Stroke etc.

[Christelle2207]

Hi. Hope someone can help. My FiL (83) had a stroke a few days ago. He's in a fairly bad way - a bit early to tell but essentially this is the latest episode in a long string of health issues. We don't expect any kind of meaningful recovery, no one expects him to be with us for more than a matter of months. Anyway, the pressing concern is that being discharged home seems currently seems very difficult due to there being stairs and no downstairs bathroom. Moving a bed downstairs for him and getting a commode etc. might be an option if he gets some mobility back. My PiL are not rich but have savings and own their £400kish home outright. If he does come home, is any kind of home help likely to be available, paid for or otherwise? Will the hospital let him be discharged without ensuring some
Kind of reasonable plan is in place? We are worried that MiL will say she can look after him but the truth is she can't. That said if someone was able to come and attend to his basic needs on a regular basis it might be possible. Or should we just start looking at nursing homes straight away?

[Christelle2207]

Thanks in advance, everything seems so uncertain and confusing atm.

[Theas18]

Welcome to elderly parents op.

Firstly the should not discharge him until his care needs are asessed and a package agreed. Unfortunately a wife who says " it's ok I'll manage" could be a difficulty....

A package of transitional care seems easily put in place here - up to 4x day carers but your mum has to accept them.... Here that's for 2 weeks then it gets dodgy as they get reassessed .i think that is the point things become chargeable properly too.

If the stairs are simple I'd really suggest you look on eBay at recon stair lifts. We got a stannah from stannah as a recon really quite cheaply and more importantly in was in within days and has been a godsend. Even if mil uses it when tired or for heavy stuff initially as my parents did ! (Bought when dad was having awful gout).

The only financial thing I'd say is spend the savings- esp on important things like holidays/ memories and upkeep / adaptations to the house or even getting the care your mum wants/ needs for him rather than soc services help. My parents relised this too late really. They Did get the one last holiday but could have had more if they hadn't said " that's a lot " when things were proposed. The money will now go on dads care. (We are planning to rent the house though rather than sell as itll yield income to pay care fees long term then ).

If your mum is living in the house that's not an issue though.

[PingPongBat]

IME the hospital will be super keen to discharge your FIL as they will need his bed. That's the reality of elderly people and hospitals, sadly.

Make sure that SS are involved as early as possible to assess his needs and make sure that he gets the reablement care that he is entitled to. Reablement is up to 6 weeks of free care & is arranged via the local authority, so maybe get in touch with them if you haven't already.

During the 6 weeks they should do further/more detailed assessment of his care needs and, this really important - your MIL’s needs & capabilities as well. They’ll do a financial assessment which will decide who pays for longer term care. If your FIL’s severely incapacitated then the hospital discharge team should look at CHC funding which pays for everything, but from what I’ve read on here it’s a bit of a postcode lottery & many people have had to fight long and hard for it.

[Needmoresleep]

Basics:

1. Is a Power of Attorney set up. If he has the capacity he needs to do it now. Ditto your MIL, so that if something happens to her you or her children can make appropriate decisions.
   

1. Have you spoken to Social Services. There will be someone at the hospital or you can call the local SS directly. Explain to your MIL that having a home assessment will help identify what adaptations are needed and perhaps funding for those adaptations. Hopefully it will cause home discharge to be delayed until a care package is in place. I would push for rehab/convalescence first. SS will be able to give your MIL information about local services eg volunteers, or perhaps day centres so she can recveive on-going support.
   

1. He should apply for Attendence Allowance and she for Carers Allowance. These are not means tested and can be used for whatever they feel is necesscary.
   

I am no expert on who pays for what, but others will be.

[thereinmadnesslies]

Ask the hospital for a copy of their discharge policy. If they try to discharge before a care package is in place, you can refuse the discharge on the grounds that it is an unsafe discharge of a vulnerable person. There should be a discharge coordinator and a hospital based social services team, ask to discuss the situation with both.

It sounds horrible but now is the best time to push for a proper assessment of care needs, while your FIL is taking up a bed. Once he is discharged it will be much harder to get social services to do assessments and provide care.

[Christelle2207]

This is all extremely helpful- I am new to all of this and it's difficult to know where to start. Unfortunately there has been no improvement at all and as it stands we can't see him being discharged home. He cant do anything for himself and it turns out the stairs at home are unsuitable for stairlifts. He also weighs a ton and currently needs 4 nurses at once to move him. Luckily MiL seems to have realised this and is pretty much adamant now that he won't be going home as she can't look after him. She is also willing and able to pay for care (for now) which is good I suppose. Power of attorney was sorted some time ago. Hospital is targeting discharge in 12 days which seems to have panicked MiL somewhat but I think this is good as she I think will be proactive now in dealing with the council etc. in finding out what can be done. A very sad situation, he didn't recognise anyone yesterday apparently though today definitely enjoyed a short visit from our baby son. There's no good options are there, just less bad ones

[PingPongBat]

Christelle have a look at this, to see whether he might be eligible for CHC funding - i.e. fully paid for care - there's a checklist you can download to see whether he meets the criteria. If you think he might, then push for a CHC assessment in hospital - www.nhs.uk/Conditions/social-care-and-support-guide/Pages/nhs-continuing-care.aspx

[Christelle2207]

That's incredibly helpful, thanks.
Certainly meets the checklist.