Urgent advice needed to prevent hospital discharge today

[Lynmax]

Please can anyone help. My mother was admitted to hospital on Saturday following a fall at home and has been on an assessment ward. They have done several tests and there are no physical reasons for the fall so they now want to discharge her.

she cannot go home, it is not safe as she lives alone and only has a very limited care package. I want to stop the discharge until we have chance to either get adequate care at home or arrange a care home.

I need to know what to say to the hospital when i go this afternoon, I am afraid that i will find her sat in the day room waiting to go home! What do i need to ask for? I have seen reference on here to best interest meetings or MDT meetings but I'm not sure what they are. Mum does not have a social worker and would be self funding. I have made an urgent referral this morning to Adult Social Care but i doubt i will hear back about an assessment any time soon.

 

[Bunpoots]

Hi @Lynmax

Ask to speak to the hospital social worker. Phone this morning and see if you can speak to her/him before you visit. They have a duty to make sure your mum is discharged safely.

 

[Andrew_McP]

Hospitals and supermarkets are among the most risky places to spend time at the moment. You cant blame them for wanting to get her home ASAP.

 

[Jaded'n'faded]

Sorry to hear this @Lynmax

If you think your mum is well enough to leave hospital it's not good for her to remain there a minute more than necessary!

As she is self funding, why not just take things into your own hands? That would mean either getting a CH to come and assess her which is obviously going to be very difficult right now, or hiring private carers. That's also going to be really hard right now Could you and your sister not cover until you can find extra carers? Presumably she could have another needs assessment at home - that would be better than her remaining in hospital, surely?

I think waiting for the hospital to do the required checks and put everything in place is fine in principle - and at any other time - but realistically things are likely to be very disrupted/disconnected right now. Might be better for your mum to get her back on familiar ground ASAP.

Three years ago I moved my mum from hospital (she'd had a fall and later a bleed on the brain) to a CH without involving SS. I found a home near me, got them to go and assess mum and the deal was done. The hospital discharge team were useless and just grateful I took the problem off their hands. Mum had had no needs assessment of any sort at that time - she refused to demonstrate making a cup of tea to the OT. She was undiagnosed then and I only had EPA which was not registered at the time. Honestly, my advice would be : don't wait for them, just do it.

Wishing you success and good luck

Jx

 

[canary]

As she would be self-funding, you do not have to wait to speak to the hospital SW, you can get on and organise extra care yourself. Speak to her care agency and find out if you can increase the carers.

The problem at the moment, though, is that care agencies just dont have much capacity to take on anything new, I had a phone call from OHs agency saying that it might become difficult to cover his slots, although they would do the best they could, but it might not be the carer on the rota that comes and it might be at the original time. Already, today we had a different carer, who arrived about an hour later than planned.

 

[Lynmax]

I've tried getting more hours from the care agency who currently only visit three times a week - they have no more capacity and might even be unable to fulfill her existing contract.

Adult Social Care - still waiting call back

Phoned 16 care homes - no rooms

I am disabled and cannot do much care, I can't help with showers, toileting, cleaning up the poo left around the house, shopping or anything else. No downstairs bathroom and I struggle with stairs. She cannot live with me for all the above reasons plus she won't use my downstairs bathroom as its not in the right place!

My sister is a key worker and also has two children to look after. My brothers partner is blind and needs a lot of care from him.

So basically, unless my mum goes back to the capacity she had four weeks ago, it is unsafe for her to go home.

I'll try getting hold of the hospital social worker again, I'm hoping that the ward have done that.

 

[Sirena]

I hope you manage to find a solution Lynmax, but I do understand why they will urgently want your mother out of hospital at the moment. Best of luck.

 

[Jaded'n'faded]

Sorry @Lynmax - I didn't realise your sister was a key worker - I know she already cares part time for your mum...

16 care homes with no availability - wow. What a nightmare for you all - stuck between a rock and a hard place

I do hope you get some answers from the hospital.

 

[Lynmax]

Sorry @Lynmax - I didn't realise your sister was a key worker - I know she already cares part time for your mum...

16 care homes with no availability - wow. What a nightmare for you all - stuck between a rock and a hard place

I do hope you get some answers from the hospital.

Yes, my sister is amazing, works 3 or 4 times a week as mums Carer and 3 shifts a week in a supermarket.

However, after my visit today I am more reassured that mum will not be discharged without a care plan although she might need to move wards. I spoke at length to the medical lead who appears to have been very proactive, they are making sure that there is no physical reason for the fall and increased confusion so a head scan is planned for tomorrow. He is going to arrange for an oncologist to assess her to see if the breast cancer has spread. He has already made a referral to the hospital social care team and once all the tests have been done, we will meet with the various teams to agree a care plan. There is no plan to discharge her soon.

He was relieved that we are considering care homes as he does not think mum is safe to return home even with more care visits. I checked that the paperwork had the correct details re her home circumstances and existing care arrangements and hopefully a meeting will be arranged soon. I really like the guy, Jonathan is my new best friend!

I'm glad I went to see her today and had the chance to talk to the main professional. Also I think that visits will be banned now so it was reassuring to see that she was as well as expected and receiving excellent care on the ward.

Mind you, I did need to seperate her from the lady in the next bed, also with dementia, but very loud and annoying mum so mum that mum shouted at her and told her to shut up! We moved mums chair to the other side of the bed and she was able to chat to a lovely, kind lady who did not have dementia but was happy to listen to mum. This lady has no visitors due to the virus, her family are self isolating, so left her my phone number in case she needed something bringing in.

 

[Roseleigh]

I know this sounds awful but get on too adult social care and get them to find a care home that will take your mum. Tell them why you and your sister cannot offer care . Tell them your mother cannot go home as she would be at risk.
This is the only way to get them to find her a place.
Care homes are closing their doors, and if you take on the care you could be doing it for months.

 

[Sarasa]

So glad that your mum isn't going to be discharged until they've investigated further @Lynmax.

 

[canary]

I like that doctor too.
Heres hoping he can open doors (almost literally!)

 

[Jaded'n'faded]

Great to hear you are making progress @Lynmax - must be a relief (somewhat!)

But I'm thinking, if you couldn't find a CH with a vacancy, how is Jonathan going to magically find a vacancy?

This must now be a problem throughout the country

 

[Sirena]

I am glad you found someone so proactive and helpful, Lynmax.

I don't know what the official position is, but I wonder if any care homes will take new residents at the moment, due to the risk of importing the virus.

 

[Lynmax]

Well, Jonathan and I are no longer friends, we've not fallen out but mum has moved wards! She is now on the Elderly Care Ward and has been allocated a hospital social worker to look at her care needs. They are still carrying out more tests, head CT was fine, no evidence of brain damage other the changes associated with Altzheimers but now want to know if there was a physical reason for the constipation which appears to have increased her confusion.

One thing we have noticed in that just two days in hospital, mums mobility has greatly reduced. She has gone from walking confidently around the house, up and down stairs, out in the garden, moving wheely bins and going to local shops on Friday to being very unsteady just walking around her bed today. Mind you, she escaped from the ward today and headed off up the corridor which was a concern as they are nursing covid 19 patients in the side rooms!

I have been told that some care homes will accept new patients in emergency referrals from social care so hopefully the hospital team will be able to sort one out. It might not be one we would want but we would probably accept it then move mum later. But I was still being pressured somewhat in a phone call from the frailty and falls consultant to take mum home - she will submit a report to the social care team but her main aim was to get mum off the ward.

In some ways the increasing lack of mobility is confirming how unsafe a return home would be but it's very sad to see the changes in mum.

We can still visit mum, one visitor at a time for an hour, but I cannot go for a while as I have an upset tummy and diarrhoea - the last thing I want to give mum!