning round and said I could take her, and her pain medication was in the bag.

Mum was kicking off, refusing to take off her hospital gown and get into her clothes, insisting she could walk the length of the hospital corridors to the car park, and it was a real palaver getting her into a wheelchair, outside and into the car, and it took all my energy so I didn't question the hospital any further.

When I got home, I found that the 'pain medication' they had so carefully managed was paracetomol, which she takes anyway for her arthritis. She also takes other, stronger, painkillers, so I have no idea why they thought paracetomol would help, and I worry that they didn't read her medication list which I supplied.

I also found that, some of the time, she can't even stand, let alone walk, which means that if she needs to go to the lavatory, someone has to physically lift her from the bed / armchair into the wheelchair and out again onto the toilet. I have chronic back pain and fibromyalgia, so I am finding that near impossible to do.

My question is: who do I contact? This is not quite a failed discharge, as she hasn't had a further medical emergency, it's more a care issue. Do I take her back to A&E (I don't think I can manage another 5 hour wait in uncomfy chairs)? Or do I call the GP? The care service who supply the one carer a day? The SS START Team? SS themselves? Admiral Nurses (this isn't a dementia issue)?

I'm really at a loss to know who to turn to or whose responsibility this mess is. Please could you lovely people advise me?

Hugs

Jo xx

Hi Jo
Defiantly back to hospital to get all the support required. Mum had the same and got discharged with no help at all.
The best result we got was gp Home visit and back to hospital.
Go straight to the PALS team who do react, don’t rely on ward staff.
If not already on it get your Mum on SS register so she gets more support.
If they provide additional pain relief insist on something to keep Mum regular. If mobility is limited they may do injections to prevent blood clots, learn about this, they discharged Mum without telling us about how to or that the injections were being given.
Insist for your Mums personal pride that she is showered and helped with personal care or they will simply give her wipes to look after her own cleaning.
If I think of anything more I’ll message.
Take care of you throughout. Always keep in the back of your head you are great but not superwoman, accept all the help offered. X

 

[Jo Sutton]

Wow!!! Thank you so much everyone. I knew everyone on TP was great, but I never expected so many replies and helpful information. Thankyou thankyou thankyou [insert huggy smiley here, when we get one]

I called the GP at 4.30 this afternoon. She was very sympathetic and said she would call me back when she had arranged something. However, when she did call back, it was to say that she had spoken to everyone she could think of ... the 'Preventing Admissions Team', SS, our care provider, etc ... and no one could help, so I needed to take her down A&E.

SHe didn't seem to know anything about a fasttrack admission straight to a ward, although annoyingly there was an FAQ about it on the screen in A&E

Of course, it's the Friday evening before Christmas. Everyone is short-staffed, the GPs are all closed, so the world and his wife heads down to A&E when they need something.

It took us 2 hours to get to triage, another two hours before we saw a doctor, another hour and a half before we could get any painkillers for her (I forgot to pack hers ... Duh!) and no hydration - luckily I had remembered to pack food and plenty of drink.

She finally got taken to the AMU ward at 3am. I asked the nurse in charge when the PT/OT assessments were likely to take place tomorrow (it's today now) and she said to ring after 9am.

So it looks like I'm only going to get a few hours sleep, after sitting in A&E for 8 hours, in a lot of pain myself, listening to a constant stream of consciousness from Mum going round and round in circles, asking if the doctors had forgotten her, couldn't she just go home, she doesn't remember falling or hurting herself, or being in the hospital yesterday, she's worried about me, why don't I go home and on, and on, and on. I must confess I left the room a few times to cry in the corridor in frustration.

But I am certainly going to take everyone's advice. She isn't coming home until I am satisfied with the care plan, and if they do the assessments without me, I will kick up merry hell. I am NOT going through that again!!!

Thank you so much @2jays, @Beate, @Amy in the US, @DareDiffer, @PollyP., @Prudence9, @Toony Oony, @Spamar, @emmags, @Lawson58 and @DollyBird16. Your support and advice has been invaluable and I love you all!

Hugs

Jo

 

[Amy in the US]

Oh, Jo, another long wait in A&E, I'm so sorry for you and your poor mum.

Definitely talk to the PALS team st the hospital and stand firm against any discharge, until you and your mum, are ready, and you have everything you need.

It's hard to have someone, anyone, but especially a PWD, in hospital, and extra hard this time of year.

I hope you'll keep us posted and we are all thinking of you.

 

[2jays]

Thinking of you and hoping that you do manage to get some rest to recharge your batteries

It’s a difficult time for you, especially as it’s this time of year. I have been where you are now with my mum being in hospital over Christmas and it’s not a good time for anybody. Hindsight tells me to remind you to take some time just for you as you will need a rested clear head when speaking to “people here to help”.... who don’t

 

[Izzy]

I hope you've managed to get some sleep. You must feel wrung out - emotionally and physically.

 

[Jo Sutton]

I'm afraid I woke at 9am, put the alarm on snooze and didn't wake again until almost 2pm

I tried calling the hospital but it kept going to a recorded message saying that all the staff were busy and please phone back shortly. After an hour of that, I hauled myself down to the hospital, fully expecting Mum to be in a foul mood.

Amazingly, she was quite happy, surprised and pleased to see me, knew she was in hospital, although she kept asking if she had had an operation, and didn't want me to stay longer than 20 minutes as she was tired.

The doctors aren't 100% convinced it's a fractured pelvis, as the x-ray was unclear, so they are keeping her in at least until tomorrow. Given that she is quite happy, that's a result in my book.

I got home prepared to enjoy an evening with hubby on our own, but everything just seems weird and I keep wondering whether Mum is ok downstairs and if she wants a cup of coffee

This journey is so strange sometimes ...

Hugs

Jo xx

 

[emmags]

Aww hun try and have a night of with the hubby, sounds like you need it and your mum is in a safe place being looked after. X

 

[Beate]

Erm no, they are not going to keep her "at least until tomorrow". Repeat after me: They are going to keep her until an adequate care package, rehab or respite is sorted out!