Help please! What are our rights re hospital?

Discussion in 'I care for a person with dementia' started by little shettie, Apr 7, 2016.

  1. little shettie

    little shettie Registered User

    Nov 10, 2009
    219
    I have posted on here re mum. She fell on Monday in respite and broke her hip. Had her op Tuesday. Now the hospital want to discharge her within the next two days!! I've just had a phone call from the physio team informing me. Told they will send mum home (she lives with us) with 4 times care a day. I've told her no, mum can't come home. The reason for mums respite was because I needed a break and she was only in six hours before she fell. Its been a bigger nightmare ever since. I feel awful saying she can't here but I can't have her here, I'm just not up to it. I had a real funny turn yesterday where I almost passed out and had to take my bed. They wont offer her rehab hospital because of the dementia, but before we even consider other options, I don't want her released too soon. Shes in a safe place, being cared for and shes been through such trauma poor thing, its seem unbelievable that they want to discharge her. I'm preparing to do battle with the SW when I get there in a n hour, but can I prevent her discharge? Can I take it higher, can I kick up a fuss to prevent because that's what I want to do if necessary. Its a carbon copy of what happened to my gran 35 years ago, she was about 90, fell and broke her hip. Mum was told she wouldn't survive the op but she did. They discharged her way too early and she fell and broke the same hip again within a day. I don't want this for my mum. Please, any help advice would be so appreciated so I'm armed with some knowledge when I get there! xx
     
  2. TooHard

    TooHard Registered User

    Sep 16, 2015
    109
    Do NOT give in!

    That's my absolute nightmare scenario and I don't even live with my mum! Last year she was discharged from hospital despite not being nearly well enough - they knew she was severely constipated when she was there and had only just taken out the catheter dealing with her backed up bladder. She had been very confused and unco-operative in the hospital and I think they were just keen to get rid of her in the guise of 'she'll do better at home'. She did NOT do better at home - I was on my knees within 48 hours dealing with faecal incontinence and the re-inserted catheter. I was there for ten days with absolutely no support. Never again. I'm still angry about it months on!

    Even a fit and healthy person would be struggling to cope so soon after surgery and if you're not fit to support her 24 hours a day do NOT be bullied or emotionally blackmailed into doing it!
     
  3. starryuk

    starryuk Registered User

    Nov 8, 2012
    1,299
    This is awful. I'm afraid I don't know about these things, but isnt there something about 'safe discharge'?

    Would PALS at the hospital help you? Could they discharge her back to the CH where she came from?

    Gosh, I wish I could help...and this was supposed to be respite for you?!:(:mad:
     
  4. sue38

    sue38 Registered User

    Mar 6, 2007
    10,856
    Wigan, Lancs
    This factsheet on Hospital Care https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=118 has some information about discharge.

    The plan to discharge her relies on you agreeing to provide care for her and you are perfectly entitled to refuse to provide that care. You're quite entitled to take yourself off on a 4 week cruise (and it sounds as though you may need one!). Remember you have no legal duty of care for your mum but Social Services do.
     
  5. Blogg

    Blogg Registered User

    Jul 24, 2014
    64
    #5 Blogg, Apr 7, 2016
    Last edited: Apr 7, 2016
    She should be offered rehab. We had a similar situation with my dad. I've got some files saved somewhere, I'll try and find them and post the links. Do not consent to them sending her home.

    The fact sheet Sue linked to above states on pages 12 & 13 that intermediate care should be offered to regain confidence.
     
  6. Blogg

    Blogg Registered User

    Jul 24, 2014
    64
  7. Blogg

    Blogg Registered User

    Jul 24, 2014
    64
    #7 Blogg, Apr 7, 2016
    Last edited: Apr 7, 2016
    Also from NICE guidelines http://https://www.nice.org.uk/guidance/cg42/evidence/full-guideline-including-appendices-17-195023341

    4.9 BASIC LEGAL AND ETHICAL CONCEPTS IN CONNECTION WITH DEMENTIA CARE
    4.9.1 Introduction
    The ethical problems that arise in the context of dementia mainly relate to autonomy, which is compromised in dementia to varying degrees. Respect for autonomy is recognised as a key principle in health and social care (Beauchamp & Childress, 2001). Many of the ethical tensions that arise in looking after people with dementia do so because of, on the one hand, the requirement that autonomy ought to be respected and, on the other, the reality of increasing dependency, where this entails a loss of personal freedom.
    Person-centred care is a means of respecting personal autonomy wherever it is threatened (Kitwood, 1997). As Agich has stated, ‘Autonomy fundamentally impor- tantly involves the way individuals live their daily lives; it is found in the nooks and crannies of everyday experience’ (Agich, 2003).
    Hence, respecting the person’s autonomy will involve day-to-day interactions and will be achieved if the person with dementia is not positioned in such a way as to impede his or her remaining abilities. Such ‘malignant positioning’ can be the result of inappropriate psychosocial structures. The fundamental way to combat this tendency, which undermines the person’s selfhood, is to encourage good-quality communication (Kitwood, 1997; Sabat, 2001).
    Another way in which selfhood might be undermined is through structural or procedural barriers to good-quality care, and service providers should take an active role in promoting the individual’s autonomy and his or her legal and human rights. Furthermore, services may discriminate against people with dementia if eligibility criteria are drawn up in such a way as to exclude them or because of an assumption that people with dementia cannot benefit from a service because staff lack confidence and skills in working with this group. Discrimination may also occur if a service does not offer people with dementia the support they may need in order for them to be able to make use of the service
    . The Disability Discrimination Acts (1995 and 2005), which include dementia within the definition of disability, aim to end the discrimina- tion that many disabled people face in their everyday lives by making direct or indirect discrimination against disabled people unlawful in a range of areas including access to facilities and services and buying or renting property.

    I'm sorry your having to deal with this :(
     
  8. care2share

    care2share Registered User

    Jun 14, 2015
    92
    London

    I am so sorry to hear of your and your Mother's situation. I think you will have to just have to stick to your guns. Even if she did come back to you I'm sure she would be a failed discharge within hours of her return. You would quite likely end up calling an ambulance or end up calling around for an emergency admission to a care home. It would only result in another fall and and on the second occasion it may be the opposite hip. Mum will end up totally immobile. The chances of her ever coming home then will be practically nil. I guess she is being turned down for rehab due to the dementia. I feel my Mother was a "dementia write-off". Do you feel that is what's happening? As I say, Stick to your guns. It is not your obligation to take on the situation. I guess eventually they will have no alternative to place her elsewhere. I guess too that it would mean she will quite likely be in permanent care, especially if the alternative was not rehabilitation. Would she be self-funding. If so, it's such an easy decision for them, isn't it. Do you have LPA? Could it be possible to get her somewhere there's great rehab. privately funded?
     
  9. little shettie

    little shettie Registered User

    Nov 10, 2009
    219
    Just got back from hospital where its been 3 hours of pure hell! Met SW and he said that discharge from hospital this early is normal and that she can come home to us with 4 care visits daily. I told them categorically that's is not happening. 4 visits = 4 hours so the 20 hours is down to me. NO! She can't be admitted to rehab as the dementia disqualifies her from that so the only alternative is to return her to respite home she fell in and then a community physio would assess her in 2-3 weeks to see if she qualifies for physio!!!!!!!!!!!!!!!!!!! I went ballistic when told this. So basically mum is being left on the scrap heap because she has dementia and she cant even stand up at the moment, her hip op was only 2 days ago and her pain is intense. They don't need to get her mobile, just send her packing to be someone elses problem!! I'm so livid, I want to take this further but don't know where to go. I told them I'd go higher with this and suddenly we after talks with someone higher up the pecking order we were informed that she could go back to care and would get community rehab that day and then physio when needed. But it took me ranting to get it, same as usual. I'm so sick and tired of it all. But I do want to question all of what they're telling me as I feel like mums rights as a human being are being denied here, its not her fault she has dementia but their saying basically because of dementia she has little or no choice. I'm sorry to rant but I'm struggling here, big time!!!!
     
  10. brambles

    brambles Registered User

    Sep 22, 2014
    229
    Female
    NW England
    So sorry you are going through all this. I am glad you have managed to get (hopefully) the care your mum needs on her discharge.

    It always makes me so cross when I see politicians and NHS staff on TV saying the most important thing is to get elderly people home from hospital as soon as possible, as that is the best thing for them. The best thing for the hospital certainly! The best thing for the patient is to be discharged to somewhere where they can receive the level of care they need (not 4 hours a day care visits).

    I wish they would bring back convalescent homes that should be able to care for those with dementia as well as anyone else needing support.

    brambles x
     
  11. rhubarbtree

    rhubarbtree Registered User

    Jan 7, 2015
    462
    North West
    Have been reading your posts with great sympathy both for you and your Mum. How awful for her to be hurt so badly within hours of going into care and now you have all the worry when you should have been resting. Well done for insisting on some sort of compromise. Hope the care home will over compensate and look after her regally when she returns.
     
  12. doodle1

    doodle1 Registered User

    May 11, 2012
    241
    Threaten the hospital with complaining to your MP. As I have said before my friend who is a Medical Director of a big London hospital says this is the only thing that works - stick to your guns . Hugs
     
  13. HillyBilly

    HillyBilly Registered User

    Dec 21, 2015
    1,948
    Ireland
    I cannot believe they want to discharge your Mum so soon after a hip op!!!
    When my Mum fell and broke her hip (in a hospital) last year, she then spent about 8 weeks "convalescing" in a community hospital, receiving physio, even though she has dementia. Shouldn't make any difference, surely?! Stick to your guns!
     
  14. RedLou

    RedLou Registered User

    Jul 30, 2014
    1,162
    Well done for what you've achieved. It's a shame you had to steel yourself and had all that unpleasantness but you've made them listen.
     
  15. MollyD

    MollyD Registered User

    Mar 27, 2016
    1,696
    Ireland
    This is not a rant. It's legitimate outrage. Fair play to you for standing up to them bamboozling you, because that is what they were doing. Exactly the same here in Ireland. Men and women who contributed in every way all their lives are now considered 'bed cloggers'. If that's the case, the onus is on the government (we don't quite have one at the moment!) to get more bloody beds. Also to provide working conditions to encourage people to work in the health/care sector rather than paying them peanuts to work slave hours.

    ^ Now *that's* a rant.
     
  16. little shettie

    little shettie Registered User

    Nov 10, 2009
    219
    I've just emailed our local MP and asked for her intervention. I'm so angry over it all I really really am. Lets see if she can/will help! I won't let this drop, its the papers next!!
     
  17. nae sporran

    nae sporran Volunteer Host

    Oct 29, 2014
    5,822
    Male
    Bristol
    Having experienced a failed discharge for my OH I wish you the best of luck. They really should think of your mum's welfare and what's best for her.
     
  18. la lucia

    la lucia Registered User

    Jul 3, 2011
    591
    This not offering rehab because she has dementia seems totally wrong. My mother has just had a major brain haemorrhage and has quite advanced dementia but she still got sent from the big hospital to the rehabilitation ward of a smaller hospital.

    It's ridiculous, your mother needs therapy and that doesn't change with dementia. If anything without therapy it could make the dementia more problematic. I agree with everyone else, stick to your guns, take it higher and remind them that this refusal to offer intermediate care is discriminatory. Apart from anything else.
     
  19. Aisling

    Aisling Registered User

    Dec 5, 2015
    1,807
    Ireland
    stick to your guns love. you cant look after your Mum. You have ddone your best. I imagine the hospital cant just discharge her. other TP s will know more about your system.

    loads of love

    Aisling
     
  20. jasmineflower

    jasmineflower Registered User

    Aug 27, 2012
    335
    Hi Shettie,
    I've just checked out the NHS Choices website. It says you must not be discharged until :

    You are medically fit (this can only be decided by the consultant or someone the consultant has said can make the decision on their behalf).

    You have had an assessment to look at the support you need to be discharged SAFELY

    You have been given a WRITTEN care plan that sets out the support you’ll get to meet your assessed needs.

    The support described in your care plan HAS BEEN put in place and it’s SAFE for you to be discharged.

    I think you would have a good argument on each of those points why your mother shouldn't be discharged

    J x
     

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