Hospital wants to discharge father-in-law but insisting on 24 hour care

Discussion in 'I care for a person with dementia' started by Leonora7, Aug 16, 2019.

  1. Leonora7

    Leonora7 Registered User

    Jul 26, 2010
    158
    Basingstoke
    Hi. I’ve not posted on here since my parents died over 5 years ago but I’m hoping for some facts re what the hospital can and can’t do re discharging a patient with hallucinations.

    Basically my father-in-law has undiagnosed dementia and lives alone with daily carers. He has been fine with the usual odd episode and fall. Two days ago he began hallucinating about cats stuck in his conservatory and this was shortly followed by the carers finding him on the floor several times. He was admitted to the local hospital last evening as the carer could not get him upright. At 1 a.m. a doctor pronounced that there was nothin wrong with him. No UTI, no dehydration and he did amazingly well (apparently) in some sort of memory test. By this point he was claiming to need to get home to feed a whole menagerie of assorted pets (he has none) and had seen his wife (20 years gone) at the table with friends, but knew she was dead. This morning the hospital is insistent that he be discharged to go home but with 24 hour care for the weekend. Neither my husband nor brother-in-law is able to stay at the house and we can only arrange up to 5 daily visits. Can the hospital just discharge him willy-nilly or are they obliged to find him a respite place.

    You help is hugely appreciated.
     
  2. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    2,993
    Nottinghamshire
    Hi. Ask to speak to the hospital social worker. He or she should be able to advise you and hopefully find an assessment bed for your FIL to be discharged to. If he’s hallucinating and falling then he needs to be stabilised before he can safely return home in my opinion. It sounds as though some input from a Mental Health specialist would also be helpful if no infection is present.

    I had problems last year with hospital trying to discharge my dad too early. They did once only for him to be returned within 24hrs and then tried to get me to take him home again. I refused! Telling them I’d hold them responsible for anything that happened to him because they’d discharged him when he was obviously unwell even though they considered him “medically fit for discharge”

    I found the social worker very helpful. Apparently she should have been contacted before dad was discharged the first time but hospitals just want patients out as quickly as possible.

    Make it clear that you are not available to offer 24/7 care and be prepared to stand your ground.
     
  3. Leonora7

    Leonora7 Registered User

    Jul 26, 2010
    158
    Basingstoke
    Thank you so much for your input. I would say I can’t believe the way the NHS behaves in this way but it would be a lie. The last time father-in-law was in A&E at that hospital he was discharged with no money, front door key or any idea where he was or how to get home. Consequently he was found on the ground in the car park and had to be readmitted. No one knows what happened and my husband’s complaint is still unanswered some 6/7 months later.
     
  4. Catastrophe

    Catastrophe Registered User

    Feb 15, 2019
    27
    Having returned too this country recently, I am shocked at the dismissive attitude to the elderly. My mil who is 94 was recently sent home from A&E with a blood clot in her leg. Only to find out from the nurse that called once a day that at the time she was sent home there were also clots in her lungs - PE. This is a really serious condition that a younger person would at least be kept in over night for. She does not have dementia and is as bright as a button, so how can we expect a person with dementia to cope with the pressure to be sent home. And there were spare beds available for her.
     
  5. canary

    canary Registered User

    Feb 25, 2014
    10,524
    Female
    South coast
  6. Philbo

    Philbo Registered User

    Feb 28, 2017
    680
    Male
    Kent
  7. Leonora7

    Leonora7 Registered User

    Jul 26, 2010
    158
    Basingstoke
    Thanks to you all for your comments and advice. The plot thickened after the hospital agreed to discharge my father-in-law home last night if he has four carers' visits a day. Apparently, he was raving on the way home, insisting that he did not live down "this road" and then had to be helped forcibly from the ambulance, saying that this was not his house, a statement he continued to make once inside. The carer was there and said that he had tried to get out of both front and back doors and made his way upstairs (for the first time in ages) to check out the house. My husband rang to speak with him and said it was if he was on amphetamines - shouting and going on about how 'they' had been very clever because it was like his house but was not - they had put photos of the family up on the walls but they had not fooled him. His pets (by this time a virtual zoo) all needed feeding, they were scattered around the house and garage and he went into minute detail about a thrush with a nest in a hole on the stairs (no hole exists). Brother-in-law was persuaded to visit and by the time he got there (lives an hour away) father-in-law was quiet and submissive.

    Today my husband has gone up to check out the situation and found him back to normal and unable to remember anything, even that he had been into hospital.

    The hospital was insistent that he was not dehydrated and did not have a UTI and - as he was treated for neither of these we have no idea what can be going on. Is this sort of random hallucinatory behaviour normal and, if so, what sort of dementia does it point to?

    Again any contributions very welcome as we are now unsure whether he needs to go into a care home shortly or whether we can carry on with him at home for a while.
     
  8. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,214
  9. Leonora7

    Leonora7 Registered User

    Jul 26, 2010
    158
    Basingstoke
    Oh gosh, that is a very pertinent article, a lot of food for thought there. Many thanks. The only thing I would say is it was such a dramatic change to father-in-law’s persona. It was as though a switch had been flipped and he was physically and mentally energised. Today he is apparently lucid and calm but racing around with his frame at top speed and full of vim. Again, very unusual as his prime occupation is usually lying in bed with the TV on at a volume raised deafeningly in order to preclude any conversation. The info suggests that there may be an underlying illness but he is surprisingly physically fit and on very minor meds. I think he needs to see a doctor, preferably a psychiatrist but he’s been on the waiting list for the memory clinic since February!
     
  10. AliceA

    AliceA Registered User

    May 27, 2016
    2,404

    My husband is in hospital waiting to be discharged when ready. He is on Section 2 this means he should not be discharged without a care package. I think you need to phone the councils Adult care Services, tell them the situation. Tell then a vulnerable person is in danger
    Section 2 is on his list of days, the ward has it in his notes. I reminded them several time!!! Good luck
     
  11. Leonora7

    Leonora7 Registered User

    Jul 26, 2010
    158
    Basingstoke
    Good luck with your husband.

    Miraculously, f-in-law seems to have now returned to previous state - keen on chocolate and TV and not interested in any interaction. His care visits have been upped and situation being monitored. We’re still flummoxed as to the rapidity of the changes.
     
  12. AliceA

    AliceA Registered User

    May 27, 2016
    2,404
    Good to hear. The slightest infection or dehydration can cause a change. A severe infection more so!
    I hope things go smoothly for you.
     
  13. Leonora7

    Leonora7 Registered User

    Jul 26, 2010
    158
    Basingstoke
    Thank you AliceA. Fingers crossed.
     

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