Who is involved in making the decision?

[Senga]

Following on from my recent posts, can anyone tell me how many 'professionals' are involved in making a CH decision.

Having had the trauma of a broken hip, home after 3 weeks - 11 days later another fall resulting in a broken shoulder, I am concerned this CH decision has been taken too early. This all started on the 4th July, firstly my sister had a very bad reaction to the anasthesia which took almost a full week to settle. Then, (I blame the catheter being left in too long), she had a full blown UTI. Since then she has had about 5 UTI's which they tell me can be normal, of course they have not helped in the confusion.

When I was informed she would have to go into a CH I was told it was the Doctor's decision. They said she is incontinent but when she is out at the outdoor canteen she always asks me to take her to the toilet. She has taken dislikes to some of the nurses and just won't ask them..... I raised this and said that if and when she is mobile enough to go on her own to the toilet I didn't think there would be a problem.

My huge worry is that she is being pushed into a CH without being given enough time to recover. Hubby said she was perfectly lucid yesterday...., I'm honestly not trying to deny it is a very strong possibility that she does need to be in a CH but I need to know it was more than just 'the Doctor', who is making this life changing decision for us.

 

[FifiMo]

I don't want to raise your hopes but it is another reason for not breaking up her home too soon. If it is a sheltered housing place that would be in her favour and like you said maybe with some carers around she might manage at home. Another option could be a rehabilitation place first to get her mobile again but she might need some help from you if she is confused to get her to do the exercises. Now that things have settled down do you see any improvement in her confusion etc?

As to who makes the decision it should be a joint one with your sister, consultant, nursing sister, social worker and occupational therapist. This is normally referred to as a Best Interest meeting. My mother's consultant said care home, then the next thing we know she was sent home in a taxi!!! Like I said to you before, it took 3 months to see an improvement in my mum following her hospital stay. We were told the confusion can be a combination of the shock of a fall, pain, being in a strange place, effects of the anaesthetic, UTI etc.

If you see an improvement in your sister and you feel she would cope at home with carers then ask for a Best Interests meeting. Before this meeting an occupational therapist might take her home to see how she is at home. They will give their views at the meeting. They may say that with some changes that she could go home. Eg grab rails in strategic places or maybe a hand rail. You might have to speak up on her behalf to get them to at least explore the options. At the end of the day it is cheaper for the council if she is at home with support.

Hope this helps,

Fiona

 

[sue38]

You might want to have a look at the Society's factsheet on The Mental Capacity Act. Anyone making decisions on behalf of your sister should comply with the Code of Practice which includes a duty to consult with close relatives.

If I were you I would be asking the doctor to demonstrate how he has complied with his duties under the code.

 

[Senga]

I thought I would hold off posting till I had spent some more time with my sister, just to see if there was any change whatsoever.

That was last Thursday hubby did the visit and had said she was pretty good. He also went on Friday, she remembered he had been up the day, before he said they had managed to hold a decent conversation, although he said she did get a little confused toward the end of the visit.

I went up on Saturday and was really pleased with her. Again she remembered hubby had been up twice, had a laugh about them getting caught in the rain. When I was chatting to her about my friend and what was happening in her life, (new man), my sister held the whole conversation, also giving her opinions. As I have said, I am sure if she got some mobility back and could do toilet duty herself then the incontinence problem could be addressed,. Another sign that she was coming back to herself was, when I had to help her, she said how she hated this and how embarrassing it was. She had never actually seemed to realise this before.

I went back up today, took her to the canteen where my son and granddaughter joined us. She laughed with the girls and chatted to my son, albeit, a slightly limited conversation.

Now I am utterly terrified as I am sure they have made this decision far too early and are not giving her the chance she deserves. Do I wait to speak to the SW or do I ask for a meeting with the Doctor who has decided this?

Thanks to all.

 

[nannis]

my mother in law

the docters have made the decision that my mum in law has to go into a care home as she is a danger to her self as she has alzheimers middle stage and diabetis so she cannot live on her own any more as she forgets if she has had her meds and she could go into a coma jn her sleep and die but she is refusing to go to nthis care home which is a lovely place and her room is ready for her she is in hospital at the moment we have been told now because she keeps refusing she is to be seen by a mental health doctor and could be sectioned can a care accept a sectioned patient or will she have to go into a mental health long time unit

 

[zena285]

When my mum was in hospital for assessment last year (they told us for two weeks, it turned into ten), we had a number of people turn up at best interest meetings, the consultant, his helper, the hospital SW, mum's mental health nurse and me, my sister and my mum, not that my mum knew what was going on! We were then told that the hospital had decided that mum would be going straight into a NH, so we argued that she wasn't as we didn't think they had exhausted every option of keeping her at home and this is why the stay in hospital lasted ten weeks, we had a number of best interest meetings after that, I think they thought they were going to wear us down....it didn't work! So after that the hospital contacted an independent advocaate to represent mum, and he agreed that mum should be allowed to go home with support so she did, I always think much to the annoyance of the hospital.
She had carers in twice a day, daycare four days a week but she wouldn't let the carers in and would leave the daycare so she ended up in a Care Home five months later but at least we tried, and it gives a little peace of mind to us.