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Another failed discharge.

Violet Jane

Registered User
Aug 23, 2021
416
0
Picking up on post #54, it does seem that when a PWD has an infection causing more confusion / Delirium it leaves permanent damage even when the infection appears to have been treated in that the PWD never fully gets back to his/her previous ‘baseline’. I think that this happened to my elderly friend last year. She had a fall and an admission to hospital in January and never really picked up fully after that. Things were probably exacerbated by the lockdown (she lives alone and saw no one - all her friends were shielding - except for when she went to the shops or we dropped off her shopping and had a few words on the doorstep), and she was diagnosed with AD after two telephone assessments in May of the same year.

A bugbear of mine is that hospitals discharge frail people before their infections are fully eradicated. They are prescribed oral antibiotics, and on the discharge summary there is an instruction that the GP review the person but, in my experience, there’s never any follow up to see whether the infection has actually cleared. As a result, infections persist and there’s often another admission to hospital, following another fall or episode of Delirium, within a few days of discharge.
 

MaNaAk

Registered User
Jun 19, 2016
5,567
0
Essex
I had clarity loratadine for hay fever for years and now I take cetirizine which is good. I hope you're getting some sleep @nae sporran. I remember the help you gave me when I cared for dad.

MaNaAk
 

nae sporran

Volunteer Host
Oct 29, 2014
8,397
0
Bristol
That is my biggest fear @Violet Jane. C's baseline has gone down a fair bit in the last couple of years with UTIs and this ongoing pain plus of course the lockdowns depriving her of her day centre and memory cafe. The discharge summary was a bit lacking in helpful details last time, so that's another thing to raise with the discharge nurse.
Sorry about your friend, how is she now?
 

notsogooddtr

Registered User
Jul 2, 2011
1,061
0
Picking up on post #54, it does seem that when a PWD has an infection causing more confusion / Delirium it leaves permanent damage even when the infection appears to have been treated in that the PWD never fully gets back to his/her previous ‘baseline’. I think that this happened to my elderly friend last year. She had a fall and an admission to hospital in January and never really picked up fully after that. Things were probably exacerbated by the lockdown (she lives alone and saw no one - all her friends were shielding - except for when she went to the shops or we dropped off her shopping and had a few words on the doorstep), and she was diagnosed with AD after two telephone assessments in May of the same year.

A bugbear of mine is that hospitals discharge frail people before their infections are fully eradicated. They are prescribed oral antibiotics, and on the discharge summary there is an instruction that the GP review the person but, in my experience, there’s never any follow up to see whether the infection has actually cleared. As a result, infections persist and there’s often another admission to hospital, following another fall or episode of Delirium, within a few days of discharge.
Hospitals are fined for failed discharges so you would think they would do everything possible to avoid them. However I've just read an article about how much pressure they are under to free up beds(even more than usual) because of huge waiting lists.
 

Violet Jane

Registered User
Aug 23, 2021
416
0
My friend is not too bad, nae sporran. Despite her many infections and falls she doesn’t seem to have deteriorated much since she was diagnosed. HOWEVER, she has a care package of four visits a day and huge input by me, without which I think things would fall apart. This does somewhat mask her cognitive deficits, not least because I am at the end of the phone for all manner of problems, real and imagined.

A big problem is that there are so many things that visiting carers can’t / won’t deal with, particularly relating to problems in the house. My friend’s house has been well maintained but things are breaking down and there is nobody to deal with this except me. For instance, whilst I was away last week I got a call that the washing machine wasn’t working. I obviously couldn’t just order another one without checking whether it could be fixed and, if not, whether the model (or similar) is still available (it’s a top loader and fits into a small space). I will then have to be there when the machine is fixed or replaced. I’ve just brought home two or three loads of washing to wash, some of it soaking wet.
 

nae sporran

Volunteer Host
Oct 29, 2014
8,397
0
Bristol
The things you find yourself sudde3nly having to be an expert in is exhausting, @Violet Jane. Good to know your friend at least has carer support and good luck sorting the washing machine.
 

nae sporran

Volunteer Host
Oct 29, 2014
8,397
0
Bristol
Hospitals are fined for failed discharges so you would think they would do everything possible to avoid them. However I've just read an article about how much pressure they are under to free up beds(even more than usual) because of huge waiting lists.
I just read that in the Guardian, so many more people going through the same battles and so much pressure on doctors and nurses. I feel for everyone caught up in it.
 

nae sporran

Volunteer Host
Oct 29, 2014
8,397
0
Bristol
I'm just back from the hospital and C is coming home on Monday. The OT, the social worker and the care manager have worked it out between them. They were going to arrange transport, but I've heard that is not always reliable for getting home on time and the community OT is coming at 10. So, I'll go in and pick her up.
The good thing to come out of it all is that the social worker is going to give me a carers assessment and will support our application for new bed like hospital bed. The Dementia Navigator has told her the situation and the stress it puts me under.
I'll breath more easily on Monday and will have to prepare a few questions for the community OT now, then the care plan will need to be updated again by next spring. Anyway, thanks to everyone for your support, advice and ideas.
 

Frank24

Registered User
Feb 13, 2018
191
0
My mum was very confused in a hospital setting and did become less confused at home. I think hospitals are awful places for anyone with Alzheimers?dementia issues. There is nothing more frustrating that trying to get information out of hospital staff - yes its a hard job, harder now with covid but no one seems to do family liaison and when the patient is confused, relying on a POA to help them through I feel that there should be a point of contact. I hope things improve.
 

nae sporran

Volunteer Host
Oct 29, 2014
8,397
0
Bristol
Thanks @jennifer1967 and @Frank24. the carers liaison officer from the carers support centre tried to help and gave me some advice, but the shortfall between Care Act obligations, hospital stated policy and finding a doctor or nurse with the time to talk to me was obvious. Credit to the OT though who did make herself available.
 

Frank24

Registered User
Feb 13, 2018
191
0
Thanks @jennifer1967 and @Frank24. the carers liaison officer from the carers support centre tried to help and gave me some advice, but the shortfall between Care Act obligations, hospital stated policy and finding a doctor or nurse with the time to talk to me was obvious. Credit to the OT though who did make herself available.
Oh dear. Its not good is it? I had a hell of a time with my Mum being in hospital so I do know what its like. You feel as if your the one whose mad, and in fact its the system... So glad your loved one is coming home and I wish you all the best with that. Also v stressful. Take care.