Mum needs a nursing home after car accident

It does sound like you need to be there to hear what is being said first hand and to advocate on behalf of both your parents. It sounds very difficult.

If she needs 3 people rather than 2 people for her care, that basically cuts off care at home, however much your dad would like to do it.

While she may be self-funding, they can't touch the home your dad lives in. This will likely leave a lot less money available and she will be local authority funding v quickly.

Does your mum have any claim arising from the car accident? That may need to be taken into account.

You must be in total shock. Your poor poor mum. My dad went into a nursing home after a stroke and they’ve been amazing to him. I would say get the best you can afford, there was such a difference between the normal ones and the fancy ones although that comes at a price. But he’s checked in every 15 minutes and they’re very good at getting medical assistance.

This is so hard for you and your family! It maybe worth having a chat with your mum's consultant - my late father refused to take on board my insistence the reality of my mum's care needs because he was overwhelmed and was talking about bringing her home when that really wasn't an option for either of them - the consultant was able to lay things out clearly and tell him what was in her best interests and my dad then accepted and was able with the help of the hospital to make plans.

@GlassLampshades From what you have said about your Mum's finances, she would be under threshold and the Local Authority would need to pay for a care home, although dependent on how far below the threshold, she may have to contribute.

As you move forward with this I want you to see this through the eyes of the social worker and their motivations when they deal with you

Local Authorities have tight budgets and it looks like your mum would be funded in full by the LA as she does not have huge assets outside of the home which can't be touched.

Care homes are expensive and the LA would have to pick up the tab, therefore, a cheaper option for them is to try and get her discharged home with equipment and a care package, at a guess, something like 3 calls a day with 2 carers depending on how she needs to be transferred. Your Dad would then need to do the care for the remaining 21 hours a day (approx).

So, when they do the means assessment they will apply pressure for the latter option of a return home, even though a care home is better for your Mum and your Dad's own health and wellbeing.

A neighbour was run over recently and needed a fortnights care.

They are claiming from the 3rd partys insurers.

Does it look like there will be a claim against another party for your mother>

Have an urgent and frank conversation with your dad OP about not agreeing to anything until he has discussed it with you. He may find himself railroaded into decisions that are not in his or your mum’s best interests. Maybe even practice some phrases with him for saying no, because it is so hard in the moment when the pressure is on from the hospital and the social worker and emotional distress is also in the mix.

Finding a suitable home takes time. Finding a suitable home once your mother has been discharged home will take even longer because she will plummet down the priority list for everyone except you and your dad. They cannot just discharge her as long as your dad keeps saying no, no, no. It certainly sounds like she couldn’t come home without extensive adaptations and equipment which is clearly nowhere near ready.

I echo the comments about re continuing healthcare and insurance. Insurance probably first to rule it out as a potential source of funding and then CHC. CHC will probably say no - appeal it. You can find the decision support tool for CHC online to get a feel for the kind of things that are assessed.

I’m so sorry for you and your dad that this has happened to your mum. There IS a way to find a workable and safe solution for all but frankly it may mean hardening yourself and being a total pain in the arse to the point of seeming heartless. It will be worth it to get your mum where she needs to be.

That’s good that you’ll go with him. Come back and talk through it afterwards!

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.

Contact Beacon who are there to advise and support on the matter of Continuing Health Care Funding. www.beaconchc.co.uk

I go this for my late OH - but only after an appeal.

@GlassLampshades I can say from personal experience - please advise your Dad not to feel duty bound to bring her home. Your Mum has complex needs. Once she is discharged home, he will be left to get on with it. When he can't cope with the stresses of it and reaches out for help he will be placed on a waiting list to be seen by community therapy/OT's which can take weeks or months to be seen. I have seen this first hand. It is not in your Mum's best interests for her to be discharged home and for your Dad to attempt to do the bulk of the care. Please remind him of this. Take your time and don't allow social workers or anyone else to pressurise your Dad into letting her come home.

It might be that when your dad sees mum in a more homely setting, in a care home unit for assessment, - he’s more able to make a decision as at least he can see the benefit of it for her then. And there should be input from different professionals to talk through her needs and risks, and how these could be met or not met at home. So it’s not all coming from you??

just realised you are getting all the info 2 nd through dad. Do talk to them yourself or be there when dad meets them.
maybe they are talking about an assessment unit? Where I am, that’s a short term nursing placement which allows for a fuller assessment and care planning for home or long term care. They would be looking for a quicker decision on that, as it’s then that you’ll have time and space to plan what’s next. Usually 4 weeks.

I thought about the insurance too if it was a car accident. The Social worker is being totally unreasonable forcing you to an answer by Monday. The rules about who is entitled to funded nursing care are very complicated.

@TreadSoftlyOnMyDreams is correct OP. The hospital staff will be under pressure to free up the bed. It is not down to you to you to find a solution to this, they need to assess your mums needs and do a financial assessment of your mum. Its not clear from your original post if this has been done.

Have a look at this guide - this is a link to an org called Beacon who can offer independent advice on whether you mum can access continuing healthcare which is funded by the NHS.

www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/#:~:text=To%20be%20eligible%20for%20NHS,how%20complex%20your%20needs%20are

If this cannot be obtained for your Mum, then in Northern Island if your Mum has more than £23,250 she would have to pay for carers. Once her assets go below this threshold, she would be required to pay part of the care fees. Once below £14,250 then she will no longer be required to pay. Important to note this means test is purely on your Mums assets. Say you Mum and Dad have a joint bank account of £50k, £25k of that would be assumed to be hers in the assessment.

The home that your Dad is living in will not be included in the means test/financial assessment as he needs somewhere to live.

If your Mum and Dad had a joint by-to-let Property for example, this would be included in the means assessment.

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?

The social worker will just be looking for a general idea of whether you’re open to nursing care or wanting mum home somehow. This is going to be a longish process and their role is to help and guide you through it. If you don’t feel that is happening , then say so.
Age UK are a good starting point, they do some downloadable booklets and guides on looking for care homes, what to ask, and how the funding works.
your dad’s home will be discounted from the financial assessment but any savings in her name only, or half of any joint savings, will be counted in.

She should be getting PIP full rate, as she qualifies, or the equivalent, don’t be rushed into nursing homes.
is it possible for negative equity?
Also if the accident was not her fault, is their compensation from other party?Please discuss with care plan, and social worker