Hospital insistent she returns home

[RebeccaD]

hiya

Since I last posted my grandma’s dementia has progressed significantly.

In November we found her collapsed beside her bed having been there all night and she spent 5 weeks in hospital being treated for a UTI.

On the back of this a care plan was put in place for 4 visits per day, alongside the 2 hours we already pay for privately.

The first week of January she had another fall, she was being treated for a UTI already but we’re sure it contributed. She spent 2 weeks in hospital, was then discharged to a care home for 3 weeks before then being sent home.

She was only at home for 10 days before on Sunday she was found at the bottom of the stairs having had a 3rd fall. Miraculously she didn’t have any serious injuries. In hospital they’ve treated her for another UTI and pneumonia.

She’s 93, lives alone in an upstairs council flat that can only be accessed by a set of internal stairs.

We’ve raised concerns repeatedly about the stairs being a huge risk, the ambulance service also put a referral in on Sunday to social services about this and the drs at the hospital agreed she was not safe at home.

Another concern is the day before the fall down the stairs she told one of her carers she was fed up and was considering throwing herself down the stairs to end it all. We don’t know if that’s what happened on Sunday, and clearly she has no memory of the fall to tell us.

We’ve just been told she’s been moved to a discharge ward ready to return home. We’re at a complete loss at what to do now, the dementia team at the hospital are just as shocked and recommended we hide the key safe key and refuse to take her home ourselves.

Has anyone had any similar experiences? Social services are adamant she doesn’t qualify for full time care and can only suggest we bid on downstairs properties through the council to remove the safety issue. Aside from the fact it isnt a quick process, we see little point in the upheaval when chances are she won’t be there for long.

thank you all in advance

 

[Knitandpurl]

I think you need to dig your heels in, refuse to take her home, emphasise how hospital and doctors agree she is not safe at home and start pointing out this is a safe guarding issue, they are responsible not you and if necessary, that if they make her go home and she has another fall, which she will, possibly with much worse consequences, you will hold them responsible.

 

[Kevinl]

I find the treatment you and grandma have received truly shocking, beyond belief that in this day and age people can be treated this way.
As a carer for my wife for over 10 years, then a patient myself with a viral infection of the brain, I can't do anything but praise the help I was offered/given by both the NHS and social services.
Gobsmacked as we say up north. K

 

[yoy]

I am amazed by this. I agree with Knitandpurl. Contact the social workers at the hospital and tell them you will not have her back home, quote that it is a safeguarding issue and that she is a vulnerable person at risk of harm. And that should they send her home you will hold them responsible as they are the ones with a duty of care. Use all those words as they are the ones they are more likely to take notice of. Your gran needs to be properly assessed and cared for. You will need to stand your ground firmly and not let them fob you off. Good luck with it.

 

[JHA]

Like others have said you need to speak to the hospital social workers who wrongly believe she is safe to return home. Basically keep repeating that they are abandoning a vulnerable adult and they have a duty of care to ensure her safety and that you will hold them responsible.

Does your gran want to go home? Does she have the capacity to make the decision to go home?

 

[canary]

Were you there when the hospital SW assessed her for care? Im wondering whether she told them that there were family members at home who would look after her.

The reason Im wondering this is because that is exactly what my mum said. Unfortunately, the home she was thinking of was her childhood home and the family who were all waiting for her and would look after her were her parents and siblings who were all long dead.......

Contact the hospital SW and make it very clear that she is living on her own and despite having carers in 4 times a day she has had 3 falls leading to a hospital admission each time (this should be a big red flag to them). Then use the wording that she is a vulnerable person who is at risk of harm and that they have a duty of care to keep her safe.

They may decide on sending her to a Discharge to Assess (D2A) bed in a local care home to assess her needs.

 

[RebeccaD]

Yeah we were there when they made their assessment, they just kept saying she doesn’t meet the criteria but won’t explain which parts she’s not hitting.

She’s got no idea where she is and believes she’s homeless most of the time, so hasn’t asked to go home when we’ve been there.

They did the D2A last time but they deemed her fit to go home, but within ten days she’d had the fall so we were hoping that was enough to convince them!

But thank you all, they made us feel totally unreasonable to even suggesting she shouldn’t go home so you’ve reassured me and given some great tips on wording

 

[DeeCee7]

Hello @RebeccaD we had this issue with the SS. We had a best interests meeting where we re-stated all the dangers, using the wording suggested above, and that we were withdrawing all our caring support as we couldn’t condone such an unsafe plan. They agreed our PWD needed 24 hour care, and he remained in the care home where he was under the D2A provision. As others have said, it’s like a poker game, you need nerves of steel, the stakes are high but you can win.

 

[RebeccaD]

Thank you @DeeCee7 that’s really useful. I’ll arrange a meeting and make sure we say all that!

 

[Bunpoots]

Hello @RebeccaD

I had this problem with the hospital wanting to discharge my dad home alone when he wasn’t safe - having regular falls and unable to do anything for himself. I did as you’ve been advised and dug my heels in. I was then called and told if I didn’t take my dad out of hospital they would section him. Knowing this would mean they couldn’t discharge him for 28 days (section 2) I welcomed this intervention which eventually led to dad getting discharged to a carehome for assessment and then a permanent placement.

So stand firm. We’re here to support you through this.

 

[Violet Jane]

@Bunpoots, that's extraordinary. He's deemed safe to go home and then he's so incapacitated that he has to be sectioned! How very unprofessional and manipulative. Did you put in a complaint?

 

[silkiest]

It never ceases to amaze me just how bad and inconsistent the care our loved ones receive is. My poor dad was in and out of hospital and care homes for a year until he died in February. During that time one home refused to apply for DOLS as he didn’t have a dementia diagnosis while a second home applied and received it with the (independent) social worker stating he was incapable physically and cognitively of living at home alone. The hospital social worker who had organised the second care home- a D2A bed (against her managers advice as he was self funding,) eventually overruled the DOLS and allowed my brother to take dad home. he was dead within 2 weeks after yet another fall and chest infection and re admission to hospital ..

 

[Cardinal]

I attended a talk on caring for dementia patients. This talk was held in the US. The person giving the talk was a former social worker. She said that because people are living longer the number of people with dementia has hugely increased. She said this is world problem. She said the cost of caring for dementia patients has reached almost a crisis point in many countries. She said they have been holding world conferences on this. She said as a social worker her main job was to keep the PWD at home with family and friends caring for them, unless there was no other option, and they only recommended Care Home placement if the PWD was a danger to themselves or other people and it was always a last resort. She said this is how many countries are handling the caring of PWD.

Several people on this thread have given great advice on what to do and what wording to use to convince SS that your grandma must be placed in a Care Home.

 

[canary]

She said as a social worker her main job was to keep the PWD at home with family and friends caring for them, unless there was no other option, and they only recommended Care Home placement if the PWD was a danger to themselves or other people and it was always a last resort.

Yes, this seems to be the mantra the world over.

It leaves us carers feeling guilty that we have failed and condemned our loved one to a life of second best when they move into a care home

Yet many people on here have attested that their person with dementia positively thrived when moved into a care home (my mum was one of them and OH loves being in respite in his nursing home) and the environment is known to make a huge difference to people with dementia, so I do wonder about this mantra that home is always best - especially as the carers needs are very seldom taken into consideration

The cynical bit of me wonders if this is more to do with finances than anything else........

 

[SeaSwallow]

Yes, this seems to be the mantra the world over.

It leaves us carers feeling guilty that we have failed and condemned our loved one to a life of second best when they move into a care home

Yet many people on here have attested that their person with dementia positively thrived when moved into a care home (my mum was one of them and OH loves being in respite in his nursing home) and the environment is known to make a huge difference to people with dementia, so I do wonder about this mantra that home is always best - especially as the carers needs are very seldom taken into consideration

The cynical bit of me wonders if this is more to do with finances than anything else........

Not cynical at all @canary just the truth.

 

[canary]

Not cynical at all @canary just the truth.

Then I wish people would be honest and admit that there comes a time when a care home is beneficial, but the problem is funding it.

 

[Cardinal]

Yes, this seems to be the mantra the world over.

It leaves us carers feeling guilty that we have failed and condemned our loved one to a life of second best when they move into a care home

Yet many people on here have attested that their person with dementia positively thrived when moved into a care home (my mum was one of them and OH loves being in respite in his nursing home) and the environment is known to make a huge difference to people with dementia, so I do wonder about this mantra that home is always best - especially as the carers needs are very seldom taken into consideration

The cynical bit of me wonders if this is more to do with finances than anything else........

You are not cynical, it has everything to do with finances. My mother also thrived when placed in a care home. She was much safer and happier.

 

[yoy]

Yes, this seems to be the mantra the world over.

It leaves us carers feeling guilty that we have failed and condemned our loved one to a life of second best when they move into a care home

Yet many people on here have attested that their person with dementia positively thrived when moved into a care home (my mum was one of them and OH loves being in respite in his nursing home) and the environment is known to make a huge difference to people with dementia, so I do wonder about this mantra that home is always best - especially as the carers needs are very seldom taken into consideration

The cynical bit of me wonders if this is more to do with finances than anything else........

Yep. It's about money every time.

 

[Knitandpurl]

My Mum was happy in her Care Home too. Was there 5 years.

 

[Tavy]

I am amazed by this. I agree with Knitandpurl. Contact the social workers at the hospital and tell them you will not have her back home, quote that it is a safeguarding issue and that she is a vulnerable person at risk of harm. And that should they send her home you will hold them responsible as they are the ones with a duty of care. Use all those words as they are the ones they are more likely to take notice of. Your gran needs to be properly assessed and cared for. You will need to stand your ground firmly and not let them fob you off. Good luck with it.

Only thing that I would add is follow up ALL that you say verbally with a written detailed account of all your conversations.
If and when you receive ANY reply tell the person or department that you would like their comments confirmed in writing.
If you do wish to hold someone and/or multiples responsible put that into writing with the following,
Due to the fragility of ******* I wish it to be known that I am holding the following******** Jointly and severally liable and responsible for any event that is the outcome of your decision/s.