Dad taken into secure unit at hospital for 3 day assessment

[thesmiths]

Things came to a head a few weeks ago when Mum and Dad kept going out for a walk (at Dad's insistence) and getting lost, walking along busy roads with no pavements, Mum is incontinent and accidents were happening, final straw was when they got lost for 6 hours, police called etc. So, 2 weeks ago Mum and Dad moved to a new nursing home where Dad could get a one-to-one carer so he could go out for a walk with company so he didn't get lost etc.

They have been there over a week now and we thought that things were going really well, he went out every day and got taken to town etc, however last night at 6.00pm they went out for a walk again with the carer, who after a while noticed Mum was stumbling a bit, so said perhaps they should go back but said was adamant, no, they were walking home (to Torquay - he doesn't know where he is). The manager of the home came out and brought the minibus as usually they accept a lift back when they get a bit tired but no, not having it. So eventually the police were called as they couldn't do anything else and they eventually agreed to go back to the home.

However, the home can't have this happening so Dad has been taken into the secure unit at the hospital for a 3 day assessment and to see what they can do. I don't really know what they can do exactly apart from drug him up a bit to try and stop him wanting to go out (which I know they are not really allowed to do). Also, if he tries to leave they will section him.

The only up side of that happening is that at least afterwards all his care home fees will be paid for, as he is self funding at the moment.

I keep thinking, if only we had had them at home with us then perhaps this wouldn't have happened, but I have an 8 month old daughter and I can't cope with two parents with memory problems.

 

[Izzy]

I'm sorry to read this but you can't think about what it might have been like if your parents were living with you. You have your daughter to consider and you're doing what you can. x

 

[Onlyme]

The idea of an 8 month old baby and two people with memory issues living in the same house fills me with dread. I am so glad you didn't even think of that one seriously. If you had tried to cope you would have had a breakdown and where would that have got your daughter?

I hope that your Dad's 3 day assessment improves the situation.

 

[CathT]

Please dont feel guilty. Coping with one parent with memory impairment is one thing, but to deal with two must be even more of a nightmare.

Re your father's admission to an assessment unit - this may be a blessing in disguise. My mum was placed under a 28 day section 2 placement over 4 months ago following a period of paranoia and agitation which my 82 year old father was finding increasingly difficult to deal with. Whilst there, the professionals have worked hard and tried different approaches to my mum's condition but sadly we got the news today that they are not recommending that my mum return home but that her needs would be better met in a nursing/EMI unit.

Her physical and mental health have deteriorated rapidly over recent weeks, to the extent that she can no longer attend to any of her basic needs, ie toilet, dressing, feeding and her mobility is seriously impared.

We are now tasked with finding a suitable care/nursing home for her, which is no easy task these days. We have also been told we will have to self fund although the NHS may contribute something to her nursing care but basically we have to meet the full residential cost. So my observation is in response to your comment that your father's future care home fees will be paid for is that I find this highly unlikely. His stay at the assessment unit will be free, but if he stays for more than a few weeks, his pension and attendance allowance will be stopped.

I asked my mum's social worker today about NHS funded CHC and her response was that it is only paid to people who are very seriously ill and require intensive care, eg bed ridden or have extreme mental health requirements.

She also told me that when my mum's ability to self fund runs out, which at over £700 pw it will do very soon, we will have to top up or run the risk of moving my mum to a cheaper home. Our SS currently allocate £402 per patient, but when state pension/attendance allowance are taken into consideration, it is nearer £300 and from what I have seen not one care home charges less than £450.

What a nightmare this horrible disease presents. If it isnt bad enough seeing your loved one lose their mental and physical health we are then made to worry about paying for their care too.

However, on a more positive note, I hope your father's stay in the assessment unit is positive and his issues are addressed and resolved and he can return to his nursing home which incidentally sounds to offer great care. I really feel for you at this difficult time.

Kind regards,

 

[kazza73]

Cath- DO NOT agree to pay a top up! If your mum is self funding initially and the money then runs out the LA are responsible for paying, even if it is more than their basic rate. family members are not responsible for top ups although often LA and SS will try to convince you otherwise! Everyone is entitled to an assessment for CHC- although sadly not everyone gets it- insist on an assessment prior to discharge!

the smiths-I'm afraid Cath is right- being admitted for a 3 day assessment will not mean your dad's care home fees would be paid when he is released. This would only be the case is he'd been sectioned under section three of the Mental Health Act in which case aftercare would be paid for by the NHS under Section 117

 

[thesmiths]

Thanks for all your support ....

Not sure I worded it right, but I did mean that if he was sectioned then his care home fees would be met in the future, not just if he was there for an assessment. As it happens he was sectioned under Section 3 yesterday. They think he will be there for 6-8 weeks. I visited him today and he seemed okay, a bit slow and drugged up, but not agitated (and not wanting to go out, which was the main thing!). He didn't even ask about Mum which is good as I think if he was thinking about her too much he would become agitated again. Luckily the staff at the unit are lovely and really helpful and caring.

 

[Nebiroth]

CathT it sounds as though the social worker is feeding you nonsense! And don;t agree to pay top-up fees!

It is correct that patients under section 3 of the MHA who are discharged from hospital but remain under section 117, their care fees are entirely paid for by the NHS. In effect they are treated as though they are in hospital - even if it's not an actual hospital but is a nursing home. And as with all hospital stays, it is entirely funded by the NHS.

A 117 in essence means, the patient is ill enough that they would normally be in a mental health hospital but this would be of no further benefit. They remain, technically speaking a "hospital" patient.

However, they must be discharged under a 117. Many people leave hospital in the normal way after being under a section 3. You would need to enquire at the hospital as to the terms of the discharge. Needless to say, there is pressure to discharge patients without a 117 as it saves money.

 

[thesmiths]

Thanks Nebiroth I will make sure that happens. Funnily enough, yesterday lunchtime the care home he was in before being taken into hospital called to say that they needed our full address because there was a refund of his fees being sent to us as it was now being paid for by the state!

 

[CathT]

Well that is a welcome change that care home fees are being refunded. My own personal experience has been the total opposite with us having to pay for practically everything and pension benefits being suspended shortly after admission. However, my mum's stay in the nhs assessment unit is non chargeable.

A friend's mother was recently discharged from the unit into a nursing home and not long after had a fall which required hospital treatment. She was in hospital for 7 weeks and had to pay her full residential costs for the duration of her stay in hospital. This whole disregard for the elderly and infirm makes my blood boil.

I have done a fair bit of research and as my mum was placed under a section 2 for 28 days which wasnt renewed I am not expecting SS/NHS to contribute towards her future care. There is talk about her getting some NHS funding for her nursing care which is due to a rapid physical decline but we are expected to meet the residential costs. However, she is not bed ridden or wheel chair bound, her current meds do not require to be administered by a registered nurse, she is not presenting challenging behaviour at the moment. It seems the majority of her care is social, dressing, personal care, toileting, feeding, etc - ie does not require qualified staff to administer.

To be perfectly honest, I am hoping that her assessment concludes she needs residential care as hopefully we will have a better choice of establishments. If the verdict is nursing and residential care, our choices in the nearby area are very limited and not very inviting.

Placements under a section 3 are a different matter completely and I think funding can be awarded on discharge. However CHC seems to be very fluid and is subject to review. For further information see thread: http://forum.alzheimers.org.uk/showthread.php?18220-Continuing-care-funding.

However, if anyone has personal experience of getting funded places, any advice would be greatly appreciated.

C

 

[Nebiroth]

Care costs will be automatically met by the NHS for someone who was hospitalised under a section 3 only if they are discharged under a section 117 - and only for as long as they remain under the 117. Not all patients are discharged under a 117 - which as I said basically has the criteria that you remain ill enough that you would normally be in hospital under section 3 but remaining in an actual hospital has little to no further benefit.

Some people leaving hospital from a section 3 may qualify for CHC but they will have to fight for it. If you are discharged under a 117, this is automatic.