How much mobility does Mum need to have for a care home to take her?

[AlsoConfused]

Hi everyone

My Mum's in a community hospital at the moment after cracking a vertebrae in a fall. She was unsteady on her feet and leaning backwards a lot before this fall and has fallen on a number of occasions previously (breaking a pelvic bone on one occasion).

Mum hasn't got a discharge date as yet ... but community hospital beds are in very short supply so I'm sure the medics will want to discharge her ASAP. Dad wants Mum to come home directly from hospital ... but only when she's fit enough to do so safely. I have my doubts whether Mum will ever be fit enough to come home and also wonder whether most homes would accept her as a resident at the time when the hospital wants to discharge her. Will the hospital require us to move Mum into residential care if it's not safe for her to come home and Mum doesn't really need to be in hospital any longer? I'd be happy if they would - but it'd upset my Dad.

Currently Mum is being taught to use a walker but needs to be supported by a carer (or physio) all the time she's using it. Will a residential home accept Mum if she still needs to have the support of a carer every time she moves, please? Mum had her accident 2 weeks ago and can now walk 20 metres on the flat.

I don't know whether Mum has yet progressed to only needing one carer to help her get up out of bed - she used to need two carers. My sister was told that the most accessible care home for Dad wouldn't accept any resident needing two carers' help to get them up. Do most residential care homes take that attitude please?

They have tried her on stairs and I think Mum frightens the physio as much as she does us - Mum doesn't follow instructions (she can't); takes her hands off the bannisters; and reverses direction on the stairs, all without warning. The physio sensibly wants Mum's living accommodation to be on one level - but that can't be managed at home without extensive rebuilding.

If the property isn't rebuilt to provide on the ground floor a large bathroom with easy access (without steps) to Mum's "bedroom" (aka our lounge) then she'll remain at high risk of a fall. If Mum is sent home before the bathroom is built then the kitchen sink / food preparation area will also be the place where she (doubly incontinent) will be cleaned up by her registered blind carer - both of them will probably go down with food poisoning.

I'm hoping the hospital will keep Mum in for long enough to give us a chance of persuading Dad to at least try the residential care option. If they don't then I think Dad won't willingly agree to anything except Mum coming home ... back to a situation that's desperately unsafe for both of them. Can any of you advise me please what's likely to happen? Dad's willing in principle now for us to attend the discharge planning meeting.

 

[canary]

When my MIL had a fall and broke a vertebrate she got a 6 week re-enablement scheme place at a CH. While she was there she got physio etc and at the end of the 6 weeks she had a "best interest" meeting to decide whether she was able to return home or not. In fact, it was decided that she was not well enough to return home and she remained in the CH.
If something like this is not suggested I think it would be a good thing to push for.

 

[Pickles53]

My mum never recovered her mobility after a bad fall at home, and she had not had very much even before that. Physios and OTs did their best, but she just kept saying she was too afraid of falling to try. She needed two carers to assist her to move from bed to wheelchair to toilet etc and ultimately a hoist had to be used. This was the main reason that she actually moved to a care home, though because of her dementia we had already been looking at homes as part of future planning.

Her home was residential rather than nursing though it was specialised in dementia care. None of the mobility problems caused any concern for the staff and they were very well trained to assist her. There were a number of other residents with similar difficulties. The home was all on one floor which at least meant we could push around easily in her wheelchair and take her out into the garden.

We did rule out one or two older homes when we were looking, as we thought rambling old buildings with uneven floors and the odd step here and there would just increase the difficulties.

Do insist on proper physio and OT help to see if your mum's mobility can be further improved, but do try and be realistic about what is possible at home. Major renovations are only a good idea if you firmly believe your mum could then be at home for a decent amount of time.

 

[Pickles53]

When my MIL had a fall and broke a vertebrate she got a 6 week re-enablement scheme place at a CH. While she was there she got physio etc and at the end of the 6 weeks she had a "best interest" meeting to decide whether she was able to return home or not. In fact, it was decided that she was not well enough to return home and she remained in the CH.
If something like this is not suggested I think it would be a good thing to push for.

Where my FIL lived, there was a residential rehab centre (all run by the NHS) specifically designed to help people recover their skills with intensive physio/OT support. It was excellent, even had areas set up like a small flat so people could get confident with household skills etc before going home. It surely can't be the only one in the country, so ask if there is something similar.

If after a rehab period mum still seems to be struggling, that would be an indicator to me that you should at least be looking at a temporary care home placement.

 

[AlsoConfused]

Thanks very much for your replies. If we could only get something like a 6 week breathing space with Mum in hospital then Dad might have recovered enough to be able to think things through properly. Dad's nearly 90 and has been looking after Mum almost without help for 8 years.

I'm pleased to say Dad didn't immediately reject the idea of maybe Mum going into temporary care "just while the house rebuilding is done".