Dad is hospital after - will they let him home?

It really is.

One of the other patients in the ward was in a much worse condition than DH. Dh was alert and though paralysed down one side, had learned to walk again.

The other chap had lost his cognitive function and couldn't walk. His wife was promised a through lift which would be installed after she got him home. He'd have his bed moved to the living room as a 'temporary' measure.

Once he was home, the OT and Social Services reneged on their promise. In the end, the wife looked into paying for a lift herself...but her husband died before she could install it.

The chap in the bed opposite my husband was also mentally alert but - again - was left with hemiparesis. To add to his difficulties, he had thalidomide and his "good" hand was the hand affected by thalidomide.

He and his wife were promised that he'd get a stairlift installed, but he'd have to have a bed in the living room first...

Knowing what had happened to the other couple, this wife played hardball: "I'm not having him home unless you have the proper equipment installed."

They got the stairlift.

Similar happened to us some years later, after DH was admitted again with an acute kidney injury. We were promised a bed raiser, to make it possible for me to get him in and out of bed without injuring myself. (I'd already damaged my shoulder from moving and handling. I've since had to have a shoulder decompression.)

Remembering what had happened to the other patients, I gritted my teeth and told the hospital that I was refusing to have DH home without the equipment. I went as far as pointing out that the house was in my name...

Miraculously, until the "correct" equipment became available, an interim device was delivered to the house.

I later found out that the OT had quizzed my darling about the state of our marriage...I have no doubt that she had the impression that I was a complete b*tch.

We were promised additional grab rails which didn't materialise. I paid a tradesman to do the one in the wetroom for us.

The man from the council installed the exterior grab rail the morning of the day my husband died.

Sorry - this is a bit of a ramble, but I don't want the OP to be caught out.

@WearyAuldWumman It's bloody awful

Not quite the same situation, but when my late husband had his stroke he had 4 months in rehab. We were promised 3 visits a day as an interim measure. (Initially, they assumed that I would give up my job.)

DH was brought home in an ambulance and taken upstairs. The extra bannister he needed had not been fitted. I was told it would be done the day he got home.

Chap from the council arrived, expecting to measure for a new bannister, not fit one.

God bless him, he managed with the materials in his van.

Then someone from Homecare arrived. They took one look at me and cut the visits from 3 to 1.

I may have missed this from pp, but be absolutely clear that you are not able to stay over with your dad - hospitals are very good at making assumptions. Ditto Homecare.

People who are at home with very limited mobility can have community alarms linked to smoke detectors, falls detectors, carbon monoxide detectors etc. If the alarms are triggered the call centre call the emergency services. It’s not ideal but far better than nothing being in place.

They will push to get the bed back whether he can manage or not, we have been told someone only needs one visit a day, we get them home and they need 7x4x2.

Keep pushing them. It's such a difficult situation OP, I hope everything works out for your dad

MIL wanted to go home, and had capacity, but couldn’t use stairs anymore. They sent her a hospital bed and commode to use in the dining room. She had a strip wash at the kitchen, but couldn’t stand to cook. She had four carer’s visits a day to empty her commode, and get her meals - using a microwave. She was housebound and wouldn’t have been able to get out the house, in a fire.

Unfortunately this has also been my experience. MIL lived in a terrace house, ended up in a wheel chair, could only get out with 2 carers or me and DH lifting her into a hospital bed in her front room, next to a commode. 2 steps to get into the house and at the back door, couldn't put a ramp in due to lack of space. If there had been a fire she would have died in it.

@thethoughtofgettingout be the relative who makes some noise about this. Be assertive. Keep on. The reality is that those who have relatives fighting their corner tend to get more of the very limited provision.

Which means “expect him to wash / use commode downstairs indefinitely?” plus up to 4 care visits a day.

Unless he has lost competence, he can’t be forced to do anything against his wishes.

Even with narrow Victorian stairs, a stairlift may be an option. Reconditioned, no point in going for new, they’re rarely used for long. You can get a swivel seat which rotates at the top of the stairs so it faces the landing and the stairs are blocked off by the arm of the seat.

Moving house would be difficult if he can’t go home - where would he go till the new place was ready?

Anything you tell the staff re discharge, also put it in writing so it gets added to his notes.

They will have to get him off the ward once the medical issue he's in for has sufficiently improved. He may go to a rehab which is like a hospital but they just help you get moving again. Or they do a care package which might be carers or adaptations. He may need a commode etc which the physios can sometimes order.
Obviously they can't command him to sell his home. If a stair lift is not feasible he may need to move his bed downstairs. And use a commode. At least when he first goes back home.

They will do an assessment including one by an OT, this will establish his level of need

It's likely they will then look for a package of care to meet his needs, this may include equipment and possibly him changing to single level living (living room probably) They will also look at any reablement potential

Do not let him come home without the above, if he is discharged without above it will become your responsibility

If he says he is happy to have strip washes at the sink or basin, they will probably send him home.

It's pretty normal to want to be at home. The system may be too eager to accept poor discharges but should people really be forced into care they refuse repeatedly?

The hospital will want (need) to discharge him when his hospital treatment/tests have finished. There are some possible steps between there and home if it’s deemed he needs/will benefit from it

• rehab hospital/hospital ward - medical oversight and nursing care, the closest there is to an old fashioned convalescent home, may have some rehab element eg physiotherapy
• a residential care home for rehab and reassessment on a temporary basis while he gets a bit of strength back

Do you have oversight of his finances? As well as owning his home does he have savings over £24k? What happens long term will depend on his £ situation and his mental capacity.

They will send him home. I fought for months against a discharge into a house which the person could not get in or out of without patient transport or ambulance. They still put him in the house - he was locked in by carers who turned up 4 times a day and it wasn't until he became unwell again that I was able to pursue a care home. The carers were undertaking an assessment and said he was fine to be alone.

Community alarm was in place and smoke detectors despite the fact he could not get out of the house even if he did understand what the alarm meant. Apparently all of this is acceptable treatment of the elderly.

Op tell them it will be an unsafe discharge if they insist on sending him home. Social services and physiotherapy need to do a thorough assessment before he leaves hospital. If he needs 24 hours care they might put him in a nursing home x

The problem in this situation is if he is deemed to have capacity he can make decisions which you consider to be unreasonable, this includes continuing to live some where unsuitable.

He can sell and move into a flat with a warden/extracare type set up or full care home. I would arrange to speak with the hospital discharge team to see what they recommend and speak to adult social services where he lives for local options. If his need for supported living is health related then the nhs should pay but getting this agreed isn't always straightforward hence speaking to adult social services

Just ensure @thethoughtofgettingout that the staff on the ward have noted that neither you or your sister can take him or provide care for him at his home and that you have concerns about his safety at home and will need an OT assessment , as will his home prior to any discharge .

There should be a social worker within the discharge team who you can share your views with. Often elderly claim relatives can support them with minimal care team input, but you may need to push back on it. They may offer a funded carehome or rehab bed as an interim measure, but such beds are scarce.

I’m sorry to say that in my area, the powers that be try to insist on moving the bed to the living room and placing a commode there.