Hospital stay

AlsoConfused

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Sep 17, 2010
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Well done you! I think you're amazing to do so much, in spite of the exhaustion you probably feel.

You've got lots of allies on your side, haven't you? :)
 

AlsoConfused

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Sep 17, 2010
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Just a concern for you - please don't go down the "top up" route, the financial consequences for people who do can be truly frightening and you'll soon have a baby (and all the allied expenses) to fund!

Read through the "top up" threads on TP please before doing anything.

Your Mum's place will be paid for by the Council as she doesn't have assets that take her over the threshold. Assuming the "best interests" meeting says your Mum can't only be discharged into residential care (and I can't see how any different solution would be deemed safe), then the hospital have to keep her with them in until a residential place is found that meets her needs. Your Mum is safe and well-looked after in hospital; you're happy for her to move on into residential care; the only blockage might be the lack of local vacancies in satisfactory homes (not your Mum's fault, nor yours ... and a problem the hospital and the Council are well used to dealing with).

The hospital will be putting pressure on the Council to come up with an acceptable solution. If there are no vacancies in a suitable home that's within the Council budget then the hospital will push the Council to fund a more expensive place.

I think your areas of major concern are (1) to get somewhere suitable for your Mum (and you'll only know what's suitable after the "best interests" meeting); (2) to get somewhere local enough for her family and friends to visit (your Mum has a legal right to this); and (3) to get somewhere generally satisfactory in terms of staffing, accommodation etc.

I think you're now on track to sort out a good future for your Mum. Good luck:):):)
 

pitufi

Registered User
Nov 29, 2015
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London
I have found that my mother does NOT have a hospital social worker assigned to her.
The one she used to have before she went in told me she is no longer assigned to her but the name she gave me in turn said she also wasnt assigned to her and thats when I found out no one is assigned to her.

is this legal? is it something i need to demand right away?

I'm finishing all the paperwork i will be submitting to the OT to try and get her to agree with me that she needs 24hr care in a CH, not the proposed 4 visits a day (1hr, 30 mins, 30 mins and 15mins) plus some daycare centre visits.

so far I've written a long letter detailing my concerns, and her difficulties before going to hospital, included a letter from her GP he kindly wrote for me also agreeing, records of antibiotics shes been on for infections relating to lack of hygiene etc (not inc UTIs), a letter from her sheltered accommodation manager who also agrees they simply cannot guarantee her safety and that she has found wandering by residents and not able to communicate with them as her speech is really very bad and has been for a while, and finally a copy of her carer's log book dating back to march when all her problems started, I've highlighted all the bad bits.

She's been clear of infections for a few months now and even the hospital say that she's fine health wise, so this to me proves that it's her alzheimers getting worse quicker and quicker and at the stage she is right now, she needs a care home ASAP.

They are offering me to let her go home and take the 4 visits a day and then get back in touch if shes not benefiting. however I feel like this is them trying to trick me cos its simply delaying her admittance to a home, saving them money. I have 10 weeks left before I give birth to my baby, and the thought of dealing with this after barely giving birth is not something i'm looking forward to.

Am i unreasonable in not letting them discharge her until we get what she needs? it sure feels like they are ****ed at me when all i'm trying to do is whats best for my mother and fight her corner.

if they literally asked her if she's ok and whether she would like to go and live in a pig sty, she'd say sure! cos the type of sweet natured person who wants to please is still there even if she doesnt understand the question. I have LPA for health but i feel like they are still trying to ask her what she wants when I KNOW my mother, i know what she would have said before alzheimer's took hold.

I remember reading one of her memory clinics notes once where they described my mother saying she'd kill herself if her alzheimer's got worse. and it breaks my heart seeing her at this low point knowing she'd really rather not have gotten this far.
 

jugglingmum

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Jan 5, 2014
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Chester
Keep fighting, I haven't read back but when I stated in hospital that I didn't consider my mother had capacity to understand the question and that I held Health POA they jumped a little so you need to state you do not consider she has capacity to understand.

If you don't think you will cope DO NOT ACCEPT her home.

Please please stand your ground. Sometimes the words failed discharge hold sway - they used to get fined for being readmitted within a certain number of days.

Everything you have written indicates your mum needs a CH, and anyone suggesting otherwise is only interested in their budget, not your mum's welfare.
 

Oh Knickers

Registered User
Nov 19, 2016
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pitufi,

You have done a fantastic job with getting all the information together and ensuring the information gives a good description of the state of her living circumstances. Well done.

Also Confused has given excellent guidance. Read through that again.

Also, you query regarding no Social Worker has been allocated is a concern as there can be no realistic movement. Highlight it should be a concern of theirs - not yours.

Gather all your information and give a top page summary of all the concerns. A final statement that should your mum end up back in hospital care you will hold them personally culpable for a failed discharge.

The cost of your mum being kept in hospital will be astronomical so the hospital will be very keen to get mum moving and out. But not to have her back again as it does not look good.

Well done you. Good to hear the fight in your posting.
 

AlsoConfused

Registered User
Sep 17, 2010
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You're making a procedural mistake by focusing your attention on changing the OT's mind, there's a faster and better route for you to follow. The OT is just one of the medical professionals guiding the care and discharge of your Mum. He / she is also much more junior in status to the Consultant caring for your Mum.

You need to go all out to get that "best interests" meeting set up for your Mum - which is procedurally what will decide when she can be discharged from hospital and where she should go after she leaves hospital. Please speak to your Mum's Consultant's PA and email her all your evidence. Say you want a "best interests" meeting for your Mum and any discharge without such a meeting would be risky in the extreme (probably unlawful too but I don't know about that).

Also tell the Consultant's PA that your Mum hasn't got a hospital social Worker at the moment and needs to have one in place so that the SW can contribute to this meeting.

Make it politely clear you will not allow a discharge from the hospital before the "best interests" meeting has been conducted and ALL PARTIES (including you) are in agreement about where your Mum goes next and how she's to be looked after. Make it very clear you can't take on any caring responsibilities for your Mum in the future - you will have a baby to look after.

Also explain to the PA that you're in the very late stages of pregnancy and you need the hospital to get this "best interests" meeting organised very quickly and at a time you can attend it (and with adequate notice) because otherwise they will need to delay the meeting until well after you've given birth :).

"Best interests" meetings are typically attended by as many of the patient's family as express an interest in coming and taking part; the patient's Consultant (or a doctor representing the Consultant); the Ward Manager / Sister; the OT; the hospital Social Worker; and sometimes the County Council Social Worker. In your Mum's case, it might also involve the manager of the Sheltered Accommodation (to say "we're not taking her back - she's not well enough to look after herself even with 4 visits a day").

I'm horrified you're being put through this stress at a time when you deserve to be "coddled" a bit.
 

Oh Knickers

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Nov 19, 2016
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Hear, Hear, Also Confused. Excellent advice again. Blimey, if this is not a time to be coddled when is?

You are, actually, in a strong position. You are pregnant, pitufi, babies can arrive at any time. No-one knows how delivery will go. Really good card to play. If you want to really wind things up mention you think you may be having getting Braxton-Hicks contractions.:D:D Just remember to tell that to your Obstetrician or nurse as well as back up. Should get things moving.;)

pitufi, you have done a fantastic job. Hope you are feeling you are getting some support here. And yes, this situation is outrageous. I would also play on that, the huge amount of stress on a pregnant woman. Set a deadline. The hospital has a month to get this sorted as after that you will no longer be in circulation for the next 3 months.

Unhappily, it has always been the case that those who talk loudest get the most action in hospital. They are all human, just overloaded.

Big {{HUG}}.
 

pitufi

Registered User
Nov 29, 2015
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London
Hear, Hear, Also Confused. Excellent advice again. Blimey, if this is not a time to be coddled when is?

You are, actually, in a strong position. You are pregnant, pitufi, babies can arrive at any time. No-one knows how delivery will go. Really good card to play. If you want to really wind things up mention you think you may be having getting Braxton-Hicks contractions.:D:D Just remember to tell that to your Obstetrician or nurse as well as back up. Should get things moving.;)

pitufi, you have done a fantastic job. Hope you are feeling you are getting some support here. And yes, this situation is outrageous. I would also play on that, the huge amount of stress on a pregnant woman. Set a deadline. The hospital has a month to get this sorted as after that you will no longer be in circulation for the next 3 months.

Unhappily, it has always been the case that those who talk loudest get the most action in hospital. They are all human, just overloaded.

Big {{HUG}}.

I absolutely feel supported on this lovely forum. I felt lost starting this thread, and I feel armed with information though I'm still learning this particular hospitals way of being.

The hospital SW has set up a meeting with a fellow SW (she won't be present), the ward sister, and my husband and I. They haven't mentioned the 'best interest' meeting terminology but I'm willing to go with all my paperwork and letters to this meeting tomorrow am and if we get nowhere I will ask for an official BI meeting with the OT and my mother's sheltered accommodation manger (who has been soooo helpful, she wrote a great letter mentioning the times she's been found wandering by the residents and her and how she wasn't able to get back to her flat unaided, and how they as a company cannot guarantee her safety in her condition)

Wish us luck! Mum did have a slight turn for the worse yesterday mood wise where they quarantined her room (along with 4 other patients) due to a vomiting bug. She wasn't allowed to leave the room and threw a massive wobbly for a few hrs. I arrived in time for dinner and was able to get her back to normalish after an hour, she was still mad and kept calling the staff stupid but she was settled in her bed and this morning I was informed she was fine after I left, still mad, but fine.

This is her 3rd week in hospital, I can't believe how long this is dragging. I'm trying really hard to work on my stress levels to not let it get to bump but it's certainly something I will be bringing up at the meeting!

Thank you so much everybody that has helped me with information and tips, fighting for care can be so confusing specially for a first timer which sadly most of us are. It feels a bit like smoke and mirrors!
 
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AlsoConfused

Registered User
Sep 17, 2010
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I do wish you all the luck in the world to get this sorted the right way - even though I too feel you've a very strong hand to play!

Your Mum being so stroppy right now is also a bonus!:) The hospital should be thinking "Well if we can barely contain her and settle her when she's in our ward, how the !"*# can we expect anyone else to when they're not sharing the same space and have a multitude of responsibilities to other people?".

All the best:):)
 

Oh Knickers

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Nov 19, 2016
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pitufi,

Before the meeting takes place it might be worth asking what the purpose of the meeting is and is a BI meeting going to result? Does not sound as though they have filled you in. Do not expect the SW to be briefed or on top of the situation in any way. Prepare yourself for the worst case scenario. Check that they are aware of what has been going on. If not hand over a copy of your massive pack with executive summary and ask them how long they will need to digest the information. Would 15 minutes be enough or is another meeting necessary? If another meeting were necessary it would be disappointing as you and your husband have negotiated time off from work. Remind them about your baby so it would be good to sort everything out today. When they have finished ensure you take your pack back as it will be needed for the BI meeting.

If you think games are being played you can also play games. If it is getting too much say you need a break as you are having Braxton Hicks contractions and need a bit of time.

Hope you don't feel I am teaching you to suck eggs?

You have got yourself really well prepared. It is time now for the hospital to demonstrate they are professional. They don't mean to be thoughtless but they are constantly firefighting so unaware of the pressures others are also working under.

All the best for tomorrow.
 

Adnil

Registered User
Jan 17, 2017
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I am in the same situation with my mother who has Alzheimers/Mixed Dementia and I wish you good luck with everything. I know what a strain all this is only too well.

We are at the stage of the hospital social worker doing a care needs assessment and I am dreading that they will decide to send Mum home alone again to her flat with 4 care calls... she had been getting 3 calls a day prior to the UTI that put her in hospital and was really not engaging with the carers, she didn't want them there. She was not managing to cope with anything at all to do with her personal care/hygeine/laundry and would not let anyone help her.

Hoping for a miracle - a decision for 24hr. care which her consultant and GP both say she needs. I don't think there's much hope even though I have POA, Mum can still walk and say she wants to go home, and she cannot self fund.
 

pitufi

Registered User
Nov 29, 2015
51
0
London
I am in the same situation with my mother who has Alzheimers/Mixed Dementia and I wish you good luck with everything. I know what a strain all this is only too well.

We are at the stage of the hospital social worker doing a care needs assessment and I am dreading that they will decide to send Mum home alone again to her flat with 4 care calls... she had been getting 3 calls a day prior to the UTI that put her in hospital and was really not engaging with the carers, she didn't want them there. She was not managing to cope with anything at all to do with her personal care/hygeine/laundry and would not let anyone help her.

Hoping for a miracle - a decision for 24hr. care which her consultant and GP both say she needs. I don't think there's much hope even though I have POA, Mum can still walk and say she wants to go home, and she cannot self fund.

Hi adnil

My mom was assesed by the physiology team to be fine. No need for help walking etc. She has said yes to all their suggestions even the ones I will disagreeing with tomorrow morning and she was deemed as non self funder by the LA in an earlier means test late last year so similar situation indeed!

Thankfully the carers we had in place before all of this were from a private agency and kept detailed logs of every visit inc all her bad behaviour and refusals of food and drink. The only way we were able to pay for them was LA financial help and attendance allowance which still meant mom had to pay £2 towards every visit. Not ideal but all the logs will help with my case.

Does your mom live in her own home? Or sheltered acc? If the safety of her current home situation isn't up to par to her situation lean on it. Mum's housing manager explained how they cannot carter from people safety that wander outside their flat and even a silent alarm wouldn't help.

Ask for written letters backing 24hr care from all her professionals in her life, GP, mental health nurse, etc and insist above all the decisions go though you since having LPA means YOU are looking over her best interests since she is no longer capable.

After I mentioned Failed Discharge everyone's vocabulary and treatment changed somewhat. So that's something else to lean on.

I noticed 3 ladies today had been discharged and the chnage rattled my mum I really want to sort this out before my husband, who is wonderful at backing me up and helping me stay strong , flies on a business trip next Thursday :/
 

pitufi

Registered User
Nov 29, 2015
51
0
London
We had the family meeting today. The SW assessed my mum to see if she was capable of making a choice and he clearly saw in less than 5 minutes that she could not. That's when the family meeting started (SW, occupational therapist, ward sister and my husband and I were present. No doctor was available to be there at that time) but the SW also said the family meeting had now changed to a Best Interests meeting since my mum could not be included due to her confusion etc.

The social worker hadn't had time to check all the paperwork with all my notes about mom's problems I handed his boss over email so as suggested by some of you, I printed them and brought them in. He read thru them quickly. The folder comprised of a letter I typed outlining my fears for her welfare were she to be allowed back home, a letter from her GP backing me up, the manager of her sheltered accommodation explaining the housing she's currently in cannot safeguard her from wandering and that she had been found outside her flat confused a few times, my own personal notes of falls and incidents of temporary blindness, and finally highlighted excerpts of the carer notes where she refused food drink and washing.

He skimmed theubit and started the meeting. Right off the bat he recounted his meeting with mum a few minutes prior and after reading my notes he said the best place for her is supervised 24hr a day in a care home!
He went round the room asking everybody their opinion and even though the OT did still mention 4 visits a day, she did mention my mom had had a few episodes the day before where her routine had been interrupted and how anxious and alarmed she became. That changed the mood of the ward sister who hadn't been informed and she softened to his suggestion quickly

We all agreed and hopefully by the end of next week she will be in a care home the council will find for her. The borough of london we live in dontgive you a choice but you can contest it. We will see what happens. It either way I feel like today was a major victory specially cos the SW was so quick with his decision calling it the clear way to safeguard her health and welfare.

I cannot stress how happy I am for mum and a huge thank you to those that helped me with all the right information, it galvanised me to look past professional opinions I didn't feel were right for her and to look clearly and with proof at what my mother really needed.

Collecting those letters and carer log books really helped. I know it's not all over but having everyone agree today means things can start moving forward. I just wish I had called that best interest meeting way sooner as suggested, better late than never though!
I've already spied a thread about moving PWD into a home as smoothly as possible and will be using those tips!
 
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AlsoConfused

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Sep 17, 2010
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RESULT!!!:D:D:D:D

I'm so pleased for you and your Mum:):):). Although the move into care is often not easy, hopefully a lot of the pressure will have eased as you now know the right path is being followed for your Mum.

My Mum went straight from hospital to hospital to nursing home and that made it very easy for her to settle. As far as Mum was concerned she'd just moved to another hospital with nice, caring people helping her, better food, lots of activities and a new family (of soft toys) to look after ....

Doing things this way also made it easier for my Dad and the rest of the family. Mum should not have stayed at home for as long as she did but Dad nearly killed himself with the strain of trying to provide 24 / 7 care in a wholly unsuitable environment.
 

Moggymad

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May 12, 2017
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Well done Pitufi you have done so well. Hope your mum settles in really well & you get the well deserved time to enjoy your new baby when he/she arrives. Best wishes
 

Oh Knickers

Registered User
Nov 19, 2016
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pitufi,

So glad for you. What a relief for you and your husband. Most of all, well done you for being so organised. How far you have moved in just a few weeks.

Wishing you all the best for your and your mum. Now you can concentrate on your own family. Phew, huge sigh of relief.
 

pitufi

Registered User
Nov 29, 2015
51
0
London
well, baby is truly getting into this kicking thing, she's taking it up another gear!
9 ish weeks to go!

mum's report should be done this week and LA said a broker will readit and offer us a place or fa few places where she could go. I have a home in mind whihc has got 2 rooms available and they did say that they agreed on a LA rate with previous residents from the same area as mum.

This sounds good but the SW lady gave me an example of £400 per week for a CH around the area, i was shocked at how low that seemed (even though i understand it was just an example) and after speaking with my local Age UK office, they said that it must have been an example to put me off, that that is far too low for 24 residential car rates.

the one i liked was double that and well, theres no way in heck most people would be able to help their PWD that much top up wise a week right?

mum is terrible spirits and nothing i can do seems to help, she literallyt decided she wanted 'out' wednesday last week and due to not being allowed, she has been in a foul mood with everyone calling them stupid, lashed out once at a nurse, and one day last week hated me, plain just hated me. this is new to me cos shes always been great with me even in a bad mood, i just stayed out of her way but kept myself in the same room, after 2 hrs of this game, she finally sat next to me and let me hug her.

i want her out asap, we used to take her for the loveliest walks 2ice a week to the local park or nearby forest, shes such a nature child and being stuck in a ward for a 4rth week, it really is upsetting her.

i cant even explain why shes not allowed to leave, mentioning waiting for a home wont work even when ive skirted around the issue she just shouts in a louder voice that she wants to leave, not listening to what i have to say. so distressing for everyone involved.

I'll be staying in contact with her SW every day, i dont want to be pushy, but i want her to have my mum in mind everyday to move things along.
 

Oh Knickers

Registered User
Nov 19, 2016
500
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pitufi,

Enjoy your baby's kicks. Wonderfull. And a new life. Enjoy.

Well done you in all that you have done and achieved. You went into to that meeting so well organised. And double well done on following up in care home costs. £400 pw! They are having you on.

Fingers crossed this is all sorted soon for you so you have a chance to unwind before you baby comes. Well, it has to be as hospital costs are eye-watering.
 

pitufi

Registered User
Nov 29, 2015
51
0
London
Update:
Social worker called late last night (after some hospital manager or other making a very stern call during the day I'm sure) saying that the home I chose doesn't have any rooms available, according to broker, and that she should go to the home they suggested first, then when the first choice one has a room then they will move her.
I had to cut the call short since it was noisy and the line was bad. I said I'd call her back this morning

Instead I called the first choice CH and asked about whether there really was no rooms left. The deputy manager said the one we viewed last week was still available!!

Cheeky! Really starting to feel like they either are bullying me into their choice of CH (looks drab, like it hasn't been done up since the late 70s, and barely any activities, residents really look spaced out rather than engaged) by outright lying or simply not really following up the information I took upon myself to find out my mother's choices etc.

SW isn't in till later so sent her an email with my findings. Just wish I would be able to speak to broker directly. I understand she's the buffer but if this room goes I'll be so cross cos it's been there all along but they've just stalled for so long already.

I guess today is my day of chasing and getting stuff moved forward.

Will hopefully have an answer by tomorrow and can move my mom then, instead of spending my birthday going to a gallery like planned with my husband.

Def not moaning, just shocked how long this has dragged on! She was admitted early July and I honestly thought this would be over by now
 

Oh Knickers

Registered User
Nov 19, 2016
500
0
Sadly, pitufi, I've come to the conclusion that some of it is incompetence or poor communication. Yes, the process does seem to take a lifetime.

Should you feel you have the time and energy it might be worth pushing the hospital end and saying you know the care home has a room and you are ready to move mum now. However, social services are dithering. See if that sends a rocket in the right direction. It is a case of the hospital care costs are thousands a week but this does not affect SS as they are not paying. There is a game of budgets and who takes financial responsibility. Unhappily your mum is piggy in the middle.

Hope you and your baby are keeping well.