Hiring a private ambulance - advice?

[Bullet]

To lessen the emotional strain of having to put Mum into a care home against her wishes (a journey of around 4 hours, during which we'd probably have to tell lots of lies about where we're going, and possibly sedate her), we're considering hiring a private ambulance. But I'm not certain of the legalities of this.

As I understand it, as Mum's next of kin, her children have the right under common law to decide that it's in her best interests to go into a care home, and simply book her in. This action then triggers Deprivation of Liberty Safeguards (DOLS), a procedure to ensure that her removal has been conducted legally. This being the case, I see no reason for a private firm to object to moving Mum on our behalf. As legal back-up, we can provide proof that we're her next of kin, plus a statement from her CPN that she lacks capacity to decide where she should live, plus the minutes of the Social Services Best Interests Meeting where it was unanimously agreed she should go into a home.

This seems pretty watertight to me. Could such a 'third-party removal' be easily arranged? Who could we approach, and how much would it cost? It would be great to hear from anyone who has been through a similar experience.

 

[nitram]

No experience but have you tried approaching the chosen care home for advice/suggestions?

 

[jenniferpa]

Umm - is your mother bed bound? Because I have to say, while you may think sedating and then moving her is the best thing to do, I very much doubt you would be able to find a reputable company willing to participate in this, nor a doctor willing to sedate her in this way. Perhaps I've misunderstood, but it does sound as if you essentially want to transport her while she is asleep? In order to avoid the questions and potential distress? I do think it might be possible to get her current doctor to prescribe something like Valium, but to be honest, you have no way of knowing how she will react to it (unless she's had it before). It almost certainly won't knock her out - at most she will get drowsy.

I do think you need two people to undertake the journey - one to drive and one to answer the inevitable questions.

I'm sorry to be a downer about your idea but I do think 1) you won't be able to do it and 2) "managing" someone into a care home situation while possibly not strictly legal is a far cry from sedating them and transporting them to another place while they are unconscious, and finally 3) is really not necessary.

 

[Onlyme]

I have a nasty feeling that if she doesn't want to go then it could be deemed as something stupid like kidnapping or against her human rights. I would make the health authority help you then they can't say you are at fault.

 

[piedwarbler]

I booked a St Johns ambulance when I moved my mum. There was no consent issue. However nobody asked me if there was a consent issue either, they just turned up and we moved.
I also used a private ambulance when mum left her home for the care home as she was immobile. Again nobody asked about consent.
Mind you then again mum went willingly both times as she knew what was happening and did not refuse to move. If she had, I doubt they would've moved her.

 

[Bullet]

I agree there's no question of knocking Mum out and transporting her while asleep. The sedation would probably just be some sort of sleeping pill as a last resort to calm her down if she became distressed. Nothing that could conceivably cause her harm, so probably not even enough to make her fall asleep. But I don't think we would attempt the journey if serious distress seemed likely.

St John's Ambulance sounds a good port of call. For Mum's reassurance, an unmarked car would be best, with someone she recognised - like one of her regular carers - to accompany her.

Unfortunately, because Mum has the funds for self-financed care, the local authority are within their rights to wash their hands of any involvement with her move into a home, so it's all down to the family.

 

[jenniferpa]

To be honest, I think your best bet would be for one of the people to be a family member.

 

[2jays]

Unfortunately, because Mum has the funds for self-financed care, the local authority are within their rights to wash their hands of any involvement ............... so it's all down to the family.

Oh the joys of Self Funding! It seems to me at every turn the door is shut in my face as soon I mention the statement "Mum is Self Funding" Do you find this too?

Well she might be self funded, but that doesnt mean I am self funded to find out what to do....

Sorry, sorry you mentioning that your mum was self funding pressed a bug bear button that I have

I hope you manage to find the best way to move your mum

Julia

 

[piedwarbler]

You could ask the GP for a diazepam if you think it would make your mum less anxious. It is a difficult situation. What does the doctor think?

 

[Soobee]

it has cost us £140 to move mum by stretcher in a private ambulance. Each trip. They were very very careful with her.

It cost £18 - £36 to move her by wheelchair taxi. They were knocking her and bruising her as they lifted her out.

The last respite home she was in refused to let her out in a wheelchair, they said she was not safe as it had no straps. They did not offer an alternative and she had to stay an extra night.

 

[piedwarbler]

St Johns cost me a lot less than that. The private ambulance I used was about what you said Soobee.

 

[FifiMo]

Hiya Bullet,

Its me again ! I'm not sure where you are intending to move your mum from and to but by way of background, we moved my mother from hospital in Scotland to care home in Telford by private ambulance (the NHS wouldn't pay to move her!). Legally, you could say that the situation was slightly different in that my mother had been deemed as no longer having the capacity to make decisions for herself and as she was in Scotland I was required to obtain welfare guardianship for her as well as financial guardianship. I couldn't move her until this had all been approved and so she was being moved on my Authority. By way of information for you - the cost of her move was £800. The firm I used was based in Scotland but does moves all around the UK. They were fantastic and I have recommended them to the hospital in Scotland should they be asked for suggested companies in future. If you would like their details then send me a PM and i'll pass them on to you. If nothing else, if they can't do the move, then they might be able to recommend someone for you.

The move itself went fine, they picked my mother up from the hospital and took her to the care home. They said that for the most part she was fine on the journey but that during the last couple of hours she was starting to get restless. From what I can gather (she didn't even remember the journey 10 mins after she'd arrived at the home) the ambulance staff treated it as a bit of a day out for her - nice drive in the car - occasional stop for a comfort break, that kind of thing. You have to give them background information about your mum (the hosp did this for us) but things like, is she incontinent, does she need help in walking, does there need to be a female with her if she needs to go to the rest room, does she need nursing care of any sort (eg do they need someone to be a paramedic on the trip). On discussing things with the ambulance staff and the hospital, we decided not to travel with her but to be a welcoming party at the home and we went there to prepare her room with some of her own things and clothes etc before she arrived. We then stayed with her, walked her round the home, we spoke to other people and told them mum's name etc (my mother kept saying goodbye to them not realising she'd be seeing them again soon!), then we stayed for tea as well, to make sure that mum ate her food and was receptive to the staff etc. We left her as she wandered off to explore and talk to her new friends.

And so the deed was done. Two things that I would point out (a) mum was more receptive to "officials" than she would ever have been with us so I think the fact that she was moved by ambulance staff helped in that regard. Maybe in your case you'd have to have someone at her end that she knows to "see her off"? and (b) I think that some people can be particuarly sensitive to the atmosphere around them - i know my mother is - by this I mean that if everyone is anxious or guilty or things like that, my mother would have picked up on this. So, try and make sure that everyone around her is in a positive frame of mind on the day and that you're all selling this stay in the hotel or whatever as being something natural and fun. This might then make your mum less anxious or suspicious about what is going on - well that's the theory! LOL

Fiona
x

 

[Bullet]

Brilliant reply, Fiona, thank you! My whole family are hanging on your every word.

The idea of a welcoming party is great. We'd already thought of moving Mum's stuff up to make the place look homely.

Our mum has also been deemed to lack capacity to decide where she should live, and Social Services are in agreement with us that she should go into a care home. but because she can self-fund they are apparently not obliged to do anything unless an emergency section is required. They initially told us that we needed welfare deputyship to move her - as you did - but the Court of Protection told me otherwise. my understanding is that under English law we can just go ahead and move her, assuming it's done in good faith and with the care home's agreement. Then the care home has to sort out the DOLS paperwork to ensure its above-board legally.

For some reason, it's taken us about a year to get these facts straight in our heads! All the advice we've recieved has either proved wrong, irrelevant or written in impenetrable legalese. I'm still not sure it's entirely correct and would welcome clarification from anyone here.

Thanks again, Fiona. I'll PM you about the details of that moving service.

 

[Bullet]

You could ask the GP for a diazepam if you think it would make your mum less anxious. It is a difficult situation. What does the doctor think?

I suppose we could take advice from the ambulance people about what drug to use? Actually, I hope it wouldn't come to that, and Mum experiences it as a jolly day out, as Fiona said.

It would be interesting to know what sort of transport is available. Do they actually use an ambulance? A vehicle with windows seems important for a 4-hour journey. Mum has no physical health issues at all (unless you count the state of her teeth!) so a car would be fine.

Thanks to all for the replies. The support available here really means a lot.

 

[piedwarbler]

With St John's Ambulance I specified I wanted a 2 man ambulance and a stretcher. The nurse suggested that we try and sit Mum up as far as possible in the ambulance to prevent nausea. A diazepam really helped - one the night before, and one the morning of the journey.

With taxis it is all a bit more complicated. They don't always have anchor straps for the wheelchair and may expect you to have your own. In any case Mum wasn't well enough so I didn't explore further.

It was £70 for the ambulance transfer.

Oh and by the way I wish I had asked about a PAT slide. The home didn't have one and I made the mistake of assuming an ambulance would have one. They didn't as they assumed the home would have one. But homes don't pay for anything they don't have to pay for.