Advice on first step with adult services

[emmags]

Hi All

We have today had a call from Adult services of the hospital my dad is in who have said he has now been diagnosed with Alcohol dementia. They want to talk to us about him and coming out of hospital and about him being self sufficient but really don't get what they mean. Wandered if anyone can explain what they are looking for.

He and my mum and still technically married and live in the same house but she has Copd and is not well enough to take on to much, only earlier this year did she get signed off from the heart failure nurse.

Thank you in advance

Emma

 

[DeMartin]

Just answering to move your thread up

 

[Beate]

What they mean is that they want to discharge him and need to know whether he requires a care package. Things in a care package could be a Day Centre or sitters and/or carers, telecare gadgets or equipment around the house like grab rails etc. So you need to sit down with them and discuss what his wife who would be his main carer thinks she needs to be able to care for him successfully. If she is not well enough to do so, then you need to say that also. That might mean a care home for him unless another solution is found. Basically, you need to be absolutely honest and detailed how care for him should and could look like in your eyes, because if he is discharged with an inadequate care package and ends straight up in hospital again, that will be a failed discharge, which is something they (and you) should be trying to avoid.

 

[Shedrech]

hello @emmags
a warm welcome to TP
I'm sorry to read that your dad is in hospital and of the recent diagnosis
also that Adult Services don't seem to have fully explained themselves - always feel free to question anything that is said to you - indeed, ask for a face to face discussion if possible, ask for anything that's said to be put in writing and sent in a letter or e-mail, and definitely get an e-mail address to contact them so if they don't write, you can send them what you remember as being said, so there is a paper trail to refer back to
Beate gives you sound info - they will be wanting to discharge your dad if there is no medical reason to keep him in hospital - be sure that a care package that YOU think is sufficient is put in place before this discharge happens
it is concerning me that they used the words 'self sufficient' - I hope that wasn't suggesting that your dad can fully look after himself
maybe sit down and write out all the things you think your dad will have trouble doing for himself eg go through the day and note down anything that is a concern to you - can he get himself up, toileted, washed/showered, dressed, breakfasted, take any pills .... get drinks (not alcohol) ...make lunch .... make tea .. have some exercise ... be safe going out and about ... toilet himself during the day ... stay warm ... get himself about the house safely ... answer the phone ...remember to go to bed ,,, change his clothes and wash them .... stay in bed to sleep over the night ... - in other words, think of all the things we take for granted that we can do; what difficulties on a BAD day does your dad have doing those - and factor in any problems with the alcohol - is it possible to sneakily change what he drinks and put low alcohol/non-alcoholic versions in the bottles instead?
also make your mum's position clear ie that your dad is effectively going back to a house where he fends for himself as you mum is not fit enough to be his carer and will not be providing any care at all (this isn't harsh or unsympathetic, it's being realistic) otherwise it will be assumed that she will be his carer
if you feel that your dad isn't able to be at home safely, push for a discharge to an assessment entre/community hospital/respite so that he can be monitored and assessed - speak with the PALS at the hospital who may well be able to help you - and ask to talk to the Admiral Nurse in the area - a link here
https://www.dementiauk.org/get-support/admiral-nursing/
there's also the AS Helpline 0300 222 1122

now you've found TP, do keep posting with any questions you have as the members here are generous in sharing their experiences and offering support

 

[emmags]

hello @emmags
a warm welcome to TP
I'm sorry to read that your dad is in hospital and of the recent diagnosis
also that Adult Services don't seem to have fully explained themselves - always feel free to question anything that is said to you - indeed, ask for a face to face discussion if possible, ask for anything that's said to be put in writing and sent in a letter or e-mail, and definitely get an e-mail address to contact them so if they don't write, you can send them what you remember as being said, so there is a paper trail to refer back to
Beate gives you sound info - they will be wanting to discharge your dad if there is no medical reason to keep him in hospital - be sure that a care package that YOU think is sufficient is put in place before this discharge happens
it is concerning me that they used the words 'self sufficient' - I hope that wasn't suggesting that your dad can fully look after himself
maybe sit down and write out all the things you think your dad will have trouble doing for himself eg go through the day and note down anything that is a concern to you - can he get himself up, toileted, washed/showered, dressed, breakfasted, take any pills .... get drinks (not alcohol) ...make lunch .... make tea .. have some exercise ... be safe going out and about ... toilet himself during the day ... stay warm ... get himself about the house safely ... answer the phone ...remember to go to bed ,,, change his clothes and wash them .... stay in bed to sleep over the night ... - in other words, think of all the things we take for granted that we can do; what difficulties on a BAD day does your dad have doing those - and factor in any problems with the alcohol - is it possible to sneakily change what he drinks and put low alcohol/non-alcoholic versions in the bottles instead?
also make your mum's position clear ie that your dad is effectively going back to a house where he fends for himself as you mum is not fit enough to be his carer and will not be providing any care at all (this isn't harsh or unsympathetic, it's being realistic) otherwise it will be assumed that she will be his carer
if you feel that your dad isn't able to be at home safely, push for a discharge to an assessment entre/community hospital/respite so that he can be monitored and assessed - speak with the PALS at the hospital who may well be able to help you - and ask to talk to the Admiral Nurse in the area - a link here
https://www.dementiauk.org/get-support/admiral-nursing/
there's also the AS Helpline 0300 222 1122

now you've found TP, do keep posting with any questions you have as the members here are generous in sharing their experiences and offering support[/QUOT


Thank you both for your replies, Shedrech have thank you for the options for where he could be discharged too, think what is difficult is the unknown, we should be having a face to face meeting and they have been told there will be me, my brother and mum there. I spoke to my brother today after a call from my dad saying his car isn't working so if I need to go somewhere use mum's or mine. My brother is thinking some of the confusion he is suffering is jus from being in hospital and on about how he will be when he is back out but the first thing dad will do is have a drink. The hospital and alcohol nurse have even said rehab is not an option for him due to his memory.

Thank you again we have a long road ahead of us and I am sure there will be many more questions from me.

hello @emmags
a warm welcome to TP
I'm sorry to read that your dad is in hospital and of the recent diagnosis
also that Adult Services don't seem to have fully explained themselves - always feel free to question anything that is said to you - indeed, ask for a face to face discussion if possible, ask for anything that's said to be put in writing and sent in a letter or e-mail, and definitely get an e-mail address to contact them so if they don't write, you can send them what you remember as being said, so there is a paper trail to refer back to
Beate gives you sound info - they will be wanting to discharge your dad if there is no medical reason to keep him in hospital - be sure that a care package that YOU think is sufficient is put in place before this discharge happens
it is concerning me that they used the words 'self sufficient' - I hope that wasn't suggesting that your dad can fully look after himself
maybe sit down and write out all the things you think your dad will have trouble doing for himself eg go through the day and note down anything that is a concern to you - can he get himself up, toileted, washed/showered, dressed, breakfasted, take any pills .... get drinks (not alcohol) ...make lunch .... make tea .. have some exercise ... be safe going out and about ... toilet himself during the day ... stay warm ... get himself about the house safely ... answer the phone ...remember to go to bed ,,, change his clothes and wash them .... stay in bed to sleep over the night ... - in other words, think of all the things we take for granted that we can do; what difficulties on a BAD day does your dad have doing those - and factor in any problems with the alcohol - is it possible to sneakily change what he drinks and put low alcohol/non-alcoholic versions in the bottles instead?
also make your mum's position clear ie that your dad is effectively going back to a house where he fends for himself as you mum is not fit enough to be his carer and will not be providing any care at all (this isn't harsh or unsympathetic, it's being realistic) otherwise it will be assumed that she will be his carer
if you feel that your dad isn't able to be at home safely, push for a discharge to an assessment entre/community hospital/respite so that he can be monitored and assessed - speak with the PALS at the hospital who may well be able to help you - and ask to talk to the Admiral Nurse in the area - a link here
there's also the AS Helpline

now you've found TP, do keep posting with any questions you have as the members here are generous in sharing their experiences and offering support

Thank you both for your replies, Shedrech have thank you for the options for where he could be discharged too, think what is difficult is the unknown, we should be having a face to face meeting and they have been told there will be me, my brother and mum there. I spoke to my brother today after a call from my dad saying his car isn't working so if I need to go somewhere use mum's or mine. My brother is thinking some of the confusion he is suffering is jus from being in hospital and on about how he will be when he is back out but the first thing dad will do is have a drink. The hospital and alcohol nurse have even said rehab is not an option for him due to his memory.

Thank you again we have a long road ahead of us and I am sure there will be many more questions from me.

 

[emmags]

Hi just a quick update to say we have the first meeting tomorrow. It had been a mixed week as someone from adult services went and saw my dad on Monday and feel he is OK to go home, thankfully mental health do not agree with it being that simple. Getting a bit anxious about tomorrow now it is getting closer, especially as I am getting frustrated with my mum who hasn't been in to see him and putting a lot of what he is saying down to coming of alcohol and is more focused on keeping him of the alcohol than the dementia aspect.
X

 

[Grannie G]

Hello @emmags

I hope you get the opportunity tomorrow to express your concerns. This is what these meetings should be about.

 

[emmags]

@Grannie G thank you.

The meeting went well in some ways. Myself, brother and mum along with the health care professionals agree that he needs a care home. He is young (67) and physically fine (amazing considering he has been an alcoholic for 8 years or so). We are dubious about the social worker assigned to his case (who was not there) and seems to think he can go home with a care plan cause he has never tried it but her colleague was and he says no from the notes and what we have said to do that would be failing him, he is going to speak to her and his manager but has assured us that won't happen.

So much is going through my head this week, weirdly if I say he's going to care I can cope. If I say he is never coming home (which is also the truth he is in hospital till a place is found) then I break down, plus his mum lived till her late 80's and his dad till he was 90 so think of how long he could be in the home hurts.

Anyway just wanted to update and say thank you for you support xx

 

[Beate]

I'm glad that you all (minus one social worker) agree on the way forward. Just to say - someone who gets dementia as young as your dad is unlikely to be in care for 20+ years, as progression might be more rapid than in an 80 year old person, so you can't apply the same life expectancy to him, I'm afraid.

 

[emmags]

@Beate I know I shouldn't say this but in some ways that is good news. Please forgive me for saying that I am not wishing him gone but in some ways he already is. My brother and I admitted earlier this year he isn't our dad in terms of the person in the body, we thought that was due to the drink but it isn't. If me and my brother are together seeing him he thinks my brother is my husband. Not sure about when he goes on his own.

I don't think I have said any of the above right and just pray you get what I mean xx

 

[Beate]

Yes, I do get it - I think we all do. Whenever I want my OH back, I don't want him back the way he was at the end - I want him back the way before dementia struck.