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Elderly parents
Original poster

Mum needs a nursing home after car accident

87 replies

GlassLampshades · 14/09/2024 08:20

Hello,

Can anyone point me in the direction of amazing resources, podcasts, websites etc where I can start to understand this whole new world that I've just arrived into?

My mum is late sixties and was in a car accident at the beginning of the year. She has a brain injury as a result, is currently in a specialist unit, and has been told she needs to leave as they can't do any more for her.

They advise a nursing home at mum's cost. My mum is bed bound due to the brain injury which has caused paralysis. She can use her hands and arms and can sometimes pull herself up to sit, but requires 2 / 3 people to move her. She does not use the toilet and only moves out of bed with a hoist to a chair where she sits for a few hours a day. She can hold a simple conversation but has clear cognitive issues, doesn't seem to grasp her situation, no short term memory.

I need to quickly understand how we go about financing this. My dad is also late sixties and in the family home in good health. The house is wholly unsuitable (a crumbling victorian terrace) for him and he would like to sell in the near future. The social worker says a decision needs to be made on Monday.

OP posts:
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BreadInCaptivity · 17/09/2024 17:58

GlassLampshades · 17/09/2024 10:30

Just an update to say the social worker didn't make contact on Monday (yesterday) about the Big Decision. Dad was in the unit and saw the SW around as they are based there. But they didn't come over to him. So he was panicked over something that didn't actually end up happening. I'm sure it will happen in the coming days.

He has spoken to Age UK who were absolutely fantastic and gave him lots of valuable information so he is feeling much better informed now.

Thank you all again.

Really pleased to hear you got in touch with Age UK.

Understanding your rights and the process makes what is a very difficult situation no less awful but less daunting.

You and your Dad need to remember that you don't have to agree to anything you don't understand or feel strongly (and can give good evidence) is not in your mum's or fathers best interest.

Original poster
GlassLampshades · 17/09/2024 10:30

Just an update to say the social worker didn't make contact on Monday (yesterday) about the Big Decision. Dad was in the unit and saw the SW around as they are based there. But they didn't come over to him. So he was panicked over something that didn't actually end up happening. I'm sure it will happen in the coming days.

He has spoken to Age UK who were absolutely fantastic and gave him lots of valuable information so he is feeling much better informed now.

Thank you all again.

OP posts:
Kdubs1981 · 15/09/2024 11:39

She doesn't come home. They need to find appropriate accommodation to meet her needs

Kdubs1981 · 15/09/2024 11:37

sleeptight1 · 14/09/2024 08:43

I don't live in NI but worked fora short period of time in Neuro Rehab working with people who had brain and spinal injuries. Many of the patients had life changing injuries. As part of discharge planning, Occupational Therapists would visit the patient's home and assess if any adaptations or equipment were needed for a safe dicharge. Sometimes equipment could facilitate safe discharge sometimes not and alternative accommodation would be needed to be arranged with a social worker. Remember it is not yours or even your Dad's financial responsibility to provide ongoing care for your Mum. The Social worker would need to do a financial assessment to ascertain your Mums (NOT your Dads as well) financial position. I have a questionmark whether your Mum may be able to access NHS Continuing healthcare due to the accident? No expert though.

The thing that jumps out at me is the social worker telling you she needs an answer by Monday? My response would be that she may want one, but she won't be getting one.

Where are the health professionals involved? There would be an MDT involved with your mum in hospital made up of Doctors, OT, Physios etc who would be involved in discharge planning.
For example, the OT would assess your Mum's cognitive and physical function and outline her difficulties (and strengths). Only from a thorough OT assessment would they be able to say what your mums living environment needs to look like and what support/care she needs. Your Dad needs a home and they cannot force him to sell his home to pay for your mums care.

Edited

Excellent advice

Kdubs1981 · 15/09/2024 11:36

Apologies, I don't have time to read the full thread and I'm answering in between fielding a toddler.

I'm presuming if she's on a DOLS she has been assessed as lacking mental capacity to consent to being accommodated in the rehab unit? Has her capacity to decide on discharge destination and care needs also been assessed? Because it should have been. If she lacks capacity a best interests decisions will need to be made (is this what is happening on Monday I wonder).

You do not let them rush you. They will have to keep funding her placement until an appropriate placement is found. And you can't make la best interest decision without options.

I would be arguing at her young age she needs a placement with experience in managing brain injury, not just a nursing home. It is the social workers job to find this.

If your mum lacks capacity you might also be entitled to an IMCA (independent mental capacity advisor) if there is disagreement in this process (don't let them tell you she can only have one if she has no family).

I would also be looking into whether there is a Headway charity in NI (brain injury) - they might be able to support you.

Don't let social care/social worker pressurise you into rushing. This is the time to get your mum's placement right. I'm sorry this has happened to her

www.headway.org.uk/

Kdubs1981 · 15/09/2024 11:25

You really don't necessarily need to fund this yourself. Has anyone looked into continuing Health Care funding (CHC), also if she needs this support then social care should look at funding it. Its like any other care, she doesn't need to pay up front and is entitled the the care she requires to meet her needs

Nsky62 · 15/09/2024 11:13

fizzymizzy · 14/09/2024 16:34

She won't get PIP at all as she is in hospital

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I get that, is not possible after discharge to nursing home, which would then AA

MissMoneyFairy · 15/09/2024 10:45

Good luck tomorrow, was mum in the car when the accident happened or a passenger in with an insured driver. What a terrible shock for everyone.

k1233 · 15/09/2024 07:39

GlassLampshades · 14/09/2024 09:36

Thank you very much. It is complex and intimidating. I am hearing everything via my dad and he is understandably traumatised and scared and I'm not sure he is able to focus on the practicalities. I will try to be there on Monday when he meets the social worker. He wants to bring her home and feels duty bound to do so, so it's not easy having to be the "evil child" insisting on a nursing home. I'm doing it for my mum though as there is no way he could provide the appropriate levels of care outside of the care package, and he'd run himself into the ground trying.

I did ask him to raise the NHS continuing care assessment with the social worker but he forgot.

The specialist unit advises the nursing home. The social worker has said mum would have to fund it.

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Op, things that helped mum with the decision to put dad in care:

  • anyone can be his carer, but only one person can be his wife. She needs to look after herself so she can be there for him.
  • Carers typically do 8 hour shifts then get a break. Being at home involves 24 hour care and it's not possible to do that for a sustained period.
  • the people looking after dad were experts. They dealt with his condition daily and were best equipped to handle his deterioration. They are also well experienced in the daily personal care needed for someone who is unable to look after themselves.
  • there's usually specialists eg physio that can come to care homes and work with your mum

My dad passed away 2 years ago. Mum now feels she's suffering carer burnout as, even though he was in care, she saw him pretty much daily and took his washing home etc

There is no shame in not looking after your spouse at home. I had to do a lot of work to get mum comfortable with that. There's a whole bunch of loss going on for the healthy person. They grieve the life they thought they would have. They grieve the loss of their partner and watch them fade away. They feel helpless and powerless. I'd strongly recommend your sad speaking with someone to work through everything.

Original poster
GlassLampshades · 15/09/2024 06:47

thequeenoftarts · 15/09/2024 05:37

Has your mum got critical care insurance/life ins/accident ins, check with your parents mortgage provider as they may cover some of this too. Anything and everything is worth a try.

No their mortgage is paid off and they got rid of all that cover.

OP posts:
thequeenoftarts · 15/09/2024 05:37

Has your mum got critical care insurance/life ins/accident ins, check with your parents mortgage provider as they may cover some of this too. Anything and everything is worth a try.

Biscuitandacuppa · 15/09/2024 02:02

Hoisting, washing/dressing, repositioning, catheter emptying and providing food are not counted as high needs care.
I have seen very frail and dependent people fail to meet the criteria for CHC funding. Given what the OP has said it does sound like it would be care funded through social services and possibly a high needs residential placement rather than a nursing home.

cuckooooooo · 15/09/2024 01:41

Don't let them pressure you into making a decision for Monday! They say that as they are under pressure on resources/hospital beds etc.

BreadInCaptivity · 15/09/2024 01:38

That's what we think but the social worker is saying things like "medically there's nothing much wrong" but we have letters from consultants outlining the medical needs. It just feels like they are dealing with her as an elderly person requiring care.

This is why you need to get evidence from the specialist facility that her condition is the result of a brain injury.

Tbh I'm surprised this is the response from the SW. From a CHC funding perspective they should be pressing the medical care needs.

You need to be very clear about the difference in your mother's presentation before and after the accident - this is not about age (which is social care) but injury (which is medical).

AD12345 · 14/09/2024 23:36

Greytulips · 14/09/2024 09:37

Are you not claiming from the car insurance? She should be covered for long term care. There’s a separate claim - for injuries.

My sisters employer won 3 million 20 years ago.

What have the insurers said?

Yes, this

alexdgr8 · 14/09/2024 23:30

Nsky62,
? how does your comment relate to the quotation ?

Lunamoon23 · 14/09/2024 23:29

I've recently been through a similar situation with my dad; I see your in NI so some of what i say may differ slightly where you are, I'm in UK. Your first step would be to contact social services (who id think the hospital would have already liased with as part of her discharge plan) and organise a financial assessment, they'll want approx 3/6 month bank statements from your parents accounts and any savings.
There is a threshold in which if they have over a certain amount you pay towards the fees of the care facility, (a certain amount is protected) once it drops down to that level they will start to look at assets although because your father is fit to continue to live in the home in not sure they could do much in regards to the property, they can't make him homeless.

It's an extremely sad situation, my father lived alone and we're having to sell his flat. He'll loose pretty much everything he's work all his life for. (He also had a brain injury and is somewhat similar to your mum) x

Nsky62 · 14/09/2024 23:08

MissMoneyFairy · 14/09/2024 09:46

She needs a full care needs assessment, a financial assessment which is all done by the ward and therapists. Does she have capacity to make a decision, not sure why there is a DOL in place, you'll need to ask, she's not able to leave by herself so it maybe lack of capacity so is there lasting power of attorney in place. Don't be intimidated by the sw, she cannot be discharged until there is a safe environment to move to. You also need to see what her insurance covered.

Harassement is a form of abuse

Nsky62 · 14/09/2024 23:04

GlassLampshades · 14/09/2024 09:38

Thank you very much. Nursing home is the only viable option in my eyes. But my dad is feeling guilty and like he should bring her home. I'm against that, for my mum's sake as well as my dad's.

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You don’t want your dad unwell too, a close friend of mine, had a live in carer for her husband, he was quadriplegic, very tough, he was ok mentally.
She lost so much, house, unsuitable anyway, mortgage on it too, a year before her pension kicked in.
Your dad will struggle, your mum will be ok, and cared for, I have worked in care, feel the atmosphere, not the ‘trimmings/ decorations’, and if you can trust your gut feeling.
Hopefully you will find a choice as to where, unexpected visits, tell a lot too.
Take care and good luck, I may not be right on some things as my care days are a while back.

ForgettingMeNot · 14/09/2024 22:27

If he sells they will want half the equity in the home for her care costs but if he stays in the same house they can only go after savings and investments.

Mossstitch · 14/09/2024 22:01

I'm in England so don't know if the same but in that situation at my hospital they have temporary carehome places funded by NHS known as a 'complex discharge bed' whilst all the assessments and longterm plans are sorted out. I'm sure the social worker didn't mean it had to be resolved by Monday, just discussions have to start to get a discharge plan in place💐

Howdull · 14/09/2024 21:56

Go and see a solicitor. Insurers need to pay out here and I'm talking millions.

AnnaMagnani · 14/09/2024 21:51

CHC defines medical needs very clearly but the bar to actually get this funding is very high.

Just passing the checklist is only the first stage and is no guarantee of funding, just further assessment.

So things like needing to be fed, having a catheter, needing to be hoisted would not in themselves score any points for CHC.

In general social workers would like nothing more than for someone to be funded by CHC as then it doesn't come out of their budget so if they are already intimating this will be social care, you can ask for a checklist but the social worker will have a good idea of who scores on it and who doesn't.

RightAngIe · 14/09/2024 21:43

Google for the chc checklist and see if your mum meets the initial criteria. (The bar is set quite low at that stage so as not to exclude people from full assessment). If she does appear to, ask the social worker to make the application.

In the meantime time, ask for a care act assessment from the social worker for your mum. She can then get the LA to identify a nursing home for you.

Do not be pushed into doing anything you don't want to do. You don't have to find a home by Monday. Your dad doesn't have to accept her home if they are relying on him to provide much of the care.

Whilst she is in the hospital you are in the strongest position to get your mum what she needs.

It gets harder once she is home.

I'm really sorry that happened to your mum.

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