Mum discharged from hospital to care home, we need her home as she is deteriorating.

[Ang15]

Hi I’ve just joined this site so thank you for having me.
my mum was admitted to hospital with delirium on 29/07 and eventually in September discharged to a care home as she needed further care; in hospital she had an unwitnessed fall resulting in 6 broken ribs 3 of which were broken in 3 places so we felt her own home not an option at the time. She was in the care home 2 weeks and developed DVT that went to her chest so ended up back in hospital being discharged to the care home again after 3 weeks. She now wanders like a lost sole and has very little conversation, asks questions but then doesn’t understand the answers, she looks broken. They have given her a dementia/ possible Alzheimer’s diagnosis. The care home is nice but lots of faults still; we pay £700 a month on top of the councils 800 a week as it a more expensive one with lovely grounds but going in her room for the first time yesterday I noticed the bedding rough and bobbly, there’s nothing worse than horrid sheets! There were 2 lights not working and a nail sticking out of her very cheap bedside table.
im meeting with the social worker there in the morning to assess her to get her home as as a family we feel with support she’d be better there with day centres too. My main question is
Can the social worker legally keep her in a care home when we want her in her own home with support, I need to go equipped with information?
thank you for reading and sorry for such a long post.

 

[Grannie G]

Hello @Ang15 Welcome.

With the catalogue of disasters you have described, unless your mother is considered to have lost capacity I`m sure no one could force your mother to stay where she is. If her diagnosis is new I think there might also be room for considering she may be happier at home with family.

It will be in her best interests if you could get a Lasting Power of Attorney [ LPA ] sorted as soon as possible. This will also depend on your mother being considered to have capacity but it will enable you to make decisions in her best interests on her behalf.

 

[canary]

Hello @Ang15 and welcome to Talking Point,

Im so sorry to hear about your mum. When someone with dementia gets an infection it really takes it out of them and delirium is often a consequence. They usually improve somewhat, but very seldom get back to "base level". Broken bones, pain and hospitalization can all progress dementia, so Im not surprised (though very sorry) that your mum has had a massive downturn.

Yes, you can take your mum home, but you have to be able to show that there is a care package in place that will meet your mums needs. Do you know what your mums needs are now? It sounds like, at the very least, she will need help with washing and dressing. If she would be on her own in her own home then she would need someone to do housework, laundry, food preparation and everything to do with running a house. I also wonder about her mobility and falls risk. Is she also incontinent, awake during the night, needs watching 24/7 (so that you cant leave her for even just a minute), or at risk of walking out and getting lost? These are the sort of things to ask about and you will have to cater for.

I would think very carefully about doing this. Social Services are very reluctant to advise a care home and almost always want to try people in their own home first, so if they have moved her to a care home I think her needs must be very high. If you bring her back home she is unlikely to improve.

I must say, though, that I dont like the sound of this care home. Care homes are not the same though, and they will often prioritise different things. Some of them spend their money on the outward, showy things in order to impress the relatives, but the basics are less impressive. Will your mum really benefit from extensive grounds? More expensive is not necessarily better. I would be inclined to check out other care homes and try and look beyond the showy stuff.

 

[MartinWL]

Bringing her home might sound attractive but her needs may now be such that residential care is her best option. Consider that her need for a care home may be because of her rapid deterioration, rather than her deterioration being caused by being in a care home. By all means consider other homes but to begin with speak to the manager about the sheets and bedside cabinet.

 

[Sarasa]

Hi @Ang15, it sounds in all honesty as though your mother would no longer be able to cope at home unless there is someone to care for her 24/7. It is very likely that if she was at home she would no longer recognise it. My husband's family very much wanted to keep their mother at home, as she loved the place so much. For a long time things were fine with my brother in law calling in twice a day and other family members visiting regularly, She then became incontinent, so carers were added to the mix. However after a few months they carers felt she needed to be in a care home. By that time she didn't really recognise her home. She's settled in very well and everyone agrees it was the best option.
Not all homes are alike, something we realised when we looked at a few with both my mother in law and my mother (who we were moving from another care home to be nearer us) in mind. One that would have been ideal for my mum would have not been good for MiL and vice versa. I'm worried that you are contributing so much to your mum's care, specially as it doesn't sound that great. I'd have a good look round at other places. Just because places are hotel like doesn't mean they are the best place to be. This websitte might be of help in the search https://www.carehome.co.uk/

 

[Duggies-girl]

We bought dad home from hospital, in hindsight he should have gone to a care home but he had terminal cancer and was not expected to live much longer.

If we had left him in hospital he would not have survived much longer, he had 3 falls in 3 weeks on 3 different wards, he also had a heart attack and a stroke which in my opinion were bought on by the stress of being in hospital, his dementia also got much worse while he was in there, he also lost almost 3 stone in weight . He went in with pneumonia and went from a man who lived alone (with support from me) to needing 24/7 care when he came out.

We had no care package, just family or I should say mostly me. I moved in 24/7 and got the odd day off when another family member had nothing better do do, as a curtesy really. In truth I was volunteered by family to care for dad because they were concerned about money, they had no intention of really helping.

Dad improved greatly after a few weeks and never had another fall. He did very well and we muddled through for another year until he died. He never really recognised his own home anymore and his kitchen was a complete mystery to him but he was happy and well cared for. He could not dress himself at first but eventually he managed to do so along with some other simple tasks. He also put on weight and his mobility got quite good using a frame but he could never be left alone again.

If you do this then you need to be very firm about who does what before she comes home. I was promised lots of help but in truth it was very sparse, after all they worked and they also had social functions and holidays planned. I really don't know how I did it, it was stressful, it was boring, it created a lot of family resentment, that has continued to this day, I drank too much wine, I ate too much and got fat, I never want to see the overbearing SIL again. I still haven't recovered from it and I think it will always remain with me. I won't say that I regret doing it but it was hard, very hard.

Be prepared that your mum may need a lot more help than you suspect and help may not be given as freely as you would hope for.

I agree that her care home does not sound very good and bobbly sheets are awful. Sorry I am not more positive but that was my experience.

 

[Lilye]

Ang 15 my heart breaks for you and your poor Mum.
My Mum has Vascular Dementia and no mobility in her legs because of this so has to be hoisted.
For the past 5 years we have been extremely lucky to have had a live-in carer which was mostly funded by our local council however 5 weeks ago we were told funding was going to cease for liv-in carers and a social worker became involved. To cut a very long story short the social worker was incompetent and after being told by the panel that Mum was now at risk (?????) she would have to go in a care home on a 6 weeks placement. We were told this on the Friday and that she had to be moved by the Tuesday or Wednesday of the following week! We were not offered any other options of care package or allowed time to sort out with family if we could find the funds to support Mum at home with a suitable care package. I reported the social worker and allocated another who is doing her utmost to get back Mum back home where she belongs, she is 89yrs of age and in late stages of Dementia.
Sadly the first care package that our new social worker put to panel was dismissed so she is now arranging for a clinical assessment. Would anyone know if we can legally remove Mum from the home if we can prove that we can support a sustainable care package? Mum has deteriorated greatly and barely eats or drinks and, understandably, cannot have the one to one care she needs in a home.

 

[MartinWL]

Unless there is a denial of liberty safeguard order in place you can take her home, but I would think long and hard before doing so. Dementia only gets worse. Are you really going to be able to provide day and night care at home with a qualified nurse available daily? The deterioration you have noticed may be despite the care home not because of it.

 

[Sarasa]

Hi @Lilye, I think if you can show that your mother would be well supported at home, there is nothing to stop you bringing her home, even if there is a Deprivation (not denial) of Liberty Safeguarding Order (DoLS) in place. I moved mum from one care home to another and the social workers were absolutely fine about it. I think there might be difficulties if you have under-estimated how much care your mother now needs though, so you would need a very clear plan. I can see how social work departments are very short of funds, and live in care is very expensive hence them no longer funding it, but it sounds like the situation could have been handled much better than it has been.
I think it might be a good idea to phone the Dementia Support Line and talk things through. They can be phoned on 0333 150 3456 or emailed at dementia.connect@alzheimers.org.uk. They are open till four today and then from nine tomorrow.

 

[MartinWL]

Hi @Lilye, I think if you can show that your mother would be well supported at home, there is nothing to stop you bringing her home, even if there is a Deprivation (not denial) of Liberty Safeguarding Order (DoLS) in place.

I think you understate the difficulty here. Before she could leave the care home, however good the destination, the Deprivation of Liberty order would behave to be cancelled by the local authority. They might agree at the drop of a hat but they might not and you would have to make a convincing case to get their agreement before turning up to collect her, suitcases at the ready. A DoLS order cannot be applied at your house (rare exceptions by court order) so she would then be free to leave even if at risk

 

[Jaded'n'faded]

My understanding is that the DoLS is there to keep the person safe with the minimum restrictions necessary.

As @Lilye has said her mother has no mobility in her legs, it would seem there's little chance of her trying to escape.

If the council are reverting to their usual maximum allowance of 4 care visits a day and that's not enough for your mum, they will insist she moves to a care home. (No idea how you managed to get them to pay for a live in carer - I assume you were subsidising that quite a lot.) To get her back home, you'd have to prove she would be safe and well-cared for with the 4 care visits they will provide plus whatever extra care you are prepared to offer or pay for yourselves.

But I don't think the DoLS (if there is one) would be an obstacle. It relates to wherever the person is at a given time (care home, hospital, etc) not to the person themself, i.e. it doesn't 'stay with you' once granted.

 

[northumbrian_k]

Indeed, my wife was under a DoLS during her short-term stays at a respite centre. It was specific to that location and did not stop me bringing her back home at the end of each stay. A case might need to be made that home care is sufficient for a person's needs but any DoLS would not have a direct bearing on making the case.

 

[MartinWL]

Indeed, my wife was under a DoLS during her short-term stays at a respite centre. It was specific to that location and did not stop me bringing her back home at the end of each stay. A case might need to be made that home care is sufficient for a person's needs but any DoLS would not have a direct bearing on making the case.

It probably won't matter as there probably isn't a DoLS order in place, but if not time limited it does have to be revoked before the person can leave the designated care home.

 

[Lilye]

Thank you all for the information some good points have been made. I will certainly speak to the Dementia Support Line and take on board everything you have all said.
One thing I will never understand, as I was told today, is that although we are now able to fund a live-in carer the council will not fund a visiting carer to help with handling and manoeuvring because they do not part fund a care package! I would of thought they would of been grateful!
Thank you all again.