Mum fell again, end of the road?

[love.dad.but..]

Surely with a relative with dementia, you can visit whenever you want? I feel sure I've seen that mentioned here on TP before? Perhaps one of the UK experts will know.

Different hospitals or even wards seem to vary in my experience but you would have thought staff would want someone to be able to visit any reasonable time to take the load off overstretched staff if a family member wants to stay. I always stayed in with dad and found staff very willing to accommodate me and respond well to me speaking for dad who couldn't communicate. I don't know if there is an official legal line on this but would think a pwd without any or little mental capacity should have access to their advocate at all reasonable times. I had health poa for dad but didn't have any problems...you can imagine the staff feeling relieved that I stayed!

 

[jen54]

Different hospitals or even wards seem to vary in my experience but you would have thought staff would want someone to be able to visit any reasonable time to take the load off overstretched staff if a family member wants to stay. I always stayed in with dad and found staff very willing to accommodate me and respond well to me speaking for dad who couldn't communicate. I don't know if there is an official legal line on this but would think a pwd without any or little mental capacity should have access to their advocate at all reasonable times. I had health poa for dad but didn't have any problems...you can imagine the staff feeling relieved that I stayed!

Visiting times are three till eight thirty, guarded lunch time,though it does say visitors can stay ..if they are helping patient eat ..not sure if that's just the five o'clock dinner though
We went in at three,mum asleep, in incontinence pad. And a catheta, on awaking she was so frail and talking about flying grey rabbit thing,lovely views, she took my hand and said are we friends again,so much nicer..so wondering how things had gone with the nurses...
On asking about mum,we were told she has a chest infection,no mention of xray results,
Told to ring tomorrow before visit and she would be in another day or so.
She was totally different today,asking if they did trips here..
Still in pain around her bottom and can hardly move
No mention of hospital social worker..thought it would be better to start things.
I had said to Dr in ae that she cannot be safe at home ..its her hip we feel is main culprit,not infection alone..
New year is awkward,Tuesday I will ring Dr and see I she knows mum is in hospital,and then i could ring local care home, I did feel guilty thinking it..but now I feel guilty about even thinking she should be alone in a cold house trying to manage stairs etc,and we can only do so much..i know next fall could be down the stairs ir lead to a break..the thought if her on the cold floor for another day alone tears me up

 

[jen54]

Visiting times are three till eight thirty, guarded lunch time,though it does say visitors can stay ..if they are helping patient eat ..not sure if that's just the five o'clock dinner though
We went in at three,mum asleep, in incontinence pad. And a catheta, on awaking she was so frail and talking about flying grey rabbit thing,lovely views, she took my hand and said are we friends again,so much nicer..so wondering how things had gone with the nurses...
On asking about mum,we were told she has a chest infection,no mention of xray results,
Told to ring tomorrow before visit and she would be in another day or so.
She was totally different today,asking if they did trips here..
Still in pain around her bottom and can hardly move
No mention of hospital social worker..thought it would be better to start things.
I had said to Dr in ae that she cannot be safe at home ..its her hip we feel is main culprit,not infection alone..
New year is awkward,Tuesday I will ring Dr and see I she knows mum is in hospital,and then i could ring local care home, I did feel guilty thinking it..but now I feel guilty about even thinking she should be alone in a cold house trying to manage stairs etc,and we can only do so much..i know next fall could be down the stairs ir lead to a break..the thought if her on the cold floor for another day alone tears me up

 

[nita]

I expect they will give your Mum an X-ray if she has pain in her back or hip. Can you ask the ward doctor about this? If not, get an appointment with the ward clerk to see her consultant.

Her falling may have been due to the infection and feeling dizzy. But she may also have broken something. My mother had a lumbar wedge compression fracture (bottom of the spine) which only really affected her some time after a fall. She couldn't stand at all and she had to go to hospital.

They won't discharge your mother till she is both medically fit (free of infection) and also able to function in some way. They will get a physio in to assess her and see if she can walk but not before they do an X-ray. The hospital social worker will have to ascertain whether she can go home and it doesn't sound likely. In that case, they will arrange for discharge into a care home. I am sorry you are having to face this and with a family to look after; worse still it being the holiday period.

 

[jen54]

Mum had xray last night, not sure what part they xrayed, as she had pain in her shoulder,knee and hip. We havent been told results..so assume no break, but her hip has been getting worse..slipping out,giving way for over a year, in beginning of year,dr said an xray would only show bone damage..
So not sure how they pick up a worn out hip,she kept saying t hurt..but when nurses adj..its all..no pain at all. Today she was saying her leg ached, but notes on bed saying at checks..no pain.
She was shuffling at hone meaning on stick and furniture,coming down or up stairs so slowely..so will be interesting to see how she stands when they check her mobility..if they do..surely they cant send her hone if she can hardly walk

 

[nita]

An X-ray can show arthritis in the hip - what they call "wear and tear". If she needs a hip replacement, it's not surprising she is finding it hard to walk. If that needs to be done, it will depend on her age and her mental condition. They may feel she wouldn't be able to cope with anaesthetic or the rehab required after the operation.

They certainly won't discharge her to her home if she can't walk, so don't worry about that. They have equipment like hoists in care homes. My Mum was at home with me and we had one. It needs two carers to operate.

I had problems with my Mum's communication with other people too. It varied depending on how she felt at the moment. If she is in pain, can you tell the nursing staff as they will get the doctor to write her up for some pain relief.

 

[love.dad.but..]

She's going to be in til at least a Tuesday it sounds so then all the necessary services are back at work and you will be able to talk to the right people and get a clearer picture but it sounds doubtful to me how they could discharge her back to her home with current mobility problems. Its horrible having to face the thought of a care home but it really does sound as though that time has come with this crisis and you have done everything you could to support her living independently safe and looked after ... time that you got help don't feel guilty..your mum's needs are more than one person can provide.

 

[Kikki21]

Mum had xray last night, not sure what part they xrayed, as she had pain in her shoulder,knee and hip. We havent been told results..so assume no break, but her hip has been getting worse..slipping out,giving way for over a year, in beginning of year,dr said an xray would only show bone damage..
So not sure how they pick up a worn out hip,she kept saying t hurt..but when nurses adj..its all..no pain at all. Today she was saying her leg ached, but notes on bed saying at checks..no pain.
She was shuffling at hone meaning on stick and furniture,coming down or up stairs so slowely..so will be interesting to see how she stands when they check her mobility..if they do..surely they cant send her hone if she can hardly walk

Jen - my mum is in a similar situation to yours. She was admitted into hospital twice over so we had experience of A&E twice over. My mum had also fallen a few weeks before, didn’t press her wrist alarm, banged on the floor. Neighbours heard & called the police. Police rang ambulance but she wasn’t checked over that day. I rang her GP & insisted on a home visit to check her over the next day & that started our nightmare. She contracted an infection & we thought she was having a heart attack & had to wait over 3 hrs for an ambulance - we rang 4 times to escalate as she kept saying she was in pain, going grey. Plus another 3 hr wait in A&E.
The hospital rushed her discharge through swiftly & then hours later, she was back in A&E this time she had had a huge seizure followed by smaller episodes so that was another 3 hr wait in A&E.
She is still in hospital & they have attempted to discharge her twice & twice I’ve blocked it.
We made a bit of an ally with a retiring staff nurse on the ward & she has been brilliant with my mum’s care today.

If you are perturbed in any way then speak to PALS, I did & all of a sudden, I have had better service & communication about my mum’s health. It has been very hard to talk to anyone on the wards. Good luck!

 

[jen54]

An X-ray can show arthritis in the hip - what they call "wear and tear". If she needs a hip replacement, it's not surprising she is finding it hard to walk. If that needs to be done, it will depend on her age and her mental condition. They may feel she wouldn't be able to cope with anaesthetic or the rehab required after the operation.

They certainly won't discharge her to her home if she can't walk, so don't worry about that. They have equipment like hoists in care homes. My Mum was at home with me and we had one. It needs two carers to operate.

I had problems with my Mum's communication with other people too. It varied depending on how she felt at the moment. If she is in pain, can you tell the nursing staff as they will get the doctor to write her up for some pain relief.

Yup, we told the nurse that mum was saying her leg was aching..we also had to keep saying her bottom was very painful fir hours last night..before they actually checked it,cleaned it and put cream on it..notes saying very red, poor mum she had been lieing in urine all night..obvious that would result in soreness. Today they have that on notes and are hopefully keeping an eye on it,but I am assuming when they ask if she is in pain..she is saying the stoic no.

 

[jen54]

She's going to be in til at least a Tuesday it sounds so then all the necessary services are back at work and you will be able to talk to the right people and get a clearer picture but it sounds doubtful to me how they could discharge her back to her home with current mobility problems. Its horrible having to face the thought of a care home but it really does sound as though that time has come with this crisis and you have done everything you could to support her living independently safe and looked after ... time that you got help don't feel guilty..your mum's needs are more than one person can provide.

Yup, the guilt has faded somewhat about care home..now I cant bear the thought of her alone in cold house,trying to litter around ,we can only do so much,we get her lunch, clean up,sort cats..make bed and flea,brush her hair etc..as well as company..but I cant face the thought of her falling as soon as we leave and lieing on floor all that time again, she had sore red arms etc which looked like carpet burns..probably from first fall and dragging herself into front room doorway she gave up...at least she will be warm and looked after 24/7 , this is a game changer for us as well as her..we now face the reality we cannot cope,cannot struggle keeping her from falling,lifting her up etc,

 

[Amy in the US]

Jen, when my mother was in hospital early in 2017 after a fall, fractured kneecap, and surgery, she did not always accurately report her pain to the nurses and staff. She would often deny pain to them, and then as soon as they left the room (or her line of sight), she would tell me how much pain she was in. She didn't always want to interact with the staff.

It got so I was better at judging her non verbal signs of pain, and I kept track of when she was due for pain meds and would start asking for them about half an hour before they were due, and made sure she had her pain meds for the night before we left the hospital to go home.

So you may have to advocate a little more loudly and aggressively for your mum. If you think she's in pain, or not getting basic care, then do what it takes to get her what she needs. You know her best.

The hospital stays are not easy. Please hang in there and look after yourself as best you can.

 

[jen54]

Well, I got a call from the hospital social worker today, she was assessing mum, said mum was contented,and pleasant, but when asked about her homelife say hr couldnt recall as she had been away fir so ling,
I went through all that happened,history,what we do fir mum, all about the house and use of aids, she asked if mum could have a bed downstairs..I said she would walk past it or demand it was removed and would not recall she had to sleep downstairs or use a commode
She was going to assess mobility when she got off phone,and said someone would talk to us and mum, ww didnt go in today as thought it would be stressful for her and so will go tomorrow,
I gave pals number,but the social woman seemed to agree that mum would be better off with placement. We will see tomorrow

 

[canary]

Well thats a hopeful response, jen.
Well done for standing your ground over not having the bed downstairs.

 

[love.dad.but..]

Glad that this seems more positive and you were assertive. Carry on with that and paint worst case presentation of your Mum's illness and challenges for her and you.

 

[Amy in the US]

The SW called you! That's something, at least. Well done you for standing firm about what your mum needs and what will work for her.

I hope you hear something helpful, or at least informative, about the mobility assessment, and soon.

 

[jen54]

Went to see local care home before visit yesterday..not for mum,sadly the bedrooms were small,hospital beds, and poor old souls looked to be late stage,in bed or chair looking far worse than mum. Only a couple responded to my hellos or smiles, most were glazed over and looking very ill. I know mum was nowhere near this stage before her fall, so can't place her in a home like this one for sure
The cost per week was a shock too.
I just feel worn out, rang some who aren't taking new residents.
On visiting mum after, I asked about the assessment etc,again saying she couldn't be discharged to her empty house..
Mum was just asleep, when I said hi mum she said my name without opening her eyes,a good sign, but when asked how she was,she said"dead"
On a drip, because she wont eat or drink much,terrible thrush in her mouth,but I suppose due to antibiotics etc..awful seeing that,as my dad developed thrush shortly before he died
Evidently she had been awake late..sitting up,last night..and that morning..when we cant visit,..makes me sad,
I had to tell them what mum eats..as menu for that day only had a mixed fruit pot ticked..and mum hates mixed fruit cocktails..it had been untouched..and last visit,a banana dumped on side table..she hates those,plus bananas are hard going at best of times
..they make me retch if I bite too big a piece.
Hoping they take note as there were things on menu she would eat I pointed out
No mention of ss talking to us,
Pyshio seeing mum today..i was told she was very unsteady on feet.
Its draining,as visiting takes a while as hospital isnt close and I can't drive in the dark..so visiting at three means driving back in dark, so depending on hubby..who hates hospitals, and its a definate three o'clock,as we arrived at ten to three yesterday to be told off and to wait.

 

[Shedrech]

hi @jen54
those visiting restrictions may be fine for a patient who is mentally capable, but not helpful, especially to your mum, in your circumstances
personally I'd be talking with PALS and asking to speak to the dementia matron ( each hospital is meant to have one, but may not be called this) and the hospital social worker - you need to be able to visit when is best for your mum and for you
ask them if they are part of the Butterfly scheme
http://butterflyscheme.org.uk/

there are good care homes out there; I hope you find one soon

 

[jen54]

Deffo only from three,very strict on that. I do think it's odd,but I was told I had to wait,as meds and checks had to be completed

Today has been taken up with sorting her house,changing bed vaccing,sorting cats and checking mums clothes,to see what she actually has in case I need more. Found all her pants hidden..
Social worker rang again, saying hospital say medically ok to discharge..what...with her poor backside..so raw and get in pain.
Social order said she didn't feel she could be discharged due to mental issues,
Recommended another local home, and said she was going to assess her mental capacity
Home looks overly online,so am going to see it tomorrow before seeing mum,and get them to assess mum for respite
Social worker ranger early evening to say she didn't feel mum had mental capacity in that she could make small decisions like having a cuppa..wearing a cardiac..but nothing big. Mum had been telling her about doing gardening..the social worker said it was obvious mum was in her own reality where she is still doing things ..she asked mum about respite,and mum actually said she felt she needed to recover somewhere before going home...so this gives us a chance to try. The home does respite so it doesn't mean plunged in permanent..
Will see tomorrow..but evidently when you are self funding as won't help unless you pay a fee..it's up to relatives to sort things.

 

[DollyBird16]

http://johnscampaign.org.uk/#/

Useful Re visiting times for carers. If the trust is signed up the visiting times are open. X

 

[Kikki21]

It seems you are also having a job with these medically fit discharges when it’s clear the patients are anything but. I’m waiting for the hospital social worker to ring me as well.

We are going round in circles with the SALT team at the moment as that is twice my mum has said she isn’t in pain swallowing & yet she has told us she is in pain swallowing every time we have visited! I did say Look she has dementia & you may need to keep reassessing and/or trying to find out why she can’t swallow or has no appetite & why she is in pain & can’t eat & is losing weight!