OT support for mum

[ChristinaG]

Does anyone have any experience of dealing with OT issues for their loved ones. Mum has been in hospital for getting on for four weeks and while she was fully mobile before she was admitted she is now struggling as she has been in bed lying down for all this time. I have been advised that she will need one of those very large supporting chairs on wheels when she gets to the Home (don't knkw what they are called) so she can be hoisted into it and moved into the lounge area during the day. They managed to hoist her onto a chair for the first time today although it took a lot of persuasion on my part via PALS to make this happen as the hospital had effectivly written her off as bed bound. At least now she has more of a chance to be mobile again. I am struggling with getting the chair in place as i need advice and her GP says it is hospital OT who are responsible so won't speak to me and the Hospital OT say it is the GP who needs to do a referral. That leaves mum with no OT advice or chair and she will struggle if left alone in her room either in bed or propped up on an unsuitable static arm chair chair in the Hin She also has terrible arthritis and her spine in bent right over. She doesn't watch tv listen to the radio or music or read and does get frightened esp during the latter part of the afternoon so she would suffer alone in her room all the time. No doubt it would be difficult for staff to keep an eye on her as well. I have said that mum can fund the chair but it needs to be properly measured to suit her i am told. Everything is such a battle. The hospital were even going to leave the catheter in when she didn't have one before she was admitted to hospital and doesn't need it now.

 

[acorns]

Hallo Christina G - it's good that you are now looking at the return home from hospital. When mum first got home from hospital she had been bed bound for a month. Before going home we got a hospital bed, hoist and Stedy. Then an intermediary care team came out and brought a mobile commode and handling belt. (We already had a zimmer, old commode etc.) No-one has been out since but I've requested an OT and physio visit as mum isn't progressing greatly with these. The Stedy seemed to hurt her knees, but the carer said there was one with a belt on it. The mobile commode's arms fly off if mum grabs them so we apparently need a green bathing commode. It's also difficult to get the sling from the hoist under mum but the carer said there was another kind we can ask for. We are waiting for the OT to come out and hopefully make some changes. We also need a riser recliner but I think we'll have to buy that to specifications like you.

So all this time mum hasn't been getting on very well with any of the equipment. Even her old zimmer frame seems to confuse her. So last weekend a private carer who has a wealth of auxiliary nurse experience was out and she took one arm and I took the other and mum actually walked at least 10 steps twice! After three months of being bed bound too! We just let her lean on the length of one arm and she held the other one! Just goes to show you should never give up ...

 

[ChristinaG]

Sounds good acorns in fact after i raised this physio in hospital got her in a chair. She was listing badly but that is progress. There is still an issue as to who is responsible for OT and as she is in a Home rather than in her own home the hospital OT says she is not their responsibility whereas the drs surgery says she is. Not a good way to operate any service as it means she isn't being supported by anyone. I wonder how many times this happens

 

[acorns]

That sounds strange that they don't know who is responsible for someone going back from hospital to a care home. Could you move things on by asking the local authority, a charity, some kind of patient liaison service or Citizens Advice about the normal procedure? In our case mum wasn't allowed to leave the hospital until everything was in place at the other end. This was a combination of hospital supplied and community supplied equipment.

 

[ChristinaG]

Mum still in hospital and the discharge co ordinator says he has checked and insists it's the Home that needs to arrange OT with a physio so who arranges a physio? Even social services say it's the hospital in addition to the GP. Spoke to the patient liaison service who gave me the contact for hospital OT so going round in circles.

 

[acorns]

Sorry to hear your mum is still in hospital ChristinaG. Do you think your mum could be on a waiting list and no-one has told you? (You've probably checked both hospital and community physio/OT teams to check that already though.) Would there be a local community dementia team who could intercede for you? You should just phone all the hospital and care home teams every day until they get tired of hearing from you and decide to sort it out.

(We still haven't had a physio visit and mum has been out of hospital since mid Jan but apparently there is a long waiting list and a 93 yr old isn't a priority ... ...)

 

[ChristinaG]

Hello acorns. The new nursing home i am hoping mum can go to is assessing her on Monday so i will ask if they can raise it too. She is bed bound although she can be hoisted into a big chair. She will need an air bed to avoid bed sores and one of those recliner chairs. She will also need physio of she has any chance of walking again. Im sorry to hear about your 93 year old mother still waiting for help. It's clearly a problem - what upsets me is how they are passing on the responsibly and i would much rather they were honest. I have chased them and will keep doing so. I am also dealing with mistakes by the hospital. I discovered yet another mistake with my mum's medication yesterday. This is the third serious meds mistake.

 

[Orlaworld]

Technically, any OT should be able to make an assessment as to the correct chair to order for your mum. And you could then go ahead and order it if you are funding it privately, using the recommendations from the OT. If the correct chair was used in hospital, then the OT who saw her should be able to supply you with that assessment. I would ask to speak to that OT and request the assessment.
If they are saying they can’t do that or won’t (and I can’t think why they wouldn’t), then after that, it ought to be a social services OT who could come out to the home and do the same assessment. The issue lies in the funding. If you are up front and say you are privately funding a chair, they may try to wriggle out of the assessment and say it is not their issue. But everyone is entitled to a social services OT assessment even if they don’t then find the equipment, because that way, you are able to get the correct advice and avoid a costly mistake.

I don’t know which area you are from but generally speaking, social services are the usual people for long term + expensive items (regardless of who is paying). Hospital OTs have more expertise with short term and cheaper items.
If you get fobbed off, find out who is the head OT in social services, or just thehead of social services, and talk to them directly. I have done this several times in order to get equipment issues resolved and it often seems to clear misunderstandings up really quickly. It’s surprising how often you get these arguments as to who is to assess or foot the bill.

I addition, you need to know if a hoist assessment has been done to enable the rest home to obtain the correct slings which will just be for your mum and no one else.
And some kind of community rehab referral needs to happen to ensure that OT and physio happens to make some progress towards getting her back on her feet. It does vary from area to area so the names of teams might be different where you are.