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Can they just not give us what was promised?

Manchester1963

Registered User
Apr 7, 2015
6
Dear Fellow Travellers - My mum was diagnosed with Alzheimers in 2012, and pretty sure she was beginning a good few years before that, so have been anticipating some decline . She's been on Memantine and done very well, - maintaining a good social life and living independently with a small amount of care agency and lots of help from myself and other family.
She recently had a small heart attack and a fall and was admitted to hospital - treated medically and then was on an elderly dementia ward.
The re-ablement team said she would have intermediate care + re-ablement at home for up to 6 weeks. After a lot of confusion and very worrying loss of any coherence on the first day of hospital, she regained her usual repetitive but making sense way of communicating after the first night - she also "covers up" well for her dementia. But she was very weak. After two weeks and following the medical treatment, the doctor said she would be ok to go home. However it would be another week before care package was ready to begin.
Next I got a call from social services who said THEY would be doing the care package and would come to her flat on the day of discharge to assess her. I said - ok, but she is getting a re-ablement and intermediate care package under the NHS isn't she - he said not, that they(ss) would offer her 4 visits and that it would be means tested. I objected and said I didn't understand why the intermediate care was no longer on offer - he said something vague - asking on the ward they were also vague. To be clear - I don't object to the means test - but in principal I though intermediate care was free - and also being still under NHS would include a level of skilled therapy (or am I naive)
We decided she would be best at home anyway - than sitting all day in the strange and often disturbing environment of the ward and luckily my brother was over from abroad and could care for her whilst I was at work.

During this week, we have found she is not properly continent and also can not clean up herself after toilet. I actually began to try and address this a few months ago (the clearing up) - with her carers, but its been problematic. I've had to buy lots of incontinence stuff for now - but surely the gp should provide these
My brother leaves tomorrow afternoon SS guy comes Tuesday.
meanwhile the ward nurse manager phones me to explain that Yes , she was offered intermediate care - but "there was no capacity - and we saw that SS could provide the package quicker"
I wonder if any of you have experienced the same situation and how best to approach the situation when he comes to assess. I basically feel as if the NHS pulled a fast one and wriggled out of their duty. I also felt that re-ablement would be something more than the quick visit that will no doubt be provided by the cheap care agency the social services use.
Can they just not give us what was promised??

While I'm on - where does nursing care begin and social care end - when we are talking about incontinence and inability to clean yourself when you have dementia...?
 

Tin

Registered User
May 18, 2014
4,825
UK
Cannot answer other questions but can tell you that if the gp knows of your mothers incontinence they will refer her to continence clinic, they in turn will contact you, but you must stress that she is now incontinent, no half ways or sometimes she can get to the toilet. Make an appointment with gp or telephone surgery as soon as possible to get the ball rolling.
 

nitram

Registered User
Apr 6, 2011
20,058
North Manchester
From your username I'm assuming that your Mum is in Greater Manchester.
You are describing a complete breakdown of >>>Devomanc<<< which was supposed to remove the distinction between LA and NHS funding bringing them both under the same budget.

While I'm on - where does nursing care begin and social care end - when we are talking about incontinence and inability to clean yourself when you have dementia...?
Incontinence in itself does does not require a nurse, a carer can deal with all its consequences, hence it is not considered nursing care.
 

Beate

Registered User
May 21, 2014
11,949
London
Incontinence requires a referral to the Continence Service via your GP. They can then assess her and prescribe a certain number of inco pads.

The care package should have been in place BEFORE she was discharged home. Is your mother already home? If not, insist she gets care in place before she leaves. If she is, remember this for next time - a discharge without adequate care at home in place can lead to a readmittance to hospital within 30 days, which is called a failed discharge. This triggers a fine for the hospital so next time mention that term and see them pale and hopefully react accordingly. The fact that a doctor declares someone medically fit for discharge does not mean someone should immediately be sent home - I had to fight that battle myself.
 

Manchester1963

Registered User
Apr 7, 2015
6
Cannot answer other questions but can tell you that if the gp knows of your mothers incontinence they will refer her to continence clinic, they in turn will contact you, but you must stress that she is now incontinent, no half ways or sometimes she can get to the toilet. Make an appointment with gp or telephone surgery as soon as possible to get the ball rolling.
Thanks - yes I will do so.