Insensitive Social Worker - Hospital Discharge

[Cath59]

Is a rant allowed here? My mother has developed dementia very fast. She ended up in hospital, possibly after muddling medication, but is now physically much better (though she still says she feels awful). We've been reassured on lots of occasions that she wouldn't be discharged until all the support she needed had been put in place. Yesterday, out of the blue she had a visit from a social worker. As far as my mother was concerned she was told that she was ready to be discharged, that they would be able to organise carers to visit two or three times a day, but that that was all they could offer. My mother thought it was going to happen straight away, has lost all confidence and doesn't feel able to be alone at any time and was really upset. The same lady came back when I was visiting. Repeated pretty much the same, refused to give any guidance on timescale, and, when we said that my mum really didn't feel able to be alone at the moment, threw a few telephone numbers at me to try to find care homes. Mentioned a couple of carehomes in my town (both of which, I knew didn't cater for dementia), and said we'd probably have to look out of the area if they didn't have vacancies. Luckily, I had already done a bit of research, knew of another home in the area which has a good reputation and vacancies (though I'm not sure how long it would take to organise) but my mother was extremely upset. The conversation was conducted between the social worker and myself, referring to my mother as "mum", I'm afraid that eventually my mum told her that she was not her mother, and that she had a name and a title!
Result, however, is that she didn't sleep much last night and today was tired, unwell, and more confused and miserable than I have ever seen her, convinced she was being kicked out of school! I still haven't managed to find out exactly how urgently we need to organise that care home place.

 

[Jessbow]

2 or 3 visits a day is about the norm I am afraid.

If a nursing home has vacancies and you have requested a place, and you mother is deemed 'fit for discharge' then It could happen tomorrow if the funding is in place. if she's self funding you could arrange it today!

 

[garnuft]

Your poor Mum, she sounds to be afraid of going home again.

There is a fact sheet available that is VERY helpful as it tells you the procedure that MUST be followed before discharge...

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=173

In my area (East Durham) there are enablement packages that are funded by the Hospital for 6 weeks after discharge.
Is your Mum wanting to go home with support? If so, this support must be in place BEFORE she's discharged (if she has been assessed as needing support).

Make sure an OT visits your Mum before she is discharged from hospital to make sure she has been assessed for any equipment that is needed...commode, zimmer frame, support around toilet, bathing or showering aids.
If your Mum is going home, make sure ALL equipment is delivered before discharge.

If she's going to go into a carehome...is she self-funding?
If so that gives you freedom to choose if not what homes do they currently have available?

Make the Social Worker do her job...smile at her while telling her you know what your Mum's rights are and you KNOW she/he will do her level best to get the best outcome.

Print out the Alzheimer's Society fact sheet on hospital discharge and give him/her a copy...then tell them that's the programme you're following.

They CAN'T just shove your Mum out without support if she has been assessed as needing support but if she's going to her own home, be aware that the care packages never include overnight care.

Best wishes to you and your Mum.

Have a good think about everything that might be needed, or may be needed before she is discharged...taking up a hospital bed gives your Mum a bit of power

 

[Cath59]

garnutt - Thank you for the link. That really is very useful. Yes, she's self funding and we went to look at a home, in the area with vacancies yesterday. The only problem is that I'm not sure quite how fast they will move. They need to assess her, and the vacant rooms are being decorated. She's scared, at the moment, of being on her own. She's changed dramatically in a couple of months and is very lacking in confidence. It's possible that she may feel differently in a while, but this home is willing to take her on a trial basis. I think what she really needs is breathing space to come to terms with things and work out what she is going to want. I was just really furious with the way it was done. She was more upset and confused today than I have ever seen her. It's all very difficult as, at the beginning of December, it would never have occurred to any of us that such a move might be wanted. I'm a little worried that we are being bounced into this, and I've only looked at the one place. It does, have a good reputation, seemed lovely, and, if we could find somewhere better it wouldn't be as close to us which, in itself, counts for a lot. Unfortunately, we have a full, busy house, so looking after her ourselves isn't really practical.

 

[Cath59]

Reading the list again, I see it includes a psychiatrist or mental health nurse. I'm pretty sure she hasn't seen anyone like that. Should I raise that? She seems pretty depressed, which I understand can go with dementia. Her life has been turned upside down both by the condition, and by the fact that my severely autistic brother had a stroke shortly before her hospital admission. Until today, she's been very clear on that, however confused everything else became. In fact, there'd be something very wrong if she wasn't depressed! Just wondered if anyone had had any experience of asking for that sort of help.

 

[Witzend]

The conversation was conducted between the social worker and myself, referring to my mother as "mum", I'm afraid that eventually my mum told her that she was not her mother, and that she had a name and a title!
.

Good for your mother! I HATE this so-common habit of so-called professionals of referring to someone in their presence as 'Mum'. Not even 'your mum' or 'your mother', let alone their name.

Why do they do it? Have they been told it sounds more 'cosy' or 'friendly'? To me it is the opposite - both rude and patronising, and it would make my own mother see red, too, even when her dementia was quite bad. She also hated people talking about her over her head, and I would try to avoid it if at all possible. More than once I also told people in advance not to refer to her as 'Mum'. But I don't think I should have had to. Professionals, if they want to call themselves that, should not need to be instructed in basic good manners.

 

[Cath59]

Thanks Witzend - good to know someone else appreciates her!

Garnutt, have now asked about a mental health evaluation, so thank you again for posting the link. I think that could be important.