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Dad is low priority for Occupational Therapy assessment

mrjelly

Registered User
Jul 23, 2012
314
0
West Sussex
A fortnight ago Dad was reasonably mobile at home with a Zimmer frame and assistance from a live-in carer. Then after a couple of funny turns (seizures) and 3 nights in hospital, his mobility declined to the point where he is now unable to walk or even stand up safely without a beefy helper on either side. If feeling an urgent need for the toilet he might summon up just enough strength to fall out of the chair or bed he is in at the time. For a week he was falling once or twice every day/night. :(

A manager from the private care company visited and did a quick risk assessment after which he recommended a standing hoist, a hospital bed, a wheeled commode and a transfer board to enable Dad to continue living at home with assistance from one live-in carer from his company. This was faxed to Social Services, who were happy to send a commode and order a hospital bed but wanted to do their own assessments of Dad and his house before sending any hoists.

The problem is that, in the meantime, we put Dad into respite in order to keep him safe until the equipment arrived. But now that Dad is in a "place of safety" he is no longer a high risk case, and the SS OT admitted that he would not be given any priority for assessment by Social Services.

What I hoped would be a temporary stay in the home now looks like it could stretch on indefinitely. My worry is that Dad's mood and mobility will decline more rapidly now he is in a care home, and a lengthy stay could mean he never comes home again.

We didn't spend very long looking around, but the home is basically OK and Dad doesn't seem too upset by the "temporary" move so far.

I just wonder - is this the best we can do for Dad?

Should we forget about Social Services and pay for a private occupational therapist to assess Dad and buy whatever they recommend?

Is it possible for a mid-stage dementia sufferer with urinary incontinence and almost no mobility to live at home any more - even with a live-in carer and all suitable equipment?

One private live-in carer is just about affordable for him, but two would definitely break the bank!
 

nita

Registered User
Dec 30, 2011
2,420
0
Essex
Sorry to hear about your Dad. A similar thing happened with my Mum. She had to go into respite while waiting to be assessed by an OT and then have equipment delivered. This dragged on for a few weeks and then we had to wait for a care package to be put in place. I didn't want my Mum to be in respite that long either, even though it was funded by Social Services. I would have thought this was an incentive for them to get everything in place for a return home.

My Mum was getting increasingly less mobile at home. We were having great difficulty getting her on to the commode and gradually she could hardly stand. She was, however, still continent, it's just that it took her a while to get there. The OT came and did an assessment and we also got an hospital profile bed and airflow mattress. The OT tried her with a standing hoist but she didn't have the strength in her legs to use it. She also tried a turntable. The hospital bed was too high for us to easily transfer her in and out of it even with a slide sheet and, at that point, we only had one care visit a day and three visits at night. It was decided that Mum would have to stay in bed until she could be taken into respite.

Mum's bed was already in the downstairs lounge but we had to move everything around and get rid of furniture to make it easier for carers to get both sides. When Mum came home she was incontinent of urine because they left her in bed at night and often during the day and she had to wear pads. We had a mobile hoist and sling, gliding commode and 2 carers x 4 times a day. It hasn't been easy, not least because at times my Mum needs the commode (for bowel movements) in between visits and we try to manage with a bed pan.

Because Mum is hoisted, she needs 2 carers to do this. I wanted to do it but, even if I had training, the carer from the agency would not be allowed to work with me. I can't say she particularly likes being hoisted but she has got used to it.

I would think you could try to hurry the SW up to get the OT assessment. I had the phone number for the OTs and would speak to them regularly.

If you had live-in care you would have to have 2 carers as they need to work in shifts. It all depends whether you father is self-funding or not. We have only been able to keep Mum at home because SS pays for her care (not that I'm entirely happy with the agency they use); Mum pays a small monthly charge for this.

It does sound, if you father is self-funding, that it will be almost impossible for him to continue to live at home, as paying for care home fees will be less expensive than paying for 24-hour live-in care, especially as he may need more than one carer at times, to assist with the hoist, etc. If he has accepted the care home fairly well, this time of respite may be a way of easing him into staying there. I know it will be hard for you as well as him but it may be for the best. Can you stall telling him it is permanent, by saying (truthfully at the moment) that everything has to be in place for him to go home, and then continue saying this, if he asks to go home. Fortunately for me, my Mum didn't keep asking to go home on this stay and seemed fairly content in the home. She actually seemed stimulated by the people around her and responded well to the carers.
 

mrjelly

Registered User
Jul 23, 2012
314
0
West Sussex
Thanks for your detailed reply Nita. It really helps me to get an independent perspective.

I thought there were some types of hospital bed that could be lowered further than others, so that might work for us.

I didn't know you needed two carers to work a hoist though - that does sound a bit of an obstacle for us, especially as Dad's toiletting needs are so unpredictable.

Other members of my family seem resigned to Dad being in a care home for good now, but I want to be sure we have tried all avenues to keep him at home first.
 

nita

Registered User
Dec 30, 2011
2,420
0
Essex
The hoist my Mum has is a mobile hoist where she has to be put in a sling and it needs one person to see to the controls and the legs of the hoist while the other watches that the person doesn't knock their head or feet.

Your father may be able to use the standing hoist. I am not sure if that requires one or two people, possibly only one. I was just thinking that his mobility may have deteriorated. The OT told me there was a very short window when the standing hoist could be used before the next stage. It would be up to the OT to assess your Dad and find out what he needs. He probably needs another assessment now he is in care.

There may be hospital beds that go lower - I was told the one I had was the only type that SS provided.

Another problem I had was with the incontinence pads. The district nurse wouldn't prescribe any while Mum was in respite as her needs could be different at home with just 4 carer visits a day. When she came out the continence nurse came. However, the ones they provided were not good enough and I have had to buy them myself. Now I don't have to wash a sheet every day!
 

lin1

Registered User
Jan 14, 2010
9,350
0
East Kent
Thanks for your detailed reply Nita. It really helps me to get an independent perspective.

I thought there were some types of hospital bed that could be lowered further than others, so that might work for us.

I didn't know you needed two carers to work a hoist though - that does sound a bit of an obstacle for us, especially as Dad's toiletting needs are so unpredictable.

Other members of my family seem resigned to Dad being in a care home for good now, but I want to be sure we have tried all avenues to keep him at home first.

Mums hospital bed went very low to the floor. if I remember right it was only the wheels that stopped the frame going right down to the floor

I understand your wish to do what you can to keep your Dad at home.
I hope you are able to get dad back home
I think you need to become a very squeaky wheel, be a polite but royal pain in the butt.
 

jamie-g

Registered User
Oct 5, 2013
23
0
Aberdeen , Scotland
to be honest i have found out the worst thing we can do is agree to hospital discharge to nursing home as social work can then say care needs are met ...... as if discharge is imminent from hospital social work have a duty of care to carry out a home needs assessment before hospital discharge and the hospital will force social work to react as its bed blocking