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Elderly parents
Original poster

Hospital want to send lady home with only twice daily care.

65 replies

MovinOnUp · 13/11/2022 00:31

I'm looking for some advice to bring to a meeting my friend is having on Tuesday with regard to our elderly friend. (We used to work together years ago)

This will be long, I'm sorry in advance. Please stick with me as I don't know what to do for the best here.

The lady has been in hospital for a few weeks now.
Admitted as suffering hallucinations and showing signs of dementia.
She hasn't been able to look after herself for some time as it turns out.

She's been outside wandering around in her pyjamas walking a non existent dog.
(She had a dog but the dog was at home and she went out to walk him without taking said dog)

Unable to look after her pets or house (really in an awful state apparently) they have both been rehomed while she has been in hospital.

Is incontinent (urinary and fecally)

Not feeding herself regularly, When she does eat she has eaten dog food (the type that comes in a roll, we think she may think she's eating pate)

Not drinking any liquids.

Refusing to shower/bath

Very confused/not recognising people she has known for years.

She was in a terrible state the day she was taken to hospital, Found lying in her bed in pee and poo.
Hallucinating very badly and in a very upset state.

She was found to be severely dehydrated and suffering from multiple infections which they have now got on top of.
I am told that the infections were so bad that she would have been dead in a matter of days had she not been found.

Despite recovering from the infections, she is still hallucinating, trying to escape the ward, not recognising people.

The hospital say she is fine to be sent home and that a carer will be provided twice a day.

I think that if this happens it's only a matter of time before something terrible happens as she cannot look after herself/keep herself safe.
The hospital say as she is capable of showering and heating up a can of soup then she is fine to go home.

I really think she should be in a care home as there is no one nearby who can look after her.

Has anyone been through similar or have any advice that my friend can take to this hospital meeting to support them not turfing this lady out to rot at home?

The meeting is with the OT, social worker and doctor.

OP posts:
Original poster
MovinOnUp · 13/11/2022 10:47

@HappyHamsters I think that's exactly right, that she's been invited to voice her concerns.
The family are aware of the meeting and I believe we're offered the option of attending remotely.
This was declined.
I don't think out of unkindness, They don't really know her or are aware of how things have been I suppose.

OP posts:
cptartapp · 13/11/2022 10:46

Be aware your well meaning intentions are propping up an unsafe situation. I would tell them there is no one to get her food and stop. This could go on for months or longer otherwise.
Cruel to be kind.

Original poster
MovinOnUp · 13/11/2022 10:45

@HappyHamsters none of that has been done. There is no plans (as yet) in place for carers entry, currently the flat is left open as she has lost every set of keys.
I'm not sure if the lady has been invited to attend herself but we will ask that she be there
@spiderontheceiling without wishing to sound unkind to them, Her family are not interested. My friend is going because there is no one else.

OP posts:
HappyHamsters · 13/11/2022 10:42

Spider is right, the family should have been made aware of the meeting qnd inviyed, if they cannot attend can the meeting be done with zoom. The hospital should not divulge confidential info about the lady to your friend so she may only be invited to part of the meeting to say her concerns.

Original poster
MovinOnUp · 13/11/2022 10:40

I don't think she'd be able to afford private care, she rents an association flat currently.

Unfortunately I'm not available to be the responder to the alarm, I live a good distance away and don't drive. My friend has a school age daughter with autism and wouldn't be able to leave her to go looking for her, even if that were possible, where on earth do you start?

For shopping, I know my friend gets her a few bits and I something add to my Tesco delivery for her, take her food We've made, but we've nothing concrete in place for her.

PALS and safeguarding lead, okay will make contact, will try today but I'll assume I won't get anywhere until tomorrow. Thank you.

OP posts:
spiderontheceiling · 13/11/2022 10:37

In what capacity is your friend going to the meeting? Do the elderly lady's family know the meeting is going ahead, have they been invited to attend and do they know that someone is going in their place?
Whilst you clearly mean well and it is vital that these points are made, I am not sure your friend is the appropriate person to make them just because the family live a long way away

HappyHamsters · 13/11/2022 10:35

At the meeting the lady should have been invitied to attend, if she is not there ask why not.
Has she had a capacity assessment or been seen by elderly mental health team
What assessments has she had, bathing, cooking, walking, money management
Has the ot done a home visit, is her home safe
If they say she can go home how will she get there, does she have keys, how will the carers get in, do not offer any help with taking her home
Who is paying for the carers, has she agreed to this, hasnthe care agency manager assessed her to make sure they are happy and can meet her needs
Tell them there is no help available from neighbours
Has she had a care needs asessment qnd chc checklist, this may be different in Scotland but check scotland care site
Reitrrate its an unsafe discharge and she sounds like she needs full time care, she wouldnt manage in a warden flat, she needs a carehome

User359472111111 · 13/11/2022 10:32

Suggest your friend writes to PALS at the hospital, and the safeguarding lead at the local authority outlining her concerns. What you have written here is sufficient.Ask for assurance that a full assessment of welfare and safeguarding issues is completed before she is discharged.

Good luck. Unfortunately social care is broken.

autienotnaughty · 13/11/2022 10:31

MovinOnUp · 13/11/2022 10:06

I'll ask about assisted living @autienotnaughty is that like a complex of flats with a warden?

My grandad lived in two. The first was as you described adapted housing with a warden checking on the residents. They all had carers and there was an alarm system that went straight to the carers office .

The second one was better, the carers were on site, the residents had their set visits but could also ring/use alarm in an emergency. There was also a communal lounge/hairdressers/cafe on site and the staff would do bingo, singalongs etc.

My grandad didn't have any savings or property so qualified for full payment by social care. They will try for the cheapest option where possible when they are footing the bill.

Beamur · 13/11/2022 10:30

Fall alarms go to a call centre. They then alert nominated people or call emergency services.
Make it very clear that whilst you're helping support her you are not available for any care or emergency contact.

CrotchetyQuaver · 13/11/2022 10:28

I think your friend needs to contact the family and ask for their support in getting her into a nursing home

cptartapp · 13/11/2022 10:23

Sounds like she's well past the warden stage and needs 24/7 care.
You need to stress there will be no involvement from neighbours. None. They will use this to their advantage.
Who will be doing her shopping for example if carers are only doing meds? Who does it now? Everyone needs to step right back as only when it's crisis point will anything change.

LIZS · 13/11/2022 10:11

MovinOnUp · 13/11/2022 10:04

There was mention of an alarm @LIZS but who does the alarm get sent to? There isn't a police station here anymore.

There are monitoring companies like the panic button around the neck , to alert a nominated person.

Rainbowqueeen · 13/11/2022 10:09

I have no experience in this but things I am wondering about:

  1. Is it possible at the meeting to suggest an alternate eg care home. Obviously she can stay in hospital forever. Are you able to research other options and present those?

2 if a carer is there twice a day and they don’t feel she is coping, what happens? Is there sone kind of reporting system?

  1. Does this lady have the resources to pay for a cleaner and a meal service?

It’s lovely that you are advocating for her. I hope the meeting goes well

Original poster
MovinOnUp · 13/11/2022 10:06

I'll ask about assisted living @autienotnaughty is that like a complex of flats with a warden?

OP posts:
Original poster
MovinOnUp · 13/11/2022 10:04

There was mention of an alarm @LIZS but who does the alarm get sent to? There isn't a police station here anymore.

OP posts:
autienotnaughty · 13/11/2022 10:04

Oh yes and if she is going home she will need an alarm around her neck.
If it's a firm no for care home what about assisted living?

autienotnaughty · 13/11/2022 10:03

Tell your friend to write down he r concerns-
Toileting
Eating/cooking/food prep
Left unsupervised with openable doors/oven/ fire etc
Risk of falling
Bathing/hygiene
Meds
Talk about no family /support

Don't mention people going to check on her etc obviously you will if needed but they will use that to their advantage if they can.

Original poster
MovinOnUp · 13/11/2022 10:02

Distant family (cousins) are at the opposite end of the UK and yes they are aware, They have visited but I don't think they would be able to take her in or even visit up here much.

OP posts:
LIZS · 13/11/2022 09:42

OT/SS can provide alarms which trigger when a door is opened or movement sensitive mats if she gets up. Could she afford additional care or be eligible for a volunteer befriender scheme? Any family?

Georgeskitchen · 13/11/2022 09:33

Adult social care should be involved. This lady should be in a residential care home. Sometimes you really have to push for these things to happen. Are her family in a different country?
Do they know the extent of her condition?

Beamur · 13/11/2022 09:30

Yep - unsafe discharge is a key phrase!

toomuchlaundry · 13/11/2022 09:29

Remember to use the phrase unsafe discharge, this was what I was advised when hospital were trying to send my DF home when he was in a similar state to this lady. He also had cancer and died whilst the hospital were still fighting with us that he could cope at home

Original poster
MovinOnUp · 13/11/2022 09:24

No one has POA and her family live far away.
Contacting the local authority is a good shout, Thank you.

OP posts:
Beamur · 13/11/2022 09:18

Poor woman.
In my experience Hospital Social workers are very hard nosed and keen to discharge patients.
Twice daily visits may keep her going but it sounds like she needs a care home.
Is there anyone with power of attorney or a near relative?
At the hospital I would state the facts as known and say you think this is an unsafe discharge.
I would also contact the local authority and report the lady as a highly vulnerable adult - she needs a social worker. They plus her GP will need to be on board to have her needs properly assessed.