Discharge from Hospital - Questions for Social Worker Please

That sounds awful, I've never heard of it, I've been a nurse 30 years and would never just let someone wet themselves intentionally, the very least the ward should have sent him to rehab with pads and pants. They need to check him every few hours and help him use a bottle or walk to the loo. If the pads were for dad that were sent to the house he may be known to the community continence nurse already, I would speak to the nurse in charge and pals. How do they manage with patients who don't have family. Which hospital is this in, there must be a senior nurse in charge or a matron.

Has a doctor or nurse looked at why he's become incontinent, has he been checked for a uti, is he on water tablets, he should have had an assessment in hospital. if you do buy him any clothes make sure you label them with his name.

If you do a bulk amazon order I can pretty much guarantee other patients will be given them.

Is this in the UK, it's very strange they don't supply pads, he should have a continence assessment and given the right pads for his needs, is this NHS, what is a secure rehab unit. They can't just leave him wet, that's neglect and abuse. For the time being I'd get him adult pull up inco pants, any idea what size trousers he wears. I'd speak to the unit or nurse manager, I've never heard of anywhere not supplying incontinence items, at home he'll need an assessment by the bladder nurse, pads, possibly a commode and a disposal service, this is all free and pads are on prescription. There are rarely washing machines, only in carehomes, I'd buy cheap pj, tee-shirt, joggers, old clothes from home. Sorry you're going through this. Speak to the therapists as soon as you can, they are always very helpful and understanding.

Luckily he wasn't a wanderer at night. A little bit of sleep disturbance, but manageable. If he had been, I guess it would have needed to be two carers to ensure total coverage without breaks.

The financial poa can be started when it's been registered and they have capacity but check the paperwork to see which box they ticked, it will either be when I lose capacity or when registered. Has it been registered with the opg. If it has take a copy to their bank, you can ask for a debit card and can set up any direct debits. They should both have assessments before they go home by the therapists especially your dad if he wanders and falls, they can arrange a keysafe, falls mats, fall detector alarm, pendants or wristbands with a telecare service with emergency responders who can be the emergency services, care agency or family. I'd start looking at care agencies, helping hands get good reviews, they may also need a few adaptations and aids at home which the therapists can arrange which are free.

Whatever the arrangements are ultimately, regardless of how happy/unhappy they are with them, the priority is that they are both safe and cared for.

Sorry! Didn't see your update.
I must admit that I went straight to private for carers. In theory she should have got a few weeks support from NHS or whoever. The care agency I used was a care at home type one. It was £37 an hour charged, but they would do whatever Mum wanted, take her to shops, out for a coffee, clean, make meals. They were lovely!

I'm just coming out the other side of this.
Do respite care. Anything else will go wrong. You will have calls constantly. My mum had fantastic carers but frankly it was not enough
And the mental strain is huge.
Book respite and then take time to think about what should be done.

I wouldn’t go straight for private care - I’m not sure what part of the uk they’re in but in Wales everyone is entitled to an element of free social care - they may then pay top up fees following a financial assessment. Keeping a social worker involved can also be really beneficial as things inevitably change going forwards.

Make sure that both rehab locations are aware of what going on with the other parent and where they are. In an ideal world both teams will work together to arrange coordinated discharges for both of your parents.

In terms of night time wandering, it is possible to have alarms put in doors to alert other members of the house to what’s happening. These can be set to only activate between certain times so don’t trigger throughout the day. They’re usually arranged as part of a telecare package and ime the council ones are better than private ones.

Regarding them not wanting carers in, nobody wants them in. The knee jerk is back the way things were so we can forget this horrible period in our lives and get back to normal. But it’s unlikely that they will be able to.

Apparently it’s easier to get carers after a hospital stay as it’s all very immediate. If they decline but subsequently need them later (when they realise they’re not fit to change beds, deal with heavy shopping etc) it could take longer during which time family will need to step in. And by then family will have used all their carers leave etc so it will be harder.

Much better to try and make them accept the care “just for a few weeks mum til youre back to full strength. We can’t have you pushing yourself and ending up back in hospital as dad would be in a pickle again so cant we just keep the carers for a few short weeks and then you’ll be back to normal?”

Followed up with “we don’t want dad in a home so having the carers here actually prevents them carting him off to a home, as social work can be reassured youre both managing and the carers can do the heavy stuff like bathing dad, so it’s a good thing to keep you both together at home longer” Just think of them as PA’s.

Long term if they both need carers would they consider extra care housing where they have their own flat but with 24 care available or a double room in a carehome, if they are self funding it may cost the same as live in or 24hr care at home.

How did you stop him from wandering at night? Did you have 24 hour staff on duty?

Do they have the money to self fund? We had a very similar situation, and the free 6 weeks care that the SW offered was totally inadequate (two visits a day for 15 minutes each, for a man with dementia who was utterly confused and couldn't do much domestic stuff in the house even before he had dementia). There were two adult children within near(ish) reach, but both had already had to take emergency leave from work to deal with the initial crisis, and just couldn't do that for weeks. We (collectively - the wife-carer in hospital and the wider family) decided to reject the SW offer and arrange live-in care instead through a private agency. That continued for a few weeks after the wife was discharged, as she was immobile. It worked very well. We did think about a respite home, but felt that he would have been very confused by the change of scene and might never have come out, which he/family weren't ready for yet.

But all that depended on them having the money to pay.