To fight hospital trying to discharge my Dad to Care Home?

[FiveShelties]

My Dad is in hospital and has been for a few weeks. He was admitted with an infection and is now desparately confused, cannot walk without assistance and now has shingles. He was forgetful before admission but is now seeing things/people, sometimes does not know who I am etc. Hospital have said he needs to be in a care home and I need to find one and have him assessed. I would like to see him in some sort of stable condition before he is moved - I do not recognise the man he has become and am really scared about what to do.

[raviolidreaming]

Have the hospital assessed / treated him for delirium?

[FiveShelties]

They say they do not treat deirium

[hatgirl]

Have you asked for him to be assessed by social services?

[FiveShelties]

Sorry - I should have said that the Mental Health Team assessed him with delirium - said it was not dementia, and that he should be treated.

[Alfieisnoisy]

It sounds like he is still unwel and the shingles are causing problems. Are the hospital saying he is now medically fit for discharge but not to home?

I think you need a meeting with them to explain how he was before and to tell them his condition now isn't recognisable to the man he was.

Obviously he could have developed ongoing issues as a result of illness in which case he might do better in a care home.

It's bit easy I know, just went through it all with a relative...although in that case they wanted to send him home when we coukd see he was nowhere near independent enough anymore.

[FiveShelties]

I saw a Social Worker and they said he needs to be in a care home as he cannot be looked after at home.

[Alfieisnoisy]

Say you want him assessed. No hospitals don't treat dementia as an inpatient but I am not sure how the MH team can say it isn't dementia. Have they done brain scans etc?

If it isn't dementia then it's clearly an issue with his current illness and as such he needs to be in hospital.

[DementedUnicorn]

What reason did they give for care at home not being possible?

[FiveShelties]

Hospital have said he is medically fit but he has detoriated again since then and I am being 'reminded' by the person from the care home bed unit (or whatever they are called) that I need to have him assessed by care homes. On has assessed and said he needs Dementia + Nursing. Sorry not trying to drip feed.

[raviolidreaming]

How odd. Some symptoms of delirium - if that's what this is - can certainly be treated, such as hallucinations. Other symptoms, such as acute confusion, may improve with time once the infection has cleared. I'm so sorry you're going through such a difficult time. Is there a mental health liaison team who can see your dad?

[Welshmaenad]

Ok, some questions.

Is he clinically well enough for discharge? Does he actually need to be in hospital to receive necessary treatment?

Why has the hospital social worker concluded that he cannot cope at home? What assessments have been completed to lead her to this conclusion?

How old is your dad? How well was he coping at home before he was admitted? Did he have care at home previously?

What does your dad want?

What do you want?

[FiveShelties]

I dont think my Mum could cope with him at home - he cannot follow what you say --- if you say put you hand here he does not seem to understand. He is needing two people to help him stand up and sit down. Social worker said he would need too much care at home

[FiveShelties]

He is 86 and has never had any care - only been in hospital once before this - he does not know he is in hospital, Thinks he is in prison.

My Mum and I just want him to be safe and well care for and I am terrified of making the wrong decision in what sort of home he needs

[raviolidreaming]

Sorry, it moved on a bit whilst I was typing!
If he's been assessed as having a delirium, they need to treat that. If he has deteriorated, it could well be that his infection markers are rising again.
It would absolutely not be usual at all to diagnose dementia whilst someone is presenting with a delirium as their cognition will be so impaired due to the delirium - aside from scans, it would be an unfair test.

[FiveShelties]

Apologies for my terrible spelling and typing - am a tiny bit stressed. Thank you for replying to me

[Doilooklikeatourist]

Just been through this with my Dad , he spent 3 months in hospital , neither getting better or worse , but once in a NURSING home , rather than a care hone his health improved tremendously
Never able to return home as he needed constant care ( doubly incontinent , blind , unable to walk , sit up or feed himself )
Dad had dementia though
Urine infection can make elderly people very confused
What sort of care will he need ?
Is there any one able to care for him at home , there will be social workers working with the hospital , and attached to his GP ( I think )

[libertydoddle]

Even if you have to pay for it the social worker should do the assessment to be clear about what type of care he needs. If he has dementia he will need a different type of care home than if he has just physical health needs.

Ask if the confusion is due to the infection or if he has a condition that causes dementia such as alzheimers. From what you say it sounds like he should have a period of intermediate care or rehabilitation first. In a calmer environment that a general hospital and which the infection cleared the confusion may improve. With proper physio / OT he may be able to get mobile again.

Keep asking questions. Ask to see the consultant, ask them if a 'continuing care assessment has been done, ask if he has been considered for intermediate care. Do not just accept a poorly planned discharge as if he goes to the wrong type of home he will be back in hospital again in no time.

[FluffyPanda]

Have they checked for urine infections?

[Welshmaenad]

It's a really daunting decision.

Despite your thread title though it seems as though you feel the hospital are correct and he would not be safe at home, so maybe the right residential care setting would be the best option?

[raviolidreaming]

I would ask to speak to the mental health team for advice. They have assessed him as a delirium - which sounds likely given your account of him prior to admission and now - and should be able to liaise on your behalf with the medical staff.

[Doilooklikeatourist]

Sorry X posted
It does sound too much for your mum to cope with though

[gillybeanz]

I'm sorry you are going through this, it must be awful for you.
I am puzzled as what you want to fight against?
Do you not think that a care home would be the best place for him if he can't be cared for in his own home?

[Welshmaenad]

YY to intermediate/rehab care as liberty suggested if this is available in your LHB. Ask, definitely.

[JimmyGreavesMoustache]

hmm
i would suggest if delirium not dementia then a spell in intermediate care would be worth exploring - this is a (approx) 6 week stay in a temporary care facility for those still too ill/fragile to go home, but no longer in need of an acute hospital bed. Ask if this has been looked at (it should be under the Care Act).

Further, it might be his responsibility to pay for his care, but it isn't his responsibility (and by extension not yours) to arrange it. Again, under the Care Act the duty to meet his needs is with the local authority.

[JimmyGreavesMoustache]

massive x post