Familar environment V safety

[mydiamondmum]

May I trouble you for comments on the following. My mother was in and out of hospital 12 times in a 6 month period with UTI’s falls and advancing Alzheimer’s. I complained as they were sending her home to danger without consulting me as she presented mentally quite well, but they were not aware that most of the things she was saying were just hallucinations. They were not listening to me and failed to have a meeting with me before discharging her.


Her basement flat had a winding metal stair case and that is the only way she could get in or out and it was dangerous because she had a walking stick and needed a wheelchair to walk more than a very short distance, but she was not aware of this as in her mind she was at least 30 years younger and had no mental or physical conditions so she would just go out putting herself in great danger and getting herself in all sort of predicaments, like informing me she was going to the bank with some man, then drawing out money which was never seen again. Also nearly always losing her keys and having falls it was not safe for her to return home, but my views were ignored and she would be discharged then readmitted a day or two later I was even crying once when the doctor had promised a meeting with me, mum the doctors social services before they discharged her only to be told the following day there has been a change of plan and she is going home tomorrow. This without a meeting, sure enough she went missing for a period of time and they eventually presented herself back in hospital. She was in great danger.


I would not mind if lessons were learnt from this, but the response I am getting back from them is ‘NHS England and the Alzheimer’s Society share an aim to reduce the number of people with dementia in a hospital care setting, due to the value of keeping them in a familiar environment ’


Surely the Alzheimer’s Society would not share the view that it is better for someone who has lost mental capacity and is in danger to themselves not only from self neglect but by negotiating stairs what were extremely dangerous she could only negotiate them going down them backwards holding on to the railings.

Also chatting away to anyone in the street who could easily take advantage of her, and going out without her stick as she thought was some 30 years or so younger and had nothing wrong with her.

I am just upset with them using the Alzheimer's Society of their excuse.


Please could you give me your comments on the above?

 

[Rosettastone57]

May I trouble you for comments on the following. My mother was in and out of hospital 12 times in a 6 month period with UTI’s falls and advancing Alzheimer’s. I complained as they were sending her home to danger without consulting me as she presented mentally quite well, but they were not aware that most of the things she was saying were just hallucinations. They were not listening to me and failed to have a meeting with me before discharging her.


Her basement flat had a winding metal stair case and that is the only way she could get in or out and it was dangerous because she had a walking stick and needed a wheelchair to walk more than a very short distance, but she was not aware of this as in her mind she was at least 30 years younger and had no mental or physical conditions so she would just go out putting herself in great danger and getting herself in all sort of predicaments, like informing me she was going to the bank with some man, then drawing out money which was never seen again. Also nearly always losing her keys and having falls it was not safe for her to return home, but my views were ignored and she would be discharged then readmitted a day or two later I was even crying once when the doctor had promised a meeting with me, mum the doctors social services before they discharged her only to be told the following day there has been a change of plan and she is going home tomorrow. This without a meeting, sure enough she went missing for a period of time and they eventually presented herself back in hospital. She was in great danger.


I would not mind if lessons were learnt from this, but the response I am getting back from them is ‘NHS England and the Alzheimer’s Society share an aim to reduce the number of people with dementia in a hospital care setting, due to the value of keeping them in a familiar environment ’


Surely the Alzheimer’s Society would not share the view that it is better for someone who has lost mental capacity and is in danger to themselves not only from self neglect but by negotiating stairs what were extremely dangerous she could only negotiate them going down them backwards holding on to the railings.

Also chatting away to anyone in the street who could easily take advantage of her, and going out without her stick as she thought was some 30 years or so younger and had nothing wrong with her.

I am just upset with them using the Alzheimer's Society of their excuse.


Please could you give me your comments on the above?

The situation you are describing was one of the tipping points for my mother-in-law to go into full time care. She was a high falls risk and didn't have the capacity to realise she was in danger . I hope your mum is safe now

 

[mydiamondmum]

Hi Rose, thank you for your reply, sorry to hear about your mother in law, I know how you feel. I didn't have poa at the times but I do now. But I am her only relative and next of kin. She didn't have a check list in hospital (I didn't even know what that was at the time) but that would have highlighted her health conditions.

If anyone knows where is states in the care act or any other official guideline where it states that she hospital should have carried this out or an MDT meeting, I would be grateful if you could let me know.

 

[Helly68]

mydiamondmum I very much sympathise with you. Sadly the situation you describe has been experienced by others. It doesn't make it any better.

Has your mother had an assessment by social services? It sounds as though this would be helpful. You may also want to keep a record of "incidents" - falls, going missing etc so that if you also attend meetings you can bring up the repeating pattern you describe.
I can see that in the health service view, hospitals are not a great environment for PWD, but it is cynical for them to use this as an excuse to discharge her back to an environment that is obviously dangerous.
Perhaps her GP could refer to social services?

 

[Louise7]

If anyone knows where is states in the care act or any other official guideline where it states that she hospital should have carried this out or an MDT meeting, I would be grateful if you could let me know.

If you haven't already done so, take a look at the hospital's discharge policy as this should provide details of what should happen prior to discharge. However, from personal experience hospitals don't always follow their own processes - the reality is that they want the bed so are keen to discharge people as soon as they can.

 

[mydiamondmum]

too true Louise. But I do believe that there are specific guidelines about this for people with dementia and are over a certain age, 80 or 85 I think.
I am trying to find out and if and when I do, I will post them here, in case it is a help to anyone else going through the same situation.

 

[mydiamondmum]

Thank you again for your replies. My LO is in a care home now, I am just dealing with a previous complaint and being fobbed off, which is about the standard way all such complaints are dealt with.

For anyone else who is going through the same situation right now, I have found an Alzheimer's Society pdf which covers this...

The link is
https://www.alzheimers.org.uk/get-support/publications-and-factsheets/booklet-when-does-nhs-pay-care

then open the link for the pdf

then if you move down to view pdf and go to page 17

It states that
'In other words, a hospital should not discharge someone with dementia without considering whether or not they need NHS continuing health care. ‘Considering’ normally involves carrying out a Checklist screening, possibly carrying out a full assessment of the person’s needs, or even fast-tracking, where necessary.'

This to me reads that the National Framework guidlines are that they should not have discharged my LO with at least a Checklist screening to see if a full assessment was necessary. Had they done this, her difficulties would have been highlighted as would her other medical conditions that she could not tell them about due to lack of mental capacity but I would have been able to.

Another very helpful information sheet from the Alzheimer's Society. Thank you.

 

[Jaded'n'faded]

Thanks for posting that link - it's a very useful publication as you say.

My concern is the use of the word 'should' as in 'hospitals should not discharge...' That would imply that hospitals are not under an obligation to do so. Whilst it may be best practice, it seems to me all hospitals have their own rules, guidelines and procedures and rarely follow those in a consistent way.

It just shouldn't be like this. Getting CHC is a major battle and that is just wrong. And I think we all know what happens to those with no one to fight their corner or where family members are just not able to negotiate the system for whatever reasons. They get nowt.