Can I refuse Mum's discharge from Hospital

So far so good OP. Once admitted there will have to be something in place before discharge. Just make sure it's good enough.
When DM was in this situation there was talk of respite care. The initial week or two would be funded but after that you have to pay unless limited savings or income. What happened in the end with DM was they sent her home with a care package which was so inadequate it was a disaster. Sister and I did a rapid tour of care homes to arrange her to move in self funded and we found a lovely place. Sadly she was readmitted to hospital within the week and died.

Pneumonia doesn’t have to be the end of the road. My 89 year old mother just spent 10 days in hospital with double pneumonia. She is prone to getting it but hasn’t for a few years. She is now back in her care home. The infection has gone but she is still very weak and has declined cognitively quite alarmingly. But she is still here. Although I’m not sure she want to be

My best wishes to you and your Mum. I hope she responds to the pneumonia treatment soon.

My 87 year old mother was in hospital with pneumonia over Christmas and New Year. She had very low oxygen sats, was a dyed in the wool smoker (40+ a day) and we too feared losing her. She made a full recovery though, and is now using nicotine patches and vapes instead of cigarettes, which is something we never thought we'd ever see.

So pneumonia doesn't always mean the end, although it can be scary.

With regard to the unsafe discharge, what we all said yesterday still holds and you may now have to make your point just as forcefully to the staff on other wards as internal communications within hospitals can be pretty poor.

Keep OT onside. She cannot be discharged unsafely. She needs full assessment. You and your brother are not available and your Dad is unable to cope. Keep ramming that home to staff and do not let them fob you off.

All the best.

They do have some savings and a house owned outright but we'll need to navigate what we should be paying for etc over the next couple of weeks. House won’t be included in the assessment while he’s living in it.

Dad was had pneumonia several times. MIL gets it a couple of times a year.

Sympathies. Been in a similar situation. Hold your ground and keep mentioning full assessment for discharge, unsafe at home and your Father's disabilities.

It was awful and the staff used all sorts of emotional blackmail on our family. Despite the fact my mother had already been discharged home once to a house with an upstairs bedroom and stairs at the front door unable to climb stairs. My Dad (himself no spring chicken) ended up carrying her up them.

Please do. If their is not good care for her refuse it ! Contact Pals

But this is why hospitals are full to the rafters with what is quite meanly termed ‘bed blockers’. Essentially elderly patients who have had falls and accidents because they live in accommodation completely unsuitable to them. OP’s mum now needs 24/7 care, that cannot be provided at home by family or well meaning neighbours.

I’ve seen this play out many times, and it never ends well - usually a hurried admission to a care home where the patient dies shortly after in a bewildered state because they don’t really know where they are.

It’s much better to settle them in after the first fall and then they can get used to their surroundings before taking a turn for the worse, which hopefully will be delayed by the fact they’re receiving proper care.

It also means hospital beds are unavailable for those there in completely unforeseeable circumstances which isn’t fair really.

Im sorry about your mum OP 71 is very young for this level of dementia, it must be very distressing for you. Hopefully you can get her settled in somewhere now she will be properly looked after.

Thanks so much

It is never easy xxxx

And hugs to you @thisisasurvivor
You also need precious sleep

Gosh poor her and I feel for you also

So so hard

I have sat in hospitals with my poor father and cried and cried

I am still crying now that he is gone

You sound like a wonderful daughter
Treasure her and continue to fight all the way

It's a bumpy journey but I'm so glad now for all we did xxxxxxx

Op, you must be so tired.
Hoping your DM rallies quickly now she being treated for pneumonia.
Take every opportunity you get to recapture lost sleep. Could it be a plan you and your brother stagger visits and go for less than the maximum time allowed this weekend - just 30 mins not the full two hours etc? DM will need to catch up on rest just as much.
Pack snacks, toothbrush and spare pants for yourself so you are one step ahead. Excellent news that respite care being discussed

It's perhaps early to start "preparing for the worst". It's not an uncommon infection to see in people who are elderly. Sometimes the antibiotics work and it clears. Sometimes, as a PP said, it can be the start of a decline. In the kindest of ways, focus on what you can do now rather than guessing possible outcomes. You've advocated well, OT have assessed and won't agree to your mum going home, antibiotics are underway for the pneumonia.

If you can, visit your mum for her comfort and to break up her day, especially at mealtimes. There aren't enough staff to assist people individually with eating so family are invaluable then, even more so if you keep a note of her appetite and drinking. Try to take in some family photos for your mum to look at and something to alleviate boredom. And very importantly, pick up dirty laundry and take in clean stuff more often than you think you need to. There's not a lot of space so you can only take in a small amount but it is amazingly how quickly all forms of clothing become soiled with urine, faeces, drinks and food. It's rather like small children but with more faeces in a lot of cases (especially when someone either cannot recognise the need to go, cannot get themselves to the toilet or are experiencing dietary and medication changes).

Chin up, it's exhausting but you'll manage. Make an effort to befriend the staff if you can and get an idea of the ward routine so you know when is best to call. Staff do generally and genuinely want to help, they're just a bit buggered at the moment.

Exactly

It is not safe

What will be in place

You expect at least 3 Carer's to attend per day at thre very least

Poor you
I have been through. This hell
Last year

My dad sadly died few days ago
But in the end a good package was in place

Admitted is not a bad think. It gives everyone time and space to workmoutbwhats best for her.

Pneumonia again isn't necessarily the end though it can be or can be the stat of the end in older folks it really depends on what else she has going on. Hope things look better over the next few days.

What is there financial situation? Who if anyone has power of attorney. If nobody has power of attorney and you do not believe she or your father have capacity to refuse care then you need to get from the court of protection the rights to force the situation. If they have funds this means seeking suitable placement, ideally together, otherwise you need to wait for a social services assessment as to what they will fund

Intervening often isn't simple either. MIL needed 24 hour care (profoundly disabled following a stroke) and FIL needed carers himself. It was obvious to everyone that MIL needed to go into a care home but FIL would fly into a venomous rage and even assaulted a couple of people if it was suggested. It's hard to insist when someone is screaming at you how vile you are just inches from your face.
My mother on the other hand smiles benignly, says she doesn't agree and sacks anyone who is engaged.

We left it too long. But with the best of intentions. I think most of us do.

I think that can be a "problem" when you are near enough to help.

You step in & gradually take on more & more I should imagine.

Also if the person is resistant to a care home.

Hope you manage to get the help you need Op.

Has anyone POA?

I live abroad & remember staff at my Dad's local hospital being incredulous that no, I would not fly in & look after my dad for 2wks so that he could be discharged.

@LadyShmuck it's almost impossible to know when is the best time to intervene.

My SIL really wanted my MIL to be in her home environment for as long as possible, and gave up her job in order to stay with her for half the week (she lived two hours away). She arranged carers coming in four times a day for the rest of the week, and MILs lovely neighbours also kept an eye and would take meals over for her.
It seemed to be working, until MIL was found wandering more than a mile from home, at 5am, by a passing police car. I dread to think what might have happened had they not seen her. They took her straight to the hospital, and it was from there that adult services arranged respite care, which turned into long term care.

We left it too long. But with the best of intentions. I think most of us do.

Have you spoken to the hospital team again? I wonder if the interface team means they could discharge her home with a temporary care package (normally 6 weeks ish) to assess her needs at home. If so, that would normally mean carers coming in 3/4 times a day to support with personal care, meals, medication etc and then having an assessment of needs at home with a physio / OT / social worker with view to having an agreed care package which would keep her (and your dad) safe.

For older people, especially those who have cognitive issues, being at home with a discharge / assessment care package means that they stay as well as they can as hospital admission often comes with a reduction in mobility / muscle wastage, increased confusion and a higher risk of getting an infection.

It may not mean that at all, but it would be worth asking the question if that's what they meant. There is a big push at the moment to discharge (with care) then assess because outcomes are often better than an extended admission to hospital.

But you also definitely need to make sure that it's clear that your dad cannot support with care and there is also no family support that can help on discharge.

Good luck OP 🤞