Care Home Refusing to Take Dad back after hospitalisation - can they do this??

[jools090867]

Briefly to summarise my father was sectioned last Feb. He was in a secure unit until the October while they tried to sort his medication and stabilise his aggression and psychotic behaviour.. This was achieved (to a degree) and a place was found for him at a local home who stated that they could cope with his complicated presentation (our CPN was not convinced at the time but decided that dad needed to be out of the unit so agreed - btw he is fully funded because of the sectioning).
Anyway - his behaviour did improve slightly for a while, but because he was losing weight dramatically and falling a lot, the doctors and CPN decided to take him off his meds for a break.
Well.. all hell broke lose last Wednesday when he went totally "insane" in the home - he tried to kill another resident, assaulted several members of staff then started self harming.. He was taken to A & E where they concluded that he had a UTI - but also that his psychosis was worse and his aggression levels elevated beyond their control.
He would not settle, would not take any meds and became so agitated when they tried to move him to a ward that he screamed and swore, punched, kicked and bit any one who tried to touch him (assaulting 6 members of staff) then when my mother tried to calm him he grabbed her arm with both hands and would not let go... breaking her arm in the process!!!
Eventually he was calm enough for them to get him back in a bed and medicate him - he is still in the hospital being treated for the UTI and being assessed by the psychiatric team, but the care home will NOT take him back...
Can they do this??? He will eventually be discharged by the hospital as "medically fit" - despite the dementia related behaviour.. at which point will he be homeless? In which case where will he go???
The team from Social Services and Continuing Health Care are trying to find him another home, but because of his severe presentation no one wants to take him - not even any of the EMI homes in the area...
My mother and I are at our wits end with worry - obviously he cant come home - not only can she not cope with him but all funding would stop if he did..
Has anyone else ever heard of or had a similar experience???

Sorry to go on - but boy is he a complex case!!

 

[Onlyme]

What a dreadful time for you and your Mum. Your poor dad must so frightened in his world.

If I was the home I wouldn't want him back as I would want to keep my staff safe which would be very questionable while looking after your dad. If nothing else the home's insurance for the staff would probably be invalid if they took him back with full knowledge of his hospital outburst.

I can't understand why anyone would mess with you dad's medication when he was not in a secure unit - I would certainly complain about that as it was very reckless.

I hope they find somewhere for him soon.

 

[Brucie]

Not only do care homes need to ensure their staff are safe with the patients/residents they host, they also need to have adequate staff to manage more difficult behaviours, which is not always the case.

Paramount of course is the safety of the other people who are being cared for, and someone who has dementia is totally vulnerable.

In some cases, I think the only answer can be in medication that is not generally used - antipsychotics.

We have a relative who was physically aggressive despite being 91, and we did look at some care homes for her. The normal homes said they would not be able to manage her but a specialist place for difficult cases would use antipsychotics to ensure everyone's safety.

She also was losing weight - before the meds - and prone to falling - or being pushed by other more physical patients. The meds weren't causing her weight loss, it was the environment, depression, hospital food.

Since aggression was the main problem keeping her from her own home we pressed, over a few months, for her to have Risperidone, so we could try her at home. Reluctantly the doctor agreed.

For the past three months she has been home, confused certainly, but not aggressive, and manageable by family, at present, at least. She is starting to regain a little weight.

I'm really sorry you are experiencing this, but, whatever the physical result, I reckon it is preferable to have someone on antipsychotics than in a limbo hell. Best wishes for the future.

 

[Noorza]

I can totally understand the care home's stance, it would be impossible for them to have him return I am sorry to say, the other resident's families would almost certainly object.

The hospital have a duty of care to ensure a safe discharge for your Dad and for others, so I would put the ball into their hands.

I would contact the REACT team in the hospital to get support for yourself to enable the safe discharge for your Dad where ever that may be.

 

[LYN T]

Hi Jools

My own husband is a complex case so I do feel for you and your family

Your Dad won't be made homeless-I'm sure he will be taken back to the secure unit if a CH can't be found. I very much doubt that your Mum would be allowed to take your Dad back home. The CH have the right to stop anyone being in the CH if they feel that they can't manage his needs. My OH is going through a medication change and I've insisted that he is monitored by going to the Mental Health Unit day hospital 2 x a week.

Unfortunately, despite the bad press, anti-psychotics can be useful BUT they have to be monitored carefully by specialised staff

I so hope you, your family and most of all your Dad get some relief soon

Take care

Lyn T

 

[zena285]

My mum was 'evicted' by her CH six months ago due to her aggression, she was subject to safeguarding with amazing regularity! The crunch came one Monday afternoon when the SW telephoned to say that Mum had to leave the CH within the next couple of days, this threw me and my sister into a bit of a panic because we thought she would be homeless too! The SW said that as it was an emergency situation they would find her an emergency placement but because she needed extra care she would most likely have to go out of the county. We had a meeting with the MHN and SW the following morning and I told them being placed out of county wasn't an option and that we couldn't keep moving her about and that we needed to make sure that the next placement was her only one, didn't want them to keep unsettling her. The upshot was that as she slept quite well on a night the CH/SW/MHN agreed for her to be able to stay until another place was found but I had to pick her up after breakfast, keep her all day and return back to the NH at bedtime. We managed to find her another home within the county five weeks later, but I have to say it was the best thing to happen as the new home is so much better with her. She is also on Risperadone and despite the reservations about it it's much better for her to be calmer and more chilled out.