Help. Mum about to be discharged from hospital

My dad was running around near naked in his block of flats and that's when they acted. Before that they told me he has capacity so can go home. I said if he wanted to jump off a roof is he allowed and they said yes

I had all this with my dad. OT insisted he could be discharged I told her he is seeing small animals sitting on hid bed. He was discharged spent 3 hrs at his flat then carer rang ambulance to send him back to hospital.

All I can say is that if your loved one has capacity and wants to go home, all the powers that be will not give a shiny shit about your abilities, needs or wants.
It's all about what they want and you are left as nothing more than a maid.
Yes, I am bitter....

It absolutely is the hospital's responsibility to ensure patients are being discharged safely and not to a situation that will see them back in A&E and readmitted in a few days.

Any hint of family support and they'll skip all the safe discharge procedures and assume she can go home with you OP and you'll look after her. Especially if your mum is telling them that. They think that because you visited once a week before, you suddenly have the capacity to provide 24/7 care. You have to make it crystal clear you can't do that, and she either needs a transfer to residential reablement care or care at home. Get a care needs assessment by social care done while in hospital and do not step in, as it's incredibly hard to get it after someone goes home and you can't manage (just been through it!)

It can usually be forced (often pretty quickly) by the family doing absolutely nothing and staying away. Cruel as it seems.

I think it is all a bit trickier if self funding - she will be paying for it and if she doesn’t want to, it is hard to see how you or the social workers can force the matter

You have to be an utter pain in the arse. Their poor discharge planning shouldn’t be your problem or put your mum in danger. We have had to step in and intervene. They were about to ship my mum off to somewhere totally unsuitable and we kicked up a massive fuss then a different consultant reviewed and said she wasn’t actually medically fit for discharge and was still in a month later. There is a huge amount of pressure on beds and quite frankly I’ve seen it happen too often that patients discharged too quickly are then back in a worse state within a few weeks. They need the beds but families have to advocate hard for vulnerable people and be very black and white about what is right for the individual.

“We have POA for finance but not health. Terrible advice from the solicitor who said it wasn’t needed.”

If your mum still has capacity, she can still allocate you as POA for health matters. This would only become effective once she lost capacity ( if she ever does) so you have time to get this done if you both agree.

The thing to remember is that the drs and nurses focus on whether she is medically fit for discharge. The care aspect of the discharge then passes to the discharge team which will include a social worker. You then have a team who is over stretched trying to make arrangements for someone who is, according to drs, medically fit.This doesn't mean that the care aspects and how it's actually going to work have even been considered let alone actually worked out. You need to say unsafe discharge on repeat to the discharge team. They should then look at a re enablement package, either in a rehab unit or at home. If the home environment is so unsuitable then it should be in a unit or a care home who provide re enablement. That's funded for 6 weeks. During those 6 weeks, there should be care assessments etc carried out and a multi disciplinary meeting to decide next steps. It's more difficult if your mum has capacity and there's no power of attorney as they will definitely keep asking her what she wants to do rather than what is realistic. To the poster who asked why do they do it like this? Because adult social care like many other bits of our care system, are on the floor, so everyone runs around patching things over until the inevitable crisis (I had to listen to my mum threaten to run a knife through my dad before anyone would take us seriously) Unfortunately it is a battle. Find out the name of the person on the discharge team, hound them for specific answers and don't back down just because.

Surely early discharge without supports in place (in order to get acute bed back) mean that such patients will be back in again no doubt when they fall etc. Doesn't make sense to me.

I looked after my mother for a year and it was not a task I would ever do again. She got full time nursing home care in the end and it worked very well. Cost a bomb, but look - who cares since I got my life back and I didn't have to worry about her safety anymore. I could actually sleep!

Agree with every single point 👏

Absolutely this, OP. Adult Social Care needs to step in on this one. Good luck.

THIS

Currently your DM is deemed of sound mind and can make all decisions regarding her care and discharge. My friend went through exactly this with his parents who were living in filth, both incontinent, couldn’t manage the stairs so weren't getting washed etc. The main way to get help is to contact social services and ask for support where they will do an assessment of needs. What then happens depends on the local authority but at least you have started the process. My friend go a care home place for his DF and supported accommodation for DM.

We are in Scotland and did this for DMIL, she has a superb care package now with carers in 3 time a day with the morning ones are doing the much needed showers/personal hygiene. She wouldn’t be able to stay on her own, in her house without this. The carers also make sure she’s meal planning and having plenty to eat/drink as she forgets to do this.

I hope you get help, its very very stressful.

great advice above about refusing discharge. You have to keep on at them thiough and DO NOT presume they know what they're doing or will do what they should be doing. My father in law is in the final days of his life currently from terminal cancer and lives with his wife who has advanced Alzheimer's. Our lives are hell at the moment. He has recently been in hospital for fluid draining off his lungs. They were instructed by family with health and financial POA he must NOT be discharged without speaking to us and care package being reviewed as it isn't sufficient, he has CHC funding.they both currently have 4 carer visits a day of about 45 mins, daily hospice at home visits and daily district nurse visits, it's not enough. The hospital did not do this, they did an illegal discharge and just sent him home in a taxi without letting the palliative team know, the hospital social worker, the care company, the hospice. Nobody even knew he was home till my father in law called us. And now we are back to square one shouting from the rooftops and nobody is listening. It's a crisis waiting to happen. The care company have complained officially to the hospital but that doesn't help us in our current situation. He needs to be in a hospice but refuses to go. Meanwhile my husband is at breaking point and our business is going to ruin with the stress and work involved in them both being at home. Shopping, cleaners, medications, gardeners, banking, medical appointments, constant trips over there when they can't operate the the Ring doorbell, the front door lock, the TV remote, arranging meals on wheels, dealing with the aggression from
my mother in law with Alzheimer's. The list is endless and my advice would be to refuse to do anything at all for her practically and focus on advocating for her with professionals as someone else suggested. I am really sorry you are going through this and I hope you get the professional support you need.

Social services wanted my DM to be the go - to for my GM. ‘Just’ to do the shopping, occasional laundry, keep an eye etc. My mum said she wasn’t doing it so GM ended up in care. They can’t make you do anything. Make sue she hasn’t a door key on her.

Why do you need to ‘push an angle’? You can just day ‘no, I won’t be providing any care.’

Think about what care you are still willing to provide, if any. Weekly shopping / visit / fridge clear out? Can she cook meals if you give her the ingredients/ ready meals? do you want to stay as the Careline contact? Remember, boundaries are for you - not for anyone else. Boundaries are the limits you set for yourself.

what care does she need? Personal care includes
getting up
getting washed
getting dressed
taking medication
eating
drinking
toileting
getting ready for bed

Will carers be able to do these things, given the state of the house?

The trick is to be involved and in the loop enough to raise the awkward questions about her welfare going forward - without getting sucked into solving the issues yourself.

It doesn't matter if yours local or live miles away, you call the Careline company and remove your name, they can be first responders, you tell the discharge team the house is unsafe, you believe this is an unsafe discharge and you are no longer able to help. Like ppl say she needs a formal capacity assessment first, then let the discharge team make decisions either with her consent or in her best interests through the court of protection. If the house is falling into disrepair has the solicitor ever visited if they currently own half. You can also resign as financial poa if you don't wish to continue.

The first step is to request a capacity assessment. You cannot move forward without this, as, if your mother has capacity, she has the right to make poor decisions, including discharging herself from hospital, living in a horde, etc.

So take things one step at a time, first off, get on to the hospital social worker and raise your concerns about capacity. Everything else stems from that one crucial question....

.

Does your mum have capacity to choose how she lives? Does she have dementia? What age is she? What does she want to do and what does she want you to do?

if she does have capacity to make (really bad) decisions then all you can do is set your own boundaries and stick to them.

what care does she need? The usual talks that a care will do are:
getting up
getting washed
getting dressed
taking medication
eating
drinking
toileting
getting ready for bed

what care are you providing?

and I’ll be left to sort her out again.
this is where you draw the boundary. Remove your contact details from the landline. Tell social work / discharge team that you will not be providing any care for your mum. Ask them how they expect her to manage all the above, and add to that shopping fur food, cleaning, laundry etc. You get to decide how much you do.

I had a similar thing with my very elderly mother when they wanted to disharge her from hospital. We found a care home that was able to take her - initially intended as a short-term stay that extended into a longer stay - as her flat hadn't got suitable grab rails and other adjustments in place, and the hospital wasn't allowed to - or certainly didn't - discharge her to the care home until they were sure it could provide the level of care she needed. Legally, I think there has to be a care plan in place before they can discharge a patient that needs on-going care. The other option we were offered was a convalescent hospital as an interim measure but it seemed rather a lonely kind of place so we pushed to find her a care home. If you or the hospital can find a care home to give her the care she needs while she's recovering and which will give you a breathing space while you assess what needs to happen with her house, that would be ideal. We had to advocate very hard for her to find a care home, we did a lot of research and phone calls ourselves so we could make suggestions to the hospital about what places might come up. Good luck with sorting it out, it's a very tough time to negotiate for all of you.

We had similar issues with my in laws and we had to give them an ultimatum, either move from their totally unsuitable house or we would have to step back and let them get on with things themselves. They did listen thank goodness and are now in a much more suitable bungalow just down the road from us.
The difference in their health and stress levels is unbelievable. They are so much happier and so are we!

I hope people are able to persuade your mum to get the help she needs.

She is their responsibility until there is a safe place to discharge her to. That's why there is a huge problem with bed blocking, because it IS their responsibility. It's far from ideal but that is not the OP's fault.

The staff need to work with SS to find her a suitable place or package. Step right back OP because otherwise they will try to put everything on you.

Presume the trust owns it with Mum having a life interest.