Mum needs a nursing home after car accident

Do not be rushed into anything

This is not up to you or your dad ‘to sort’

In the nicest way possible, DO NOT allow you dad to bring her home
This will happen way to fast , they will have a bed delivered the next day, with transport booked and he will be ill equipped to look after her, from your dads side of things, this kind of thing can not be rushed but the unit will want it rushed through

Iv been there and its awful

We did bring my mil home but that was the right thing to do for her (as there was nothing wrong with her mind, she wouldnt of coped being in a home)

I fault tooth and nail for continuous healthcare and finally got it. After weeks and HOURS of meetings and assessments.
We got 8 hours a day. The other 16 hours a day myself and partner had to cover, it was full on 24 hour day. She was fully bed bound and couldnt even really pull herself up, Oxygen support too so was extremely hard work. And we only got 8 HOURS A DAY
(Im ill & Partner was disabled at the time too)

Do not say you can pay anything.
Tell them you arent accepting her home and look into continuous healthcare or insurance through the accident
You must attend every meeting with your dad as it sounds like they will fast talk him into having her at home which is EXTREMELY DIFFICULT

Is the car insurance not going to pay towards this?

I'm sorry you're in this position. Unless the accident was totally 100% her fault, you'll be able to make a claim for compensation which will help. The at fault insurance company should be able to do an assessment of her needs and possibly start paying interims to help fund her care.

From what the OP has posted then I think there is a clear case to be made that care should be at least partially if not fully funded.

The DST as I posted above makes a recommendation as to if the person has a PHN (primary healthcare need).

If they do then the recommendation is usually full funding (but it's a bloody high threshold) if not then joint funding is still a possible outcome.

At their core DST's are essentially a bun fight fight between the NHS and LA about who foots the bill.

Both the SW and Nurse Assessor will be under pressure to fight their own corner.

The OP's job is to make sure that her mother's condition is recorded accurately.

It's worth bringing as much evidence to the DST as possible. Ask for testimony from the specialist unit about her injuries and abilities (or lack of). Make sure you have all medical and rehabilitation info to hand.

Download a copy of the DST domains before the meeting and make sure you are clear how each impacts the person.

Tbh the SW should do most of this reseach but are hugely time constrained and stretched so don't assume they will.

https://www.headway.org.uk/about-brain-injury/individuals/rehabilitation-and-continuing-care/continuing-care/

Some info here from Headway

Hi OP,

can I suggest registering on carers.uk.org and accessing their forum. There are people on there that have a wealth of experience in situations like this. They helped me so much a few years ago when our situation became unmanageable. From negotiating social services, to finances, to benefits and discretionary trusts.

So sad OP, I am sorry. Your Mum isn’t all that elderly, it must be so hard for you and your Dad.
I don’t know the rules in NI, but my Dad’s nursing home fees were paid by the LA as his condition was medical not old age related. Surely this is true for your Mum too ?

If it is because of a car accident there should be insurance to cover the lifetime costs of your mum’s care. The social worker is wrong. Was your mum insured?? Are they going to pay out?

Also just to add, my mums funding was originally via Continuing health care CHC but then after a review (after about 12 months) it was taken away from her (basically if they live too long!) however her local authority took over the payments.

Oh gosh I’m sorry this sounds like a horrible situation.

my mum needed same level of care (she had a brain tumour). She had no savings (I think the criteria is that you need less than £24k in the bank but don’t quote me). She was named on mortgage but because my stepdad was living in it, this wasn’t taken into account.

my mums care was completely funded.

This is a horrible situation, I'm so sorry.

Definitely attend the SW meeting with your dad, to share the burden of making tough decisions. It's also good for someone to offer a second opinion, push SW for clarity, other options etc.

In the meeting, take copious notes, summarise them verbally in the meeting and send them a written summary afterwards so they are held accountable. Don't let them push you into a hasty decision to get your mum off their caseload - I stupidly agreed to a move under pressure and I greatly regret it. If you haven't decided by Monday, realistically are they going to dump your mum on your doorstep without any support? A short-term nursing home place may give you more thinking time like a pp said, but be very clear (ie in writing!) how it's funded and how long it's for if it's not an ideal placement.

Hi OP.

Firstly you absolutely need to be with your father when he meets the social worker.

They cannot discharge your mother unless she has somewhere to go where her complex needs can be met.

You need to advocate for both your parents and to separate their needs.

Ask your father to raise with the SW that he wants you as his advocate and that no meetings/decisions should be made without your input/support. Be clear you want that on record.

As pp's have said the decision to move your mother back home is very significant. Once there you will really struggle to move her if your father can't cope - and given what you describe I'd be amazed if he could.

On paper it might sound achievable with specialist equipment and carers coming in but they can be hard to source and retain (poor pay). Your mother needs a level of care from your description it would be very hard to provide at home.

You need to ask the SW about D2A ( discharge to assess) where your mother would be eligible for (I think 6 weeks) of funded care. If they can't assess in that time the funding also has to be extended. Has an OT (occupational therapy) assessment been done re: the property and the feasibility of home care?

Ask if any of these assessments have been done and if so ask for the paperwork. Challenge the findings if necessary.

Make sure a CHC checklist (continuing healthcare) has been completed and sent to the ICB (integrated care board). If so was she classed as eligible for a DST (decision support tool) meeting?

If not why not - given your description she should absolutely meet the DST threshold.

The DST meeting is where your mothers SW and a nurse assessor look at 12 domains (eg breathing, mobility, continence, cognition etc) and make a recommendation about funding that the ICB rules on. Funding may be denied, full or partial.

You absolutely need to be present for the CHC checklist if it has not been done and crucially for the DST. Lots of YouTube videos on DST to prepare you and worth a watch.

Re: finances if the property is in joint names then half is her asset. They cannot force your father to sell whilst he is living there to contribute to your mothers care, but if he chooses to sell he may have to hand over her share of the sale (impacting his ability to buy) or sign an agreement with the LA for deferred payments on his death. You need to get advice on this pronto - I'd contact Age UK for advice https://www.ageuk.org.uk/.

Has your mum got an LPA(Legal Power of Attorney - 2 types one care the other finances)? Does your father? If your mother does not it's too late as you can only set up an LPA when you have capacity and it appears she no longer does. Get it sorted for your father now if not done already.

Last point make sure you make clear to your father and the SW that your mother cannot be cared for at home.

They cannot force your father to do this or give timescales - especially if they haven't looked at CHC/D2A.

Hope that helps.

You don't get it when in hospital

I understand that your Mum should be receiving Attendance Allowance. Does she have LPA s in place.
I agree with PPs, do not let your Dad agree with anyone that she should be allowed home.

Sorry I haven’t rtft so if this has already been mentioned then I apologise. Was the car accident your mum’s fault? If it was someone else’s then is there a personal injury claim being pursued? Cost of care like this would normally form part of that claim and you can get interim payments from the defendant to fund immediate costs (if liability has been admitted).

From experience with my Dad (RIP), if your mother needs to use a hoist to move to a chair/toileting, then that'll require two care assistants - in my Dad's case they visited four times a day. Please point out to your father that this will mean he will never be assured of privacy in his own home - either he'll have to let the carers in, or they'll have a keysafe and just come in when they arrive. I know his instinct will be to have your Mum at home, but please make him aware of the ongoing effect on his own life. I wish you and your family well.

I’ve not read the whole thread but wasn’t there insurance? Will that pay out for care? Sorry to read about your mum. Hope things work out.

OP, I understand that you are anxious and upset, but why aren’t you answering questions about claiming on your mums or the other drivers car insurance. That is what insurance is for.

Solidarity. Just another vote saying - glad you are planning to be there at the next meeting. Take notes - names and roles, what the options are, what the timescales are, who will do what next, contact numbers.

I have to say that once you are there, you may find that the situation is not quite as your dad remembers it. It is SO hard when he's probably still in a period of shock himself.

Questions to raise if nobody else does are definitely about CHC funding and whether there are any funded nursing home places she could go to in the short term while you look for a long term option. In England where I work there is a thing called Discharge To Assess or D2A which is a period of a few weeks in funded care, out of the most expensive acute hospital beds, while everyone works out what the best plan is. You don't get much choice of home but it is a starting point.

I’m so sorry, this must be incredibly stressful for you all to try and process😢

I can only echo what others have said, financial and needs assessment needs to be completed by adult social care. Hospital staff may be under pressure because they need to create beds but your mum needs suitable care so the discharge team need to step up!

I lost my big brother recently to a car accident, it’s horrific how life can change so suddenly and without any warning♥️💙

Maybe suggest to your Dad that she goes into a nursing home to start with, as a type of step down care from the hospital setting. Hopefully having it put that way seems less final to him as it leaves the possibility that she might eventually come home. Just dont talk that way to the social workers etc and get him to ‘pretend’ to them too

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

A financial assessment should only be done once it has been established that someone does not qualify for NHS Continuing Care Funding, for which no financial assessment is required - it is solely based on nursing need. See link to Beacon above.

Financial assessments are only done by the local authority via social services - but only when it is established that it is a social services matter and not CHC funding (from the NHS) as above.

Do not get sucked into financial assessments until the basic principle of who is responsible for the care has been established - health service or social services.

Beware! - without the proper support and advice you will be bamboozled into thinking that CHC funding does not apply - I have watched it happening so often!