Aggressive Hospital Discharge Team

[bazouteast]

Mum was diagnosed with AD in 2012. In July she had a serious medical condition and has been in hospital for 10 weeks. Her medical condition is improved but she's now bedbound, doubly incontinent, unable to feed herself and her dementia has deepened. Now the hospital want her out and we find we have a full on disagreement with the Discharge Team on process.

We scrutinised 13 Nursing Homes (NH) mostly suggested by Social Workers, shortlisted three, visited these armed with our selection criteria – including helpful comments from here. None of the three we selected had vacancies however our chosen NH advised vacancies arise rapidly at present, and agreed we are a priority (no waiting list - its F-C-F-S). They expect vacancies soon and invited us to call back every day. Of course vacancies are never guaranteed but the hospital are unwilling to give us any grace period. To begin the search again would take a long time.

Has anyone else experienced a brutal approach from a Hospital Discharge Team? I thought we were doing well to have selected a NH just one week after discharge was approved, but the Hospital are being brutal and rather bullying. They are behaving as if we have been bed-blocking for months in fact for most of her stay they did not think Mum would live and it is just three weeks since I discussed end-of-life care with my Mum’s doctor, and whether I could be contacted any time day or night.

The bottom line is - can a Hospital Discharge Team force us to accept a NH of their choice or can we hold out for the NH of our choice? Does anyone have any experience of this? I hold LPA for my Mum's Health & Welfare.

 

[Kevinl]

1. however our chosen NH advised their turnover is rapid at present, they agreed we could be a priority (they don't have waiting list - its F-C-F-S), and they expect vacancies quite soon. They even invited us to call back in 48 hrs!

2. we have been bed-blocking for months in fact for most of her stay they did not think Mum would live and it is just three weeks since I discussed end-of-life care with my Mum’s doctor, and whether I could be contacted any time day or night.

Well on point one the 48 hour turnaround is this a care home or are they building the Burma railway in World War 2? That sounds very concerning.
On point 2 it is social services who are responsible for her on going care and the term "bed blocker" is an offensive cover up for a failure in their system to follow their legal obligation and do what they're paid to, look after her.
If the hospital refuses to give you a "grace period" tell them you're walking away and can they refer it to social services, see how that goes down.
They want to play hardball, slam in back into their court, once the social services are involved the discharge team will have to wait (he said politely).
Indicate your preference is to walk away and you'd like social services to handle the situation as their legally obliged to, I did and suddenly everyone wanted to help, you ask "Has anyone else experienced a brutal approach from a Hospital Discharge Team" they did with me and they then had to put her in an assessment unit, best thing that ever happened but my wife was early onset so it's a slightly different situation.
They could, if you refused to pay a top up then say they could having offered you one place say they'd discharged their obligation, but it all takes time and gives you a chance to think.
K

 

[AlsoConfused]

It seems to me your hospital discharge team are being unreasonable. In your shoes, I'd email your Mum's consultant giving all the positive news about having already found a suitable place for her, she's at the top of the waiting list etc. Ask the consultant to have a word with the discharge team as you feel they're not hearing the good news that Mum's already got a place and will move as soon as there's a vacancy (likely to be in the very near future).

If you don't get any joy from the consultant talk to PALS and the hospital social worker.

My own Mum's consultant put the issues to us as follows - "we'd like you to get on with finding a nursing home place for her ASAP but don't worry, we won't push her out". His behaviour was far more reasonable than your Mum's hospital discharge team!

 

[bazouteast]

Discharge Team

Hi Kevin
Thank you for taking the trouble to respond.
I really appreciate you taking the time and giving me the benefit of your experience.
I feel completely alone, surrounded by a pack of angry dogs. The 'Team' approach me individually, copy each other into everything, I have no single point of contact - just a gang, ganging up. Thank you for your time and input.
Baz

 

[Kevinl]

I feel completely alone, surrounded by a pack of angry dogs. The 'Team' approach me individually, copy each other into everything, I have no single point of contact - just a gang, ganging up.Baz

That seems to be how it works, they all have the same hymn sheet, the agenda is already sorted and you're just their for a "rubber stamp" of the next of kin agreeing.
They never want to give you an e-mail address, withhold their phone number and refuse to put anything in writing is the normal plan.
I had to "disengage" until they were pooing their pants to get hold of me, then suddenly they needed to.
I like playing poker, but not with my wife as the stake and she is now in a lovely home, I got asked if I wanted dinner there today, as normal, all fully section 117 funded without a top up as NHS funded care pays the balance.
You say "I feel completely alone, by a pack of angry dogs" and I know what you mean but my answer was to (threaten) to walk away, then somehow they need you.
Without the consent of the next of kin it's all just "paper tigers" to quote Mao.
K

 

[Lorna44]

We had to wait 2 weeks for a bed to become available in our chosen nursing home....we took to dodging calls from unknown numbers and dodging nurses in the corridors...they then rang our chosen home and tried to discharge her there early, into a different room and with nothing prepared...it was awful, Mum then took a downturn and things were delayed anyway...but she's there now.
Stick to your guns, you know your mum best, not them..