Mums ankle fractured in four places..... But what happens now? Advice please

Discussion in 'I care for a person with dementia' started by Buskitten, Jan 8, 2019.

  1. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    #1 Buskitten, Jan 8, 2019
    Last edited: Jan 8, 2019
    Hi again everyone, me again
    following a fall / accident ( we don't really know) on saturday, mum was visited by a GP at home yesterday and sent to hospital where a multiple fracture was diagnosed and treated. Ok, so I'm 400 miles away, I arranged the GP visit, as she would have done nothing to address the situation
    mum has significant cognitive impairment although if you just met her in, for example A and E, you wouldn't necessarily know this; she has come home from hospital in a cast, and has poor mobility. She lives alone in a house with stairs and will undoubtedly find navigation difficult, indeed dangerous especially since she has her leg in plaster now, in addition to her already rickety state.
    guys do I now telephone her local social services or the doctor to ask about a care plan / safeguarding strategy whilst she recovers from the injury? her memory issues are not formally diagnosed yet and this physical injury has now exacibated a situation which I already felt was tenuous. I'm sorry if I'm repeating myself i don't know what to do to help her - she's so vulnerable. I have no doubt she will have said she's ok and has loads of support in the village where she lives.... This is not the case, but she will seem very plausible to health care professionals and I imagine they've just let her go home. I can't even see how she'll manage her stairs to get to bed / bathroon, let alone undress Etc......... Oh such worry
    Sorry for all these questions xxxxx
     
  2. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    Oh, I think someone said yesterday to ask the Dr to refer to social services re safeguarding. I asked mum last night if she felt she could benefit from a bit of help; she said no. Do I ignore her and go ahead and try and get her some enablement help? Surely I shouldn't do nothing when I know she's at risk? It's so hard to know what to do for the best.
     
  3. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,951
    Suffolk
    Ignore her. Needs over wants at this stage.
     
  4. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    Yes that's what I thought sparmar
     
  5. canary

    canary Registered User

    Feb 25, 2014
    10,256
    Female
    South coast
    I would certainly contact the GP about this.
     
  6. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    Ok canary thank you I'll ring them now
     
  7. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    Made a referral to Adult Social Services by voice mail and email so waiting to hear back.....
    Thanks for your help everyone :)
     
  8. sinkhole

    sinkhole Registered User

    Jan 28, 2015
    269
    Presumably they only asked her if she was OK to go home and she said yes?

    A lot of assumptions are often made by hospitals, but IMO she needs some care and it sounds like it's got to the point where you'll just have to do what's right for her and not what she thinks is right.

    My experience is that once some care is in place she will come to accept it and then it will get easier to increase it as and when necessary.
     
  9. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    Hi Sinkhole, yes - referral made now I wait to hear from the team to see how / if they can help mum at her home :) I was also thinking to employ a sort of cleaner / keep-an-eye-on sort of person ( a local person ) for a couple of hours a week to ensure fridge / bathrooms etc are kept on top of; what do you think?
     
  10. sinkhole

    sinkhole Registered User

    Jan 28, 2015
    269
    Do you have someone in mind you can trust? If not, I would personally recommend using an agency for that as there's more come back and protection if something goes wrong.

    Anything is a start. You just need to build up trust with her so she sees you are doing this for the right reasons.
     
  11. Fullticket

    Fullticket Registered User

    Apr 19, 2016
    460
    Chard, Somerset
    I am surprised (appalled actually) that she was discharged with no checks on her ability to look after herself on her own, in a home with stairs and given her age. I can only guess that she told them something like her daughter would look after her and no-one looked any deeper than that sentence, i.e. where does your daughter live, what is her telephone number? Sorry, just a comment and no practical help to you at all given your situation at the moment.
     
  12. jenniferjean

    jenniferjean Registered User

    Apr 2, 2016
    403
    Female
    Basingstoke, Hampshire
    It might be a good idea to put her doctor in the picture too. They are usually able to put pressure on SS for a quick response.
     
  13. sinkhole

    sinkhole Registered User

    Jan 28, 2015
    269
    My view, having dealt with 3 different hospitals in relation to my mum and her sister in the last couple of years, is that they often ask the questions hoping to get answers which justify discharging the patient, rather than looking for reasons why they shouldn't be discharged. They have targets and time pressures on them all the time of course, but it's not a 'joined up' service they give. There seems to be little or no communication between hospital, GP and the patient's family in these situations.

    I've spent this morning ringing around trying to find out what my mum's new prescription should be after the hospital stopped her Tramadol on Sunday. So far, nobody can tell me as there's "nothing on the system yet".

    Same thing happened to my aunt when she had a fall on a bus. The hospital knew she had dementia but took her word that she was OK to go home. At the time, she lived on her own in a badly-maintained house with 3 flights of steep stairs, littered with hoarded junk. It was a health hazard for a young, fit person let alone her!
     
  14. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,507
    Female
    From what you have said in your previous posts I am not sure it is tenable for your mother to live on her own without daily care anyway - and definitely not now she has a broken ankle, she is at high risk of falling again. It is really difficult when she seems lucid to health professionals, and says she doesn't need help, but you have to your best to get that help for her. I hope you emphasised to SS that this is urgent, otherwise it could be weeks before they even visit to assess her. If you speak to the GP, he should be able to escalate it with SS, but if you don't hear back quickly keep trying.
     
  15. jugglingmum

    jugglingmum Registered User

    Jan 5, 2014
    5,067
    Female
    Chester
    Re hospitals - before the crisis happened my mum was in hospital with cellulitis for a week, and went home by taxi.

    She refused to let the hospital contact any relatives (which should have rung alarm bells) as we were busy with work and young children and she didn't want to worry us. She also refused to let them arrange for anyone to go to her house and collect clothing. This was as her house was hoarded and no one would have been able to find anything - we weren't aware of this, but this is also the reason she didn't want us contacted as she knew I wouldn't let her carry on living like that. I was too ignorant of dementia and other hoarding issues at the time for alarm bells to ring and it was another 2 years before crisis happened. (I was aware things were wrong, but hostess mode was papering over a lot of cracks).

    The wording of the mental health act doesn't take into account the changes in the brain and social services are so scared of contravening this that they take someone saying they are OK and can cope at face value and move on to the next on the list.

    @Buskitten - despite the apparent urgency of the situation, it might take some time to get SS to visit, and they might say your mum refused intervention.

    I am assuming your mum is self funding, and if so you need to be extremely assertive with her, and take over and arrange things, if this is possible. This is a chance to take this as the crisis that lets you in the door to sort things out.

    Even to the point of suggesting she stays in a care home near you, if you can find one, until she has recovered and then you return her home, this might buy you time to find somewhere near you for her to rent, and have care in place.

    To me the idea of supporting a parent in their own home is very hard to put into practice when they are 100 miles away when they have got to the stage of struggling to cope without any outside help. It isn't just about your mother's best interests but yours as well.
     
  16. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,507
    Female
    Yes I agree. I lived a long distance from my mother and she managed for a while with care in her own home (4-6 hours a day), but that was made easier because she was amenable to accepting help, didn't have any other health problems/injuries, and she was self funding and I had LPA. It worked fine for 18 months but she now needs supervision 24/7 and is in a care home near me. If she had been resistant to help or relied on SS care, it would have been a nightmare.
     
  17. Rosettastone57

    Rosettastone57 Registered User

    Oct 27, 2016
    978
    If your mother is self funding personally I would just go ahead and make some sort of care arrangements yourself. With my mother in law as we already had power of attorney for finances I was simply able to arrange the care whether she liked it or not. To outsiders my mother-in-law appeared very capable but in actual fact she could do nothing for herself. To be blunt if you wait for a person with dementia to ask for help or see your point of view you will wait forever
     
  18. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    Hi everyone and again, thank you for your comprehensive replies and good advice. An update is that Hereford social services were completely on the ball and got back to me really quickly with a list of agencies and support to look through - as she is self funding, she can cherry pick - well, I can ! I've spoken to mum who is accepting to having some help " while she recovers " this has at least bought me some time. I will now ring around and get her some help for the next month or so at least. I feel a bit better as to think of her all alone there is gut wrenching . Just to have someone popping in and helping her with a few tasks would be such a relief.
    thank you again for taking the time and trouble to offer such helpful advice xxx
     
  19. Buskitten

    Buskitten Registered User

    Dec 10, 2018
    77
    Oh forgot to tell you, an occupational home assessment is also being arranged to see what the house needs in way of mobility aids, key safe etc so that sounds like it could be helpful
     
  20. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,624
    USA
    I'm so sorry to hear about the fracture and you must be frantic with worry from so far away.

    Sadly, yes, this is the crisis that gives you the opportunity to get care in place.

    I would put everything in place that you can: a cleaner, carers, a day centre, changes to the house, even having her stay in a care home or nursing/rehabilitation facility. Whatever you put in place, blame it all on the hospital, the doctors, social services, anyone's idea but yours!

    Now is the time for the care she needs. I wouldn't ask permission or discuss any of this with her, just get on with it. If it wouldn't be difficult and painful to move her, I would suggest putting her in a rehabilitation facility near you. Best wishes and please keep us updated.
     

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