Hospitalisation after fall - advice on processes?

[lesley1958]

Dad fell at home 2 weeks ago and broke his femur. He also had a chest infection.

The hospital pinned the break and cared for him very well, but he has not yet regained any mobility.
This week he was transferred to a small district hospital only 3 miles from my mum (previous one was 20 miles away) for rehabilitation and physio.

We went to see him yesterday and he was very sleepy. I think they make have given him morphine? to ease the transfer as his pupils were very small and he was much more out of it than he was in the last days at the main hospital.

We already had SS funding in place for 5 2 hr care visits a week at home to help with washing and dressing. I have been told that we should have a SW allocated to look at the care Dad needs now. That didn't happen while he was in the main hospital and no-one has mentioned it yet following the transfer. Am I right about this? And if so, will the hospital put the allocation of a SW in motion or do I need to push? (I contacted SS when he fell to tell them he had been hospitalised as I wasn;t sure what to do about the ongoing payments which are direct payments and which I manage. They presumably put it on his records).

Also, I feel that mum and I need to look at homes that offer nursing care. But can anyone advise me on the criteria that the powers that be define use to decide whether "nursing care" is a requirement in terms of funding? We live in a rural area and some of the homes that offer nursing care are not specialist dementia homes.

It's all such a minefield and I am so confused and there is so much to do - and my poor lovely Dad in the middle of it all and my Mum struggling to cope. They have been married 63 years.......

Any advice or pointers most gratefully received.

Lesley

 

[nae sporran]

Morning Lesley. Sorry to hear about your dad's troubles.

All I know about the situation is that my neighbour had a fall in February and that meant 6 weeks rehab at a facility in south Bristol. After that she would have had to pay a fee. Her daughter chased up Social Services a few times to hurry things along.

The only practical advise I have, iif you have not already tried them is the Care Support Centre in North Bristol
http://www.carerssupportcentre.org.uk
Their Carers line was very helpful when C was in hospital a few years ago. Best of luck, Rob

 

[Havemercy]

Dad fell at home 2 weeks ago and broke his femur. He also had a chest infection.

The hospital pinned the break and cared for him very well, but he has not yet regained any mobility.
This week he was transferred to a small district hospital only 3 miles from my mum (previous one was 20 miles away) for rehabilitation and physio.

We went to see him yesterday and he was very sleepy. I think they make have given him morphine? to ease the transfer as his pupils were very small and he was much more out of it than he was in the last days at the main hospital.

We already had SS funding in place for 5 2 hr care visits a week at home to help with washing and dressing. I have been told that we should have a SW allocated to look at the care Dad needs now. That didn't happen while he was in the main hospital and no-one has mentioned it yet following the transfer. Am I right about this? And if so, will the hospital put the allocation of a SW in motion or do I need to push? (I contacted SS when he fell to tell them he had been hospitalised as I wasn;t sure what to do about the ongoing payments which are direct payments and which I manage. They presumably put it on his records).

Also, I feel that mum and I need to look at homes that offer nursing care. But can anyone advise me on the criteria that the powers that be define use to decide whether "nursing care" is a requirement in terms of funding? We live in a rural area and some of the homes that offer nursing care are not specialist dementia homes.

It's all such a minefield and I am so confused and there is so much to do - and my poor lovely Dad in the middle of it all and my Mum struggling to cope. They have been married 63 years.......

Any advice or pointers most gratefully received.

Lesley

Hi Lesley - what a stressful situation for you all. I can tell you that the rehab hospital will definitely have social workers who will be attached to the facility - as opposed to the community teams that look after your dad in the community, although they should communicate. You should not have to do anything beyond making sure that the nursing staff have put in the referral. What probably happened in the acute hospital is that your dad was on the "rehab" pathway (ie the ward knew he would require rehab so no need to to refer to hospital social services) That is what would happen in the large acute hospital where I work.

If you are thinking that your dad might need a placement then you should liaise with the allocated social worker (when you have contact details!) A lot will depend on whether he will be self-funding or not. A best interests meeting usually takes place with family and appropriate professionals. However if social service funding is going to be needed, then they may talk about 'least restrictive option' for your dad especially if he expresses a wish to return home. A lot will depend on whether he is deemed to have capacity to make decisions about where he lives. In my experience if a patient has "significant nighttime needs" then it is more likely that a placement will be agreed to.

If this were me I would be asking the senior nurse on the ward to ensure that a referral to SS has been done and how you contact the allocated social worker.

At the same time you could ask about the morphine and if there is any other pain relief that could be used. Don't be afraid to ask - you have the right to be involved in these things.