New to all this and in a complicated situation, All help gratefully received....

[amigababy]

I've heard from my sister that dm has had a mild stroke last week. The reason I heard from dsis is that me and dm have been NC for 7 years. I live an hour away and dsis abroad (Europe)

Dsis has spoken to the doctor today who says that he recommends 24 hour nursing home care, and neither me or my sister know where to start. I can go for a meeting with the doctor and his secretary, and I can contact the local council tomorrow.

Dm owns her own house, I don't know what other assets she has or her day-to-day finances. There is no df, she has a carer with whom I believe she also has a personal relationship, he doesn't officially "live with" her. I hear that he is a nice person dealing with a difficult situation too and that he means well.

Do you have any advice on how I deal with the council when neither I nor my dsis have any real knowledge of dm's finances, other than the house, which can be valued. What sort of questions should I ask the doctor when I see him, about care and rehabilitation?

[53Dragon]

The 'carer' complicates matters without a doubt. If doc is recommending 24 hour nursing home care then it probably isn't a 'mild' stroke. If there is no prospect of rehabilitation then you need to give the carer notice to leave the house so that he is entitled to be allocated housing by the local authority. (Assuming that he doesn't have anywhere else to live.) Sounds harsh but it's in his best interests if your mother isn't going to be returning home and needing his services. That will be your first step - to ascertain whether there are any prospects of her returning home.
Other than that - the health service relies on the fact that elderly people have caring relatives. If you don't want to get involved long term then it may be better to spell out the situation and tell her doc that social services need to make provision for a care package.

[amigababy]

thanks 53Dragon. I think he has his own home. Maybe I should be brave and speak to him, as well as the doctor (I can call hospital tomorrow)

They said it was mild as she's up and walking. But I think she was fairly confused before it and is now even more so. Anyway the doctor will explain.

Oh dear I'm really good at being organised and life all in little boxes and now it's getting very messy. Not very good at emotional kinds of things

[CMOTDibbler]

Is your mum in hospital now? The best starting point is the hospital social worker, and they will be responsible for ensuring that she is discharged safely.

If your mums level of confusion is the reason for recommending residential care, then something will have to happen in terms of appointing people to manage her affairs, and unless she has made a power of attorney, then she will need her mental competance assesed.

[amigababy]

Yes she's been in about a week, they want to move her to a rehabilitation ward but there is no room there (general NHS problems) so she is on the first ward she was admitted to.

I don't think anyone (the carer) will have a POA.

I didn't know there was a hospital social worker, that sounds good.

[Needmoresleep]

HI,
I agree about the hospital social worker with the aim of ensuring she stays in either hospital or rehab for as long as possible.

Longer term you first need to decide if you want to get involved, either short term to help your sister or whether despite problems in the relationship you want to do the right thing.

I would:

1. Meet the carer and talk things through with him. You want him on side, not least because anyone willing to share the load is a good thing.
   
2. Work out where she is financially. If things are not clear (and I ended up taking a large suitcase of paper home) sort it into ultilites, banks etc. You will need to know how much money there is for immediate care should it be required. (In the early days gong through my mums stuff felt very invasive. However if the carer supports, the paperwork is perhaps the easiest part.)
   
3. Look at access to her money. If there is no POA you might speak to Office of Public Guardian about the next step, and take action if it is felt that the stroke has left her with dimished capacity. If she still has capacity try to get your sister and the carer to line up and tell her she needs to sign a POA. If she is unlikely to trust you, it should probably be your sister. (I would work hard to get the wording so it is both your sister and you and that you can act independently as banks can be funny about adding names of people overseas onto accounts.)
   
4. Have a look at local homes offering nursing/respite care. The hospital will discharge her as soon as she is no longer in need of medical treatment but this does not mean she will be well. If there is rainy day money which you can access, this is a rainy day. A few weeks in a private home will give you a chance to first see what remaining disability she has, and what sort of care levels, adaptations etc, she will need going forward.
   

Also grill everyone you meet. Elderly care is a huge learning curve. If you can pin down a plan for the next few months then that is a good start.

Good luck.