DM about to dangerously discharge

On the face of it, I'm ideally placed to take care of my father - I'm retired, no dependent children, DH still fit and active, live 10mins walk away etc. But I wasn't willing to do it (he would drive me distracted), and I found SS and indeed hospital discharge team very sympathetic to that. I was under not pressure to "do my duty as a daughter".

A key safe is a good idea. I think you can get them from B&Q. That's 5 visits some days including the district nurse. That's good news. Maybe she will feel more secure having people call more frequently and you will have a bit more of a break. I'm a community nurse and I see some relatives exhausted caring for an elderly relative. Make sure you make time for yourself.

How are the carers going to get in to her house? Is there a key safe or something in place?

It's going to be ok Dorset. She's going to have people in and out all day, she'll be eating regularly and they will be reminding her to take her medication. There will be people other than you keeping an eye on her so you don't need to feel that you are bearing that load by yourself.

Now I've made you feel better, the next thing to brace yourself for is her getting rid of the carers.

Argh cross posted. Glad it's all set up OP. That's great news

Very few alarms work like that, it goes to central monitoring centre and they call one of the two emergency contacts on her file. Unless it's clear that she has fallen or has a fire /needs an ambulance/ fire service they call the relative /neighbour to go check first or to meet ambulance there. It's hard (almost impossible!) to get an agency to agree to be emergency responder for a client with lifeline (unless your area has a specially funded service which most don't)

Well if she goes home without care set up she'll just bounce back into hospital again or have a rotten time. Don't facilitate it. It's fine to say tell mum once care has been set up to start I'll pop round but I'm not stepping in for a discharge before we have a start date,

Carers are working during this period, but all care agencies are busy so it takes time to find her slots again. That's not adult services being difficult, that's just how agencies work as 28 visits a week (4x daily x 7 days) is a lot to cover and weekly rotas may have already been sent out - so that's a lot of rejigging for care cordinator in agency to do as they have to guarantee they can cover every care call from that point, before they can accept a package even if it's a restart.

Please take a mental step back. If mum has capacity she knows the risks even if not acknowledging them. Ward staff can do MCA.

She's been admitted to hospital 3 x recently despite a 4x daily package, this tells the story that she's not really coping or that her health is deteriorating / fluctuating a lot. You can't prevent the road she's on with worry or angst in your part, nor fix it for her.

It's what she needs to do for her own sense of control until she feels ready to listen or accept her limits now. Or for increasing evidence that she's losing capacity or being unrealistic

All you can do is be wise, give advice, stay strong, remind her the nhs rehab unit will be her best opportunity to increase her strength, get more mobile and well enough to stay independent at home longer but it's her call, You don't need to step in to fix her choices, she's likely going to fall again soon and it sounds like she'll need to keep failing before she accepts she might need more.

It's very hard I know but you must step away. Do not go and get her. You need to tell social services and the hospital what you have told us here - you are a key worker, you have children of your own to care for, and so you CANNOT take on your mother's care. I had to get used to including 'I work full time, I'm a parent myself with primary age child, my husband works away and I live a two hour drive away' in all conversations about my dad's care. Social services didn't like it but they had to accept it. Get your statement in and make it clear they will be responsible if she has any problems after discharge.
The alarm shouldn't be for you to respond to. You need what I know as a 'community alarm' that if pressed goes to a central team who will answer it and go to the house if necessary. You have to pay, but it's worth doing.

Will have my fingers and toes crossed for you

This may sound uncaring and cruel but go off grid to your mum for the next 72 hours. Be absolutely unavailable to her; she is safe and she needs to rest. This is your time to rest and recover, too.

Five years ago this week my DF had a catastrophic accident after getting discharged too early. He was back in hospital after just four days and died 96 hrs later. Know what you are going through.

Keep strong Dorset

My MiL once told my DH that it was his job to look after her.

Sorry I haven’t read your previous threads but are you able to have your mother home with you until her care package is in place?

The hospital will be penalised for a 'failed discharge', where a patient is returned to hospital within a short time of being discharged.

The pressure for beds is so great, that bed managers will try to override and pressure clinical, patient facing staff to get beds ready for the next patients.

Reiterate that you cannot cope, that she needs a physical needs/occupational therapy assessment, a detailed dementia assessment, a proper care package in place and her needs and discharge need to be flagged up with the district nurse team and the GP.

Do not back up any statement relayed to you from your mother.

You cannot physically cope with your mother, her neighbours are just as frail as she is, there is no support in the community and the discharge will be unsafe.

Don't go and pick her up. I'd be suspicious of her capacity assessment as her 'weighing up information' seems to be my daughter and all the neighbours will do everything for me plus I'll be fine anyway

Well she isn't fine and you and the neighbours aren't doing everything to help her.

Don't go, stick to medical advice. Has she had a proper memory test such as a MOCA or ACE-III?

Sadly an unwise decision does not mean someone lacks capacity.

Care alarms are really easy to install and there are multiple options available all doing the same thing, a quick google will sort the. But it does depend on her actually wearing it...

Yes you would go down as the next of kin but you are under no obligation to turn up to help her if she calls for assistance, it would go through their call handlers, and if she's fallen or sounds hurt they will call an ambulance for her. And yes that can be a waste of resources but it's all in a day's work for them and gets her back in front of the NHS for more assessments and oversight.

basicaly stall her!

as a suggestion if/ when DM calls you, youre "looking" for the key /misplaced whatever, cant drop it off today (too busy, sorting her home, shopping blah di blah.....).

Id say DONT drop her key or purse! without those she can`t go anywhere!!

I can empathise with you. My DM is exactly the same, she has been assessed as having the capability to make decisions. Sadly she makes unsafe and even dangerous decisions.

DSis and I are both physically and mentally burnt out. After three hospital admissions in ten days during lockdown the hospital had a right go at DSis. She stood her ground and asked them what exactly are we supposed to do? They had no answers.
We've both withdrawn our support and refused to enable her behaviour. It's hard but necessary.
Good luck and please look after yourself

We can't always have what we want, (right now I want a holiday), when I was growing up the line was "I want gets nothing" which is handy now because I repeat it back. She wants to go home but she needs to stay there. You are both adults, what's she going to do if you don't do what she tells you - send you to your room? She can make whatever decisions she wants but you don't have to facilitate them. If she doesn't talk to you for a week then that's just the way it is.

Good luck