Mum's confusion & hospital dismissing our concerns

My Mum was suddenly sent home, alone, to an empty house , very clearly confused and not her normal self.
The GP tested her and she did indeed have a UTI, the hospital said they had tested her but she was in a terrible state when left at home. I was so angry and had the whole “lessons will be learned “ response but it was shocking.
So I would insist on a repeat urine test at the very least. Glad her social worker is on the case too. I hope she is better soon OP.

Use the words “unsafe discharge” if she is refusing a care package and she is still presenting as confused. This should trigger further evaluation.

Glad to hear the social worker had seen Mum before and agreed with you, and they are reassessing her.
Hope you get some better news soon.
It’s not easy, particularly when you are so far away.

I’m so pleased. Keep up the pressure though. You’ve done really well to get to this stage. It’s amazing how they do recover.
thank goodness someone who knows her has seen her.
one say my mum was out for coffee. The next she was laid in a hospital bed not knowing what was going on etc.
a few months later she’s out for coffee with her friends.
Try and real a little knowing she’s in safe hands for now and don’t overthink what the future may hold. One day at a time x

@NellyTheCake if she has tried to "escape" hospital, they may well have medicated her, for their convenience!!

Seriously! It happened to a relative (although about 10 years ago) and we had no clue until we received the discharge papers

just be aware that every hospital has different policies so some of the advice here regarding the discharge process may not be relevant to your mums hospital trust.
@Beautifulsunflowers not sure if this is the advice you are referring to? Discharge to assess is a national policy.

OP, as PP have commented, the six week rehab service isn’t perfect, but at least it will provide a baseline of current needs.

If your Mum is discharged with support you’ll need to consider things such as access for staff, a key safe is the usual option.

Also, some telecare may help. A pendant alarm and if you are concerned about her going out some door contacts that would alert the telecare base if she went out.

The telecare does need a named contact along with a plan of what to do if she were to leave the house whilst confused.

The telecare can take time to set up. I know some families who have installed a Ring doorbell as an alternative.

If assessed as lacking capacity and decisions to return her home she will need a Deperivation of Liberty in the Community safeguarding order. The process and the order, which is made via Court of Protection, takes months and hopefully your Mum’s confusion will have settled in that time. But the worker can start the process and then monitor.

In the meantime, the worker needs to make reference to this in the support plan after speaking with the local authority’s legal staff regarding any restrictions and actions needed to return her home and actions needed to do this such as any physical touch such as guiding her by the arm away from roads, linking arms whilst walking if the intent is to prevent her from wandering off etc.

Have a look at the Just Checking system which is separate to telecare

https://justchecking.co.uk/

There is no alarm connected but gives an picture of people’s sleep pattern and movements within the home.

You can speak with the assessing worker and request the telecare is in place prior to her returning home.

I know it’s overwhelming, and your Mum may be content back at home to remain indoors. But you don’t know this and it’s better to be informed and suggest solutions.

In our case it was a bleed on the brain and explaining just how different they were from normal meant they looked beyond the UTI originally suggested and scanned then performed emergency surgery which gave us another ten years. I’m sorry if my earlier post was too abrupt and it’s not enormously likely it’s the same thing. I hope your mum feels better soon.

I'm sure you're on this but as soon as she is well, get POA sorted if you haven't already. Good luck.

I agree that it sounds like it could be a delirium that can take a few weeks to settle.
just be aware that every hospital has different policies so some of the advice here regarding the discharge process may not be relevant to your mums hospital trust.
i would call tomorrow and ask to speak to a dr. Ask them why they think mum is confused. Ask when her last bloods were taken and if they think it’s a delirium or something else.
it will probably be an occupational therapist rather than a physiotherapist who is seeing mum. They will do an assessment to see what mum needs to enable a safe discharge. You can also ask to speak to them and voice your concerns.
Being medically fit for discharge just means that medically they aren’t doing anything for her that cannot be done in the community. She’s not requiring iv fluids or iv antibiotics for example. However there’s the social side of a discharge and that’s what now needs sorting. Speak to the therapist about what options there are for discharge.

Get in your car and go and advocate for your mother.

My mum goes delirious when she is in hospital and talks rubbish. She was last admitted to a frailty assessment unit a couple of years ago with breathing difficulties due to COPD.
I picked her up from hospital and she thought she was waiting on the railway station platform for me to bring the car round.
Obviously I was beyond worried - no hint of dementia previously.
Took her home and I was able to stay with her for a couple of days when she reverted to her normal self. I had a dementia assessment done by her GP a couple of days later and she was fine.
It's very scary to see your mum so altered but it may only be temporary. A couple of nights good sleep in her own bed will probably help. She had limited her food and drink as well while in as she was scared she wouldn't be able to get to the toilet.

I had the same with my mum when she got hospital delirium. The stories were totally wild and the ward sounded like a riot! It went after about a day, she couldn’t have been discharged though. Hospital ‘capacity’ seems to consist of the patient being able to say yes or no rather than actually being able to understand the question.

You need to ring the ward, ask for the discharge co-ordinator and ask if a discharge to assess notification has been sent to the hospital social work team.
It’s likely that this hasn’t happened if your Mum has declined support at home and has been deemed by ward staff as having capacity regarding this.

You could also contact the hospital social work team directly and discussing your concerns regarding your Mum’s current presentation with them.

My mum had this. They sent a dementia nurse to assess her. She asked me how long she’s had Dementia for. I said if you can get it overnight she’s got it. It was madness. Such wasted resources.
it turned out it was my mum’s sodium was too low. You need to tell them she can’t be discharged. Try and get her GP
involved if they know what’s going on.
being in hospital can cause great confusion, but I know how worrying it is when it’s not normal.
I really hope you get some help and answers x

Unfortunately if they think she has capacity she can refuse what they offer.

I’d try a local private recommended care agency & speak to them about a week of care disguised as home help. They will be used to this sort of request.

The hospital arranged care and re-enablement package is basic, times random and not usually very helpful. We were promised all
sorts for re-enablement that just didn’t happen. Instead DF had some lovely ladies who came on a very strict deadline at random hours, one came to make him food at 1, and the next turned up for dinner and bedtime at 3, and called me annoyed that he wasn’t cooperating, and she only had another 15 minutes before her next call. Poor man didn’t want to eat again so soon or to go to bed!

So we thanked them kindly and said no longer required. And I spoke to a local agency who sent someone round at set times for an hour to ‘cook and clean’ and of course do a lot more as he needed, but for him it was face saving as it wasn’t ‘care’, just a nice helpful housekeeper until he got back in his feet

Fucks sake. That's rubbish.

Right. Keep saying very loudly that to you, she is presenting with acute cognitive impairment and therefore you are questioning her mental capacity to refuse care. Ask who did the mental capacity assessment; they should assume capacity but NOT if she has a temporary impairment of mind.

She is probably dehydrated.