Hospital discharge .... feeling a bit pressured

Roxymoo

Registered User
Apr 13, 2019
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Hi my Dads been in hospital after having a fall for nearly 2 weeks. He’s ok from fall but had an infection and then even worse confusion. Now incontinent, can’t feed himself or walk unaided. The social worker called Saturday to say hosp are pushed and need the beds. I totally get that but when I saw my Dad on Saturday he still looks awful and no where near being able to leave. He’s going to have to go to a care home as my mum will not be able to cope. He’ll be self funding for a time.
I need to speak to a Dr today as I’m assuming the infection they were treating has cleared up now if they’re trying to discharge him. I hadn’t even got round to asking for a needs assessment or best interests meeting, as he seemed so far off being well enough to leave, it all feels very rushed. Any help support appreciated. Thank you
 

Cat27

Registered User
Feb 27, 2015
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Merseyside
Personally, I’d ring the ward first thing & ask to speak to the ward manager. Tell them all your concerns & insist on a needs assessment before discharge.
 

Izzy

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Aug 31, 2003
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Bunpoots

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Apr 1, 2016
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My experience with my dad last year - I had to fight for it - was that the hospital social worker found a placement for dad in an assessment bed in a carehome which they chose so they could decide if he was going home with a care package or into a carehome 24/7.

I used Pals who were great at telling me what was happening. I’d had a different version every time I spoke to someone on dad’s ward.

Everything was being very rushed with my dad too and, after one failed discharge, I refused to let him go home. To cut a long story short dad was put on a section 2 because I wanted him kept there until they could find somewhere safe for assessment (he would not have been safe at home) and he was considered “medically fit” in spite of the fact that he could no longer walk or do anything for himself.

They made “section 2” sound like a threat but, for me, it was a great relief as it meant they had responsibility for him...and I could breathe again.
 

Beate

Registered User
May 21, 2014
12,179
0
London
Tell them you will not allow them to discharge him before a proper needs assessment has taken place. If he has house keys on him, remove them. This is one of those situations where you have to stay strong and not let them bulldoze you. My OH was technically medically fit for discharge after a week but had lost the ability to walk. I told everyone in the hospital that I couldn't look after a non-mobile person and that I refused to become housebound myself. Eventually I ground them down. He was transferred to a physio rehab ward and from there to a care home.
 

Roxymoo

Registered User
Apr 13, 2019
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0
Thank you everyone this all helps. I am going into the ward later today and am prepared to be very firm over all of this.
 

ssw

New member
Aug 5, 2019
1
0
Hi my Dads been in hospital after having a fall for nearly 2 weeks. He’s ok from fall but had an infection and then even worse confusion. Now incontinent, can’t feed himself or walk unaided. The social worker called Saturday to say hosp are pushed and need the beds. I totally get that but when I saw my Dad on Saturday he still looks awful and no where near being able to leave. He’s going to have to go to a care home as my mum will not be able to cope. He’ll be self funding for a time.
I need to speak to a Dr today as I’m assuming the infection they were treating has cleared up now if they’re trying to discharge him. I hadn’t even got round to asking for a needs assessment or best interests meeting, as he seemed so far off being well enough to leave, it all feels very rushed. Any help support appreciated. Thank you
Hi RoxyMoo
I have just joined the forum.
Firstly I appreciate how stressful it must be at the moment for you, your dad and your family. If your Dad does not have an appropriate care package in place for his discharge or would be considered a vulnerable adult you do have options. Like in the previous posts you may have Pals in your hospital trust and I would approach them for support. Also you can
ask the Ward Manager for a Section 2 . This is a legislation that protects vulnerable adults so that they do not leave the hospital without an appropriate care package in the community or in a home in place.

Ward staff are used to this so don't feel intimidated by asking for one. Your best interests and theirs is that your Dad is safe and looked after following his discharge from hospital.
If your Dad is a self funder, ie is above the threshold for assessment this should still mean that he wont be discharged until arrangments are in place. If you haven't already spoken to the Hospital or ward social worker then request to speak to them. they can clarify all of this. Hope this helps and your Dad gets sorted.
 

Roxymoo

Registered User
Apr 13, 2019
30
0
Hi I
Thank you for your replies, they really helped. I today spoke to Consultant and Social Worker and both agreed he is not ready to be discharged. Social worker said she has contacted the CHC nurses for them to do an assessment as his needs seem complex.

Because he seems to be declining they have had a CT scan for his head today and done more bloods to rule anything else out. Get results tomorrow.

If that comes back clear the Consultant thinks its just down to delirium and if that is the case he will need to be assessed in a care home setting as the hospital is a false environment for assessing.

I am worried if I say yes to assess within a care home setting I am pretty much agreeing to him being discharged?

I have called PALS and left a message so hopefully they call back soon.

The thing I don't understand about the delirium is that in the 2 weeks he's been in hospital, he started off really confused to the point I thought it was delirium but then had 2 days in a row when I visited and he seemed to be improving, he was sitting up and talking a bit and trying to interact with the nurses and other patients. Now he is just sleeping non stop, doesn't know who I am, can't keep his eyes open and is sometimes refusing food. I don't mean to be dramatic but he honestly looks like he is dying in there. There must be more to it than delirium. Will await answers tomorrow.

I also spoke to a potential care home who even said based on his needs as I explained them it could be unlikely they would even be able to take him!

Thanks for your support xx
 

DesperateofDevon

Registered User
Jul 7, 2019
3,274
0
Hi I
Thank you for your replies, they really helped. I today spoke to Consultant and Social Worker and both agreed he is not ready to be discharged. Social worker said she has contacted the CHC nurses for them to do an assessment as his needs seem complex.

Because he seems to be declining they have had a CT scan for his head today and done more bloods to rule anything else out. Get results tomorrow.

If that comes back clear the Consultant thinks its just down to delirium and if that is the case he will need to be assessed in a care home setting as the hospital is a false environment for assessing.

I am worried if I say yes to assess within a care home setting I am pretty much agreeing to him being discharged?

I have called PALS and left a message so hopefully they call back soon.

The thing I don't understand about the delirium is that in the 2 weeks he's been in hospital, he started off really confused to the point I thought it was delirium but then had 2 days in a row when I visited and he seemed to be improving, he was sitting up and talking a bit and trying to interact with the nurses and other patients. Now he is just sleeping non stop, doesn't know who I am, can't keep his eyes open and is sometimes refusing food. I don't mean to be dramatic but he honestly looks like he is dying in there. There must be more to it than delirium. Will await answers tomorrow.

I also spoke to a potential care home who even said based on his needs as I explained them it could be unlikely they would even be able to take him!

Thanks for your support xx

It’s a total nightmare of a situation.
Hugs & empathy are all I have to offer, keep posting
Xxx
 

Louise7

Volunteer Host
Mar 25, 2016
4,689
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I don't mean to be dramatic but he honestly looks like he is dying in there. There must be more to it than delirium.

Have you checked to see if he has had a change in medication? When Mum was admitted to hospital after a fall we were told that she had delirium caused by an infection and as the infection had cleared up but the delirium hadn't she was not likely to improve. We subsequently discovered she had been given anti-epileptic medicine seemingly 'by mistake', did not have an infection and there had been no proper diagnosis of delirium. During a subsequent admission Mum looked like she was dying - we were not able to rouse her for long periods and she wasn't eating or drinking - but it turned out that she had been over-sedated with pain relief and once the medication was stopped she returned to her normal self. From experience delirium tends to be a bit of a 'catch all' diagnosis - with not much effort going into establishing if there are other problems - so it's worth checking to see if medication may be causing the changes to your Dad, although an infection can cause havoc in someone with dementia and the hospital environment won't be helping him either. Hope there is some positive news for you tomorrow.
 

AztecCamera87

Registered User
Mar 12, 2019
204
0
Hi my Dads been in hospital after having a fall for nearly 2 weeks. He’s ok from fall but had an infection and then even worse confusion. Now incontinent, can’t feed himself or walk unaided. The social worker called Saturday to say hosp are pushed and need the beds. I totally get that but when I saw my Dad on Saturday he still looks awful and no where near being able to leave. He’s going to have to go to a care home as my mum will not be able to cope. He’ll be self funding for a time.
I need to speak to a Dr today as I’m assuming the infection they were treating has cleared up now if they’re trying to discharge him. I hadn’t even got round to asking for a needs assessment or best interests meeting, as he seemed so far off being well enough to leave, it all feels very rushed. Any help support appreciated. Thank you

I feel your pain so much. We have had constant trouble with the hospital rushing my dad out of the door on his numerous trips there over the past few months. Once they dressed him up in his old soiled clothes and left him in the discharge lounge without telling me or my sister. We only found out because the District Nurse called my sister to tell her she was coming over to see dad in the evening. Let's just say my sister was not happy, as the hospital were aware that we hadn't received his 'hospital' bed for downstairs (it was coming later that week) and so dad had nowhere to sleep (he can't use the stairs safely). There excuses were that they were not aware about the sleeping arrangements and did not know he needed a hospital bed (they were very much aware) and well, your dad said he wanted to be discharged so we didn't need to call anyone. (he had no house keys, no clean clothes, and was pretty delirious). Anyway, thats one story of the poor treatment he has had in hospital (he doesn't always have poor treatment there, but we have a few tales now).
 

Roxymoo

Registered User
Apr 13, 2019
30
0
A bit of sad update on this.....It seems this feeling rushed and pressured is a very common thing. Well we stood our ground and insisted on further tests which they have now done and all have come back clear. So thank you for the advice about being strong and assertive with them and not intimidated.

But unfortunately they have said his prognosis is not good and he is going down and down every day and they are now fast tracking him to a nursing home that we have been to see and chosen for his end of life care. Because he is at end of life he will not be charged for this care he receives at the care home.

Its all felt so sudden to go from 2 weeks ago, his dementia was getting worse but he was still walking to the shop and buying the newspaper, to this, all in just 2 weeks.

The care home will be a nicer environment for him at least. I am hoping this stage doesn't last too long for him and he can be at peace soon.
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
Im sorry to hear your news @Roxymoo
Sometimes they can go downhill so fast. Sometimes, of course, they can bounce back, but I too hope that this stage doesnt last long.
(((((((((((((hugs)))))))))))
 

Trekker

Registered User
Jun 18, 2019
211
0
London
A bit of sad update on this.....It seems this feeling rushed and pressured is a very common thing. Well we stood our ground and insisted on further tests which they have now done and all have come back clear. So thank you for the advice about being strong and assertive with them and not intimidated.

But unfortunately they have said his prognosis is not good and he is going down and down every day and they are now fast tracking him to a nursing home that we have been to see and chosen for his end of life care. Because he is at end of life he will not be charged for this care he receives at the care home.

Its all felt so sudden to go from 2 weeks ago, his dementia was getting worse but he was still walking to the shop and buying the newspaper, to this, all in just 2 weeks.

The care home will be a nicer environment for him at least. I am hoping this stage doesn't last too long for him and he can be at peace soon.
So sorry Roxymoo, wishing you and your Dad the peace you both deserve xxx
 

DesperateofDevon

Registered User
Jul 7, 2019
3,274
0
I’m sorry that you have had this news. I hope for all it’s peaceful & am sending my love & hugs to you & your family.
I am adopted & my biological mum passed away last year. The time I sat with her I talked, laughed & cried & said all that was in my heart- though I doubt she knew or heard as she was on massive pain relief; but I now treasure that precious time together ,listening to her heartbeat.
My love & thoughts are with you at this time
Xx
 

Woo2

Registered User
Apr 30, 2019
3,652
0
South East
Sending you hugs over the airwaves and wishing you strength , thoughts with you , take care of yourself .
 

Roxymoo

Registered User
Apr 13, 2019
30
0
Thank you, many people don’t get this time so I am trying to look at it that way. Thanks @DesperateofDevon that’s what I plan to do too, even if he isn’t aware of any of it, it will help me in the future knowing we had this time.