Carers knowing better than health professionals

Quizbunny

Registered User
Nov 20, 2011
106
Mum has had a couple of small falls in the last week and the CH called out paramedics. On both occasions the paramedics assessed her and said she was fine and didn't need to go to hospital. Yesterday my sister was at the home when the ambulance arrived and was told by the paramedics that the the acting manager had said she wanted the family out of the way whilst the assessment was underway. This was obviously because my sister was saying that she didn't think there was much wrong with mum, the home were insisting that she needed an X-ray. The paramedics concluded that she was ok and this was confirmed by the Gp who had also arrived. He actually has now stopped her BP meds as he thinks this maybe why she's a little doddery.

Upshot is that even with the GP and paramedics saying mum was fine the acting manager was, and is, still insists she should be in hospital. In fact the acting manager is making a complaint about the paramedic! How do we deal with a CH that think they know better than anyone, the family included, whats best for mum?
 

Jessbow

Registered User
Mar 1, 2013
2,944
West Hertfordshire
Be careful- they have responsibility for her in general terms. Difficult to over ride what they say/think sometimes.

Maybe the manager thought that your mother might be in pain in the night and need extra attention and maybe she didn't have enough staff to manage that need.

It is difficult.
 

LadyA

Registered User
Oct 19, 2009
13,558
Ireland
I don't know too much about the system in the UK, but from what I understand, you have both Care Homes which don't have much actual nursing support, and Nursing Homes, which are sort of "up a level" of care? Could it be that the Manager feels that your mum is reaching a stage where she needs more nursing care than their home can provide - and her being hospitalised would be a way of introducing the idea of a move to the family?
 

Tin

Registered User
May 18, 2014
4,825
UK
It is difficult to know if there is an ulterior motive for the care manager to insist on x rays and hospital stay or if just wants to be absolutely sure and being a bit over cautious. Have you asked why there is so much concern and pushing for this?
 

Quizbunny

Registered User
Nov 20, 2011
106
Mum is definitely not a candidate for nursing care. She is mobile and up until the last week manages very well. She often stays in bed all day and doesn't like to get dressed even when she does get up. I can understand that they have to be seen to be having her assessed when she has taken a little tumble but why won't they accept the outcome of the professionals opinion. Both my sister and I are beginning to think that her mobility is what may be the issue, she obviously needs watching and as they run with so few staff having her in hospital makes life easier for them. We are very aware that a stay in hospital would be very detrimental to mum, not only would she struggle to understand where and why she was there, she would in all likelihood come out considerably worse than when she went in. The fact that they attempt to exclude us from any discussion about her wellbeing is more than an irritant, and as we have LPA for health and welfare is just not on.
 

Beate

Registered User
May 21, 2014
11,835
London
I was just going to ask whether you had health LPA! In this case it's quite clear that you can decide what she goes to hospital for, and if your decision is backed up by medical personnel, she really has no leg to stand on. Please remind her of the LPA and its legal powers and tell her to back off the hospital issue and keep you informed of any health issues. If she's still uncooperative, get back-up from the OPG.
 

stanleypj

Registered User
Dec 8, 2011
10,707
North West
I find it hard to imagine that the OPG would be capable of acting with the required urgency in such a case, but it would be interesting to know whether any members have referred a case to the OPG when their H&W LPA was being ignored and whether this brought about the desired outcome.

I didn't get the H&W LPA as the medics I've dealt with have usually been quite happy to listen to what I have to say and I've read about instances where people with the LPA have still had their wishes ignored. I wonder whether in practice it makes much difference.
 

mrsapple

Registered User
Feb 4, 2013
49
Northumberland
Maybe it's time to get an Emergency Health Care Plan in place? My mum's CH sent her into hospital on several occasions, always ringing me AFTER the paramedics had taken her off there. She always came back to the CH in a far worse state than before, declining mentally and physically at a much faster rate. I now think that hospital is the very last place a PWD should go in most circumstances. The EHCP I set up at the CH stipulated that if they had health concerns about mum they would always ring me first, and I would make the decision whether to call the GP or paramedics out. She was only to be sent to hospital in the event that she was choking, had a fracture or a bleed. This system did fall down on one occasion when she was sent into hospital by a member of the night staff who hadn't read her notes, but on two further occasions it did work, the GP attended and checked her over.
 

Ed1964

Registered User
Jan 18, 2012
121
It IS very difficult. One of the problems here is that the staff are still there when you go home... This could be the Home just trying to cover their backs, of course. If your mum does have a break and it manifests later, it might be considered neglect on their part if they could have, but didn't push for a hospital visit. So, so complicted, care home etiquette. Hospitals don't want people in, care homes always seem to run on the minimum staff ratio...it just goes round and round. Trust the paramedics. Did the home tell you that your mum had had a fall? What the circumstances were? Ultimately the home is a business...care is something else.
 

Padraig

Registered User
Dec 10, 2009
1,039
Hereford
Reading these posts tells me little has changed for my days of caring. Why I ask myself do these people in the 'profession' exclude helpful input from the people who know the patient best, i.e. the relative.
In the short period my wife was in a Nursing Home I visited every day and spent eight to nine hours there. One day a couple of carers entered my wife's room and asked me to leave while they changed her incontinent pad. I refused and questioned why: "Who do you think has been changing her for the past few years before she arrived here?" At the time we had been married some 40 years. They left the room to report me, then returned and changed her in silence while I watched. Just as well I stayed. The sight of her supported by both women shocked me. She was skin and bone and had dreadful pressure sores.
That was one of many reasons I later decided to remover her from the 'Home'. Of course they insisted I could not take her out, but as has been said it's a business. My response: "Try stopping me I'll not pay another penny".
It's a pity there is so much 'training' to follow the line with-in a box, and not enough teaching. To teach some one a subject properly the learning process never ends.
 

jaymor

Volunteer Moderator
Jul 14, 2006
12,669
England
I would have thought as the paramedics have been called and in their professional opinion everything was fine and hospitalisation was not required the home are covered regarding being found negligent if something shows up later.

you really do need to clear this up and they should sit down with you and spell out very clearly why they continue to go on about a hospital admission.
 

Onlyme

Registered User
Apr 5, 2010
4,995
UK
I would suspect the manager of wanting her admitted do they can refuse to have her back due to level of care required but that may be me being cynical.
 

Quizbunny

Registered User
Nov 20, 2011
106
Thank you all for your input.

Phoned the home today and apparently mum is up, happy, eaten everything put in front of her and is currently singing along to Max Bygraves. Hopefully they are now reassured that she is best off where she is.