Hospital recommending nursing care can I push for mum to stay in her flat?

Discussion in 'I care for a person with dementia' started by nellen, Aug 19, 2015.

  1. nellen

    nellen Registered User

    Mar 17, 2009
    96
    Derbyshire
    My mum has dementia and was admitted to hospital 10 weeks ago with pancreatitis - that cleared up after 3 weeks then mum got several infections and a week ago shingles!! She has complex needs: macular degeneration, mobility problems, incontinence, kidney damage, etc. Since being in hospital she can't seem to weight bear and is generally weaker. Before going into hospital my mum lived in sheltered housing with a care package that includes carers 4 times a day, day centre 3 times a week The hospital social work team wouldn't agree mum going home with an increased care package mainly because of her lack of mobility and and needing two carers to work together, and there only being one carer on site at night and no nursing care. Since then the hospital has struggled to know where to discharge mum to and are now saying 24 hour nursing care in a care home catering for dementia.

    I am wondering if instead of her going into a nursing home (I feel like I'm condemning her) I can push for an proper assessment of her needs with a view to her returning to her sheltered accommodation with a revised package that includes visits from a nurse The hospital social work team have NOT met my mum let alone done an assessmentof her needs, they have based their decision on reading her hospital file and talking to ward staff. Also the hospital is in another bigger town 15 miles from my mums home town and the social work team isn't her local one who know her well. They actually say they don't know what provison is available in her locality for her. I wonder if the decision to recommend nursing care is an easier option than trying to come up with a specific individualised package geared to my mums needs
    Has anyone any experience of this kind of thing
     
  2. cragmaid

    cragmaid Registered User

    Oct 18, 2010
    7,942
    North East England
    Hi Nellen, the maximum number of daily visits by carers is, I believe, 4.I don't think the LAarrange nursing visits, that is done by the GP/District nurses via the discharge/reablement team.
    If they are asking for Mum to be discharged under nursing care, I would ask that she is assessed for full CHC or at least nursing care funding.
    To be honest, If Mum is needing 24 hour extra care to what she was receiving, I would be tending to think of a CH anyway.
    They are not all horrid places, you are not condemming her, nor are you ceasing to care for her, you will just be caring in a different way.
     
  3. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,045
    Staffs
    There is Department for Health guidance that people should not be discharged direct from a hospital acute ward into permanent care home environment. They should be entitled to a period of reablement and continual re-assessment. Whilst there everyone concerned can see what the real possibilities are.

    I got this for my Mom but all the LA did was place her a NH for 6 weeks and the "specialist team" visited just once. Some other areas do things better apparently.

    The New Care Act goes into reablement in depth and is well worth a read. Sec 2.12 starts on page 10.....
    https://www.gov.uk/government/publications/care-act-2014-statutory-guidance-for-implementation

    :)
     
  4. susy

    susy Registered User

    Jul 29, 2013
    801
    North East
    Although they may be right and 24 hour care may well be what she needs without a proper assessment this is not a decision that should be made. It sounds to me like a home visit (with your mum) should be made. If your mum is familiar with her surroundings her mobility may well be fine. Mobility take a hammering in hospitals as there are lots of spaces to walk in without familiar furniture to lean and gain support from.
    I will second the fact though that care homes are not all bad places. Like most things in life all we really get to hear about are the bad ones yet there are many that are filled with care, activities and love. If your mum, due to her illnesses, or just a general decline, needs this then get a list and check the local homes out and see what you think. Listen to your gut. It's not about decor it's about care and welfare. This is not about letting her down, in fact it's the opposite. Best of luck xxx
     
  5. canary

    canary Registered User

    Feb 25, 2014
    10,814
    Female
    South coast
    I agree with Pete R. There should be a period of reablement followed by a best interest meeting to decide how much progress she has made and where the best place for her should be.
    My MIL had this after she broke her spine and she went home with a care package (though it didnt include nursing care - I believe cragmaid is right about that), but my mum stayed on in the CH.
    I believe both decisions were right for each person.
     
  6. 1mindy

    1mindy Registered User

    Jul 21, 2015
    539
    Female
    Shropshire
    Please don't look at it as condemning your mum. When mum went into a C H she transformed and loved being there . I only wish we had made the decision years earlier I'm certain she would have been in a much better mental state if we had. Please be open minded to the option.
     
  7. nellen

    nellen Registered User

    Mar 17, 2009
    96
    Derbyshire
    Thank you everyone. I don't know what I'd do without this forum. I don't use it very often except (maybe selfishly) when I need support or advice or reassurance and I always get what I need from you.
    I was asking the question for my brother who is finding it hard to cope with the thought of mum going into a nursing home. I have come to terms with it more than he has I asked the social work team yesterday if there was any way that we could get her back home with an increased care package and she was adamantly NO. I told him this and said we must work together to get her out of hospital and well cared for and build up her strength with the reablement team etc then we can get her needs reassessed. he seems to have accepted this.
     

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