DF now refusing discharge from hospice and wants to stay!

@AnnaMagnani They don’t but the OP should be contacted by LA social worker and the hospice should facilitate this. It’s an issue because SS must be involved with future care decisions. As op knows there’s not enough money for a nursing home, SS need to be involved regarding what might be possible. They like cheap home care and will expect op to do it though as 4 short visits is never enough. Depending on mobility, a regular care home might well be ok.

Of all the hospices I've worked at, having a social worker was rare.
Possibly there might be a discharge planning nurse but probably not.

There just isn't funding for these roles.

OP I would suggest that on your next visit you ask to speak to the doctors and say that you know he wants to stay but you also find him very difficult and you just aren't in a position to do more than visit. Finding a care home has been very difficult, and as his daughter he won't accept from you that he needs to go to one.

Just tell the hospice that they need to get a care manager or social worker to discuss with your dad what his options are as you do not have POA and are frankly at the end of your tether trying to cope and then step back . Stop visiting everyday and take back control of your life a bit . It may sound harsh but if he’s got capacity there is very little that you can do .

Dad, the hospice say you can’t stay here, it’s not an option. You can go back home, or into care home - you choose. I can’t look after you … I have a job and my own life to lead. Then step back. Very hard to do, I know, but it may be the only way to get him to accept a change.

I’m a nurse and if someone refuses to leave they’re within their rights to get them admitted to hospital with ‘social concerns’ and then they’d be stuck in hospital instead awaiting a social assessment for a palliative preferred place of care so I’d really try to work with them. Hospices often have their own social workers

Is he on a ward or in a hospice? You’ve said both in your posts.

Equipment can be provided but the care a person needs at end of life is sometimes unpredictable and doesn’t work well with a typical package of care which will be timed visits by carers, not qualified nurses who can administer (injectables if needed) medicine as required. So a Nursing Home is sometimes the best option. And if he is CHC fasttrack funded then it’s nothing to do with social services. It’s health funding. And CHC will have a brokerage team who look for placements and care packages. This doesn’t have to be the OP’s problem. If she wants, she can try and chase up CHC brokerage. But frankly she sounds burnt out with caring for her father and no judgement here, caring is hard, hard work.

This is her Dad not her. She is not responsible
for a grown adult who refuses to go home.

@tarheelbabyAlmost any house can be adapted to accommodate a person who is going home to die. All you need is to make space for a hospital bed. Hospices are not part of the state or NHS. Communities fundraise to keep them going. If they say someone doesn’t need their service, your selfish response is “ignore this, stay put, they can’t make you leave”. I bet you’re one of life’s takers.

@KilkennyCats hospices and palliative care have been banging on about not just doing end of life for decades!

A short admission for symptom control is a very normal hospice admission before going home/to a nursing home.

@KilkennyCats The hospices here are not that generous! There’s a huge shortage of spaces and it’s difficult to get a place. This one seems to be used instead of hospital which also doesn’t happen here. Hospital brokerage contract sorts out care home and I said that to op yesterday. This placement seems to have bypassed SS and hospital so no one is sorting it out. The Hospice must know there’s no home places for state funded people so what did they expect to happen? It’s the dreaded “bed blocking” of course and they will expect op to look after him. That’s the default now. That’s why we have millions not working. People don’t think about what they need to do in old age and then don’t like what the options are. A home further away or home care team.

Oh, I see.
Thanks @PandyMoanyMum

@KilkennyCats our local hospice offers symptom management admissions as well as end of life (ie last days of life) care. Not unusual for patients to have to leave once stable. It is a charitably funded and therefore they can decide their admission and discharge criteria. It’s free to the patient but so much effort goes into fundraising for people who really need the expertise of the palliative Drs to manage symptoms. Worst case scenario of a stable patient is that they would be sent back to hospital pending a suitable Nursing Home place.

Is it definitely a hospice, op?
It would be extremely usual to be admitted to a hospice and then recover enough to be discharged home within two weeks??
They provide end of life care.

@Totallybannanas let social worker sort it out and you step right back. just say you are taking no part in his care so they will have to do it!!

I get that, I would suggest then that you tell the Hospice to liaise directly with your Dad and Brokerage. Explain you have burn out.

There should be a Brokerage team at CHC who can contact you with vacancies which fall within their funding limits. Have you spoken to them? If the Hospice are pushing you, suggest they contact the Brokerage team and when you are told of suitable vacancies, you will look.

I think if I were you this is the moment to be strategically unwell. Stop visiting. Let the hospice know that you’re having a minor procedure (unspecified) and once you are discharged in a day or two, although you are having to work from home and therefore are not free to make calls, you can’t drive or lift anything for two weeks so won’t be visiting.

The hospice will have people who don’t have family running about all the time. They’ll cope, if they want the bed that much.

In this case I believe that OP’s father is in receipt of Continuing Care funding as he is coming to the end of his life.

No you can't make him go.

you said he doesn't want to go home. Is that because he wasn't getting enough support at home? How about home with paid carers? Better option than a sub standard care home?

what was your relationship with him like prior to him needing care?

Well they’re focusing on a nursing home so it doesn’t sound like they think home with a package of care is viable.

Tbh I would try to let it happen. This is so draining for you. You can’t control where there is space. Even if the home isn’t brilliant, there will at least be staff there and food provided and the basics. I hope you can reduce the frequency of your visits tbh you sound exhausted.