What are the alternatives to a nursing home?

Discussion in 'I care for a person with dementia' started by Dayperson, Aug 17, 2019.

  1. Dayperson

    Dayperson Registered User

    Feb 18, 2015
    277
    Female
    Shropshire
    My relative has been in hospital for what seems like an eternity and this has left her immobile. I guess the hospital is trying the physio to try to get her moving again but has anyone had experience of this (a long hospital stay and getting mobile after a long period)?

    Is it even possible or does it depend on the dementia type and co-operation of the person involved?

    What are the possible outcomes?

    Is it inevitable she will end up in a care home / nursing home or would it be possible to apply for a council flat to suit our needs i.e. large wet room and ground floor? Does the council have a duty of care to provide us a flat with a wet room because we have someone with dementia?

    I guess the social worker will push for a nursing home as the 'easy option'.
     
  2. Banjomansmate

    Banjomansmate Registered User

    Jan 13, 2019
    1,074
    Female
    Dorset
    The Banjoman’s cognition means that after his operation to repair his broken femur he was unable to interact with the physiotherapist to do the exercises to get him back walking so it may depend on your relative’s mental ability as to whether or not they can get back on their feet again.
     
  3. charlie10

    charlie10 Registered User

    Dec 20, 2018
    293
    My FiL spent about 6 weeks in hospital earlier this year......broken hip followed by pneumonia etc. During ths time he had some fairly scary delirium (fighting with the nurses, refusing treatment etc) and we thought his mental state had deteriorated.....he also became extremely weak, to the point of having to be turned in bed and propped up in a chair. We managed to get him into a Reablement unit for 2 weeks where he had more physio (the hospital physios had got him to the stage of standing and doing one step) and then he was discharged home (lives alone, one carer visit a day, and BiL visits once a week). Over the last 4 months or so he has progressed to the point where he can walk a dozen steps to his kitchen area to make a cuppa, microwave his dinner etc (lives downstairs now) with a zimmer, and if he goes out to appointments he uses a wheelchair.

    There was a point when we were certain he would never get out of bed again, I'm really happy we were wrong! Before his fall his mobility wasn't great, but the long period of bed rest and possibly the delirium made it so much worse......it took time to get him back to where he is now, but it shows what a tough nut he is at 91!

    Of course it may be entirely different for your relative.....as Banjomansmate said it also depends on their ability to follow instructions and do the necessary, but maybe there is still hope for them regaining some mobility over time......nothing is written in stone and surprises seem to be the norm rather than the exception
     
  4. TNJJ

    TNJJ Registered User

    May 7, 2019
    332
    #4 TNJJ, Aug 18, 2019
    Last edited: Aug 18, 2019
    Hi.My dad had a stroke in 2016 ,then again in 2017. He has left sided weakness and can only walk about 6steps with a gutter frame.He is 86 and I would say now in the middle stages of VD.When we go out he goes into a wheelchair.He has 4 care visits a day and lives at home alone.So your relative could go home.Dad does NOT have wet room.He cannot use his shower so he goes 1 a month to a care home for a bath and some day care.That is all he would agree too.(has capacIty)The rest of the time he has a strip wash with the carers....He also has a catheter.I have just asked for some new equipment for dad.A wheeled commode,which hopefully will help everyone..Hope this helps.
    ;)
     
  5. Dayperson

    Dayperson Registered User

    Feb 18, 2015
    277
    Female
    Shropshire
    Thanks for the replies, I guess you've given me some hope we can get mum home again
     
  6. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,141
    The physio should be able to advise on whether further physio/rehab would increase mobility. Is your relative ready for discharge? If so an assessment should be carried out into her care needs. Is she self-funding? If not social services will not push for a nursing home as the 'easy option'. They will go for the cheapest option, with a care home as the last resort. They will try a package of care at home first, unless her care needs are such that this would not be suitable. Did she already have a package of care in place prior to hospital admission?

    What type of accommodation is she in at the moment - is it a council flat? If she owns her own home or is privately renting the council don't have a duty of care to provide her with a council flat. If she is deemed as being able to go home on discharge then occupational therapy can visit to recommend/provide any equipment, and if she owns her property she could apply for a grant for adaptions such as a wet room. I think you need to wait for a needs assessment prior to discharge to discuss with social services what the options are and then take it from there.
     
  7. RosettaT

    RosettaT Registered User

    Sep 9, 2018
    232
    Female
    Mid Lincs
    My OH went into hospital from walking 3 miles a day to staying in bed for 12 weeks for 95% of time and of course lost all mobility. TBH they were basically too busy to get him up and out of bed even in rehab. He was in there 3 weeks when I spat the dummy and was told 'I have 23 other patients and there is only me' to which I replied 'Not my problem that is yours and your departments, my OH is my concern'. She then told me he couldn't walk and was gobsmacked when I said well he walked to the trolley when he was transferred here so any further loss is down to you'. The ambulance team didn't realise he wasn't fully mobile so with their encouragement he got up and shuffled to the trolley. I have to say I had to fight to get him rehab because they saw his diagnosed and wrote him off because they said wouldn't be able to follow instruction. I knew he could (and he still can!)

    Within 24hrs we (I insisted I was there) had him walking 30yrds within 4 days he walked a 100. Unfortunately he was then 999d back to A&E and was flat on his back again with another infection for a month.
    I was told he could have physio at home but it never materialised, in fact there is a 4mth waiting list here, so I went private for him.
    It has done him the world of good, he couldn't even feed himself when he came home. It's only once a week and is taking time. He still can't walk but can bear his own weight and we are talking of going from a hoist to a Sara Stedy it will be so much easier for me and better for him. His whole mobility has improved, His sitting, his arm movements, everything. Expensive going private but a decision I don't regret. The important thing is they did an assessment first to see if they thought physio would help and she is a specialist in Neurological conditions.
     
  8. TNJJ

    TNJJ Registered User

    May 7, 2019
    332
    you can apply for a grant for a wet room.But dad is self funding and over the threshold so he would have to pay for it himself.
     
  9. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    2,894
    Nottinghamshire
    My dad was in hospital for about two months. He was walking (shuffling) when he went in but the hospital staff said he was unable to walk or to take instruction. However one nurse there told me my dad was walking - it just took time and patience to get him up and he could walk to to toilet with a frame. So don’t give up hope.

    Dad was later transferred to an EMI carehome where the hospital informed them that he was non mobile, rotunda transfers. I asked if he was walking, was told no, and then explained what had happened in hospital - how only one nurse had him walking. So they tried and found he could walk...

    I think hospital staff don’t have the know how or the time to help PWD to get back on their feet.
     
  10. Philbo

    Philbo Registered User

    Feb 28, 2017
    661
    Male
    Kent
    If you see my post "Respite Woes", my wife has ended up in a NHS run respite care facility for an assessment period (up to 6 weeks), following admission to A&E from the same unit (she was on 2 week respite stay).

    So due to a large blister on her heal and then a mini seizure due to a UTI, she has been virtually immobile for the last 2 weeks (she walked into the respite centre, albeit she was getting to shuffle a bit).

    The care centre have been hoisting her out of bed etc but yesterday (whilst she was more alert) I was sitting facing her and holding her hands. She started to lean forward as though trying to stand so I quickly stood by her side and put my arm under her upper arm and help her to stand.

    She manged with my help to stand up and bear weight for a couple of minutes before I sat her down again. I did this a couple of more times and one of the staff came over and said how surprised she was to see this. However, she explained that they were not allowed to assist someone in this way - they can only place their hand in the small of their back to help steady, rather than lifting in any way.

    I do get the H&S issues, risk assessments, approved practices etc but at the end of the day, I can get her more mobile without, in my opinion, causing harm to my wife or myself. Their "approved" procedures mean she is likely to remain immobile!

    I am waiting for tomorrow, so I can discuss further with the unit manager but it is exhausting trying to fight all these battles.
     

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