bed blockers adding to the lack of hospital beds

[newcovidisolations]

My mum was medically discharged to leave hospital into rehab (following a stroke) well over a month ago but due to no rehab beds being available she is still taking a hospital bed from someone who needs to be admitted from a&e. She has now tested positive for covid and despite no symptoms at all is now taking a private room on the ward for 7 days as they insist she isolates.

Over 3 weeks ago I rang every private rehab within 50 miles and none could assess her to see if she could transfer until 5th Jan. Despite fees of over £2k per week with extra charges for all physio.

She could possibly have regained mobility with daily physio in rehab had she been discharged weeks ago whereas now she could have far more care needs for the rest of her life.

The system appears broken to me and could affect any one of us and I cant understand the lack of protests. Any of us could need the hospital bed not just the elderly. Her ward is not just used for strokes.

Actually they do still exist. I work on one.

I understand what you are saying @SmokeyPaprika , it does actually happen now. I see people who are deemed to be end of life because they have developed an infection, are incredibly frail for whatever reason, and the decision is made not to actively treat them and give TLC in their final days instead. Very few people would argue against that, the vast majority of families are in agreement that this is the kindest and most humane option.

Actually they do still exist. I work on one.

An actual long stay ward as opposed to an elderly care ward ? where people are not expected to be discharged @EddietheEagle ?

Well it's an elderly rehab ward, we accept patients over 65 from the acutely wards once medically fit. They come to us for physio and occupational therapy input.

They then either go home following discharge planning and home visit, alterations as needed to the home by occupational therapy, or to a residential or nursing home.

Some are waiting for care packages to commence / increase. Some patients are with us months, some weeks.

Should say I agree with this, there is a point where prolonging life is wrong and it is possible to state advance wishes, along with a DNR. Sorry if I was snappy @SmokeyPaprika I got the wrong end of the stick, not in a good place at the moment

Still have a horrible suspicion I'm right about Logan's Run though, unless things improve very dramatically and I don't see the will to do that.

However there is a noticeable minority who treat the place like a hotel. Eg,, staying in bed all morning, watching TV all day in their rooms, Refusing to join in group exercise classes. Socialising with their visitors for hours on end.

Whats wrong with any of that? I thought the operative word here was care home; it’s not a youth hostel! My MIL is 96. What do you expect her to do at her age? She was in a rehab care home. She spends all day at home on her own, watching television. Why would she want to do something different anywhere else? We suggested to her, she go eat in the dining room. Her response was:

”I’m not eating with that lot!”

Just because people are in the same age bracket, doesn’t mean to say, they have things in common. For all we know, maybe many of them had dementia - she didn’t!

She got precious little physio - they told her, she’d get more if she went home. She got none whatsoever at home!

Interesting that someone mentioned the falls of patients in the ward her Mum was in. Back in the old days, there were special chairs with tilted seats that people who were confused and couldn't stand unaided safely, were sat in. Obviously these were really a type of restraint and were deemed innapropriate. Did they increase the staffing ratio's when they got rid of them ? No, so unless the ward manager can pitch hard enough for 1 to 1 staffing, those people are now at an increased risk of fall's and injury. Staff are left in the unenviable position of trying to decide which patient to manoeuvre to the floor catch whilst in the middle of their drug round in a six bedded bay !

My DF has recently been discharged from one of those wards to a nursing home, after a failed attempt to have him back at home with care package. He was not suitable for physio due to his Alzheimer’s.

I think what BirmaBrite was referring to was what the hospital my DF has just been discharged from used to be. A long-term geriatric hospital, where most patients left in a box. In the 1980s my DF’s father was in the same hospital, but it was long term. He was there for about 6 years after experiencing a massive stroke with no prospect of recovery. He died there, eventually, despite getting antibiotics for every infection! This was a man who could neither move nor speak.

I wonder if some of the reluctance to increase capacity in hospitals and social care is to do with demographics. We currently have large numbers of elderly, but politicians and planners know that once the older baby boomers start to die off there will be less need, as Gen X (born 1965-1981 approx.) coming behind them are much fewer in number and are balanced out by the large working population of millennials behind Gen X.

Given the amount of time significant improvements take, the bean counters may have judged it as not worthwhile for the time frame.

Despite being on an acute ward (hopefully an acute stroke ward), she should still be receiving rehab as long as she is medically well enough. Have you spoken to the SALT, OT or Physio or even the stroke nurse about her therapy?

My DF has been in hospital a couple times in recent months. Care the first time was appalling and we made a complaint. They practically tipped him out the wheelchair into my DPs home to get him out and even though he wasn't well enough admitted they wanted the bed. Second time same hospital different ward, in for a week with Pneumonia, not watched and had an unexplainable fall so had ti have scans etc to check he was OK. He again was sent home no care in place, with the possibility of choking and getting aspiration Pneumonia again. When DM said what do I do if he chokes they said call an ambulance, last time an ambulance was called they didn't come for 40 minutes and he was left unconscious on the floor. We had a crisis with him this week his dementia is worse and he's becoming violent, the social prescriber says DM needs respite and he is becoming a danger. You will have an emergency call within 48 hours from the crisis team, 4 days later we have still not had a call. My DM is struggling, the rest of the family is struggling but there is no help really, it took 6 months for an assessment for equipment in the home! I am worried sick about DM I don't know which way to turn for help as everyone is very kind but nothing ever happens. I hate seeing DF like this, they will keep treating his Pneumonia until one day the antibiotics don't work, uts wrong, it's cruel and humiliating for him now and it's agony for the rest of us.

Yes @Seeingadistance that is the type of ward/hospital that used to exist that I meant when talking about long term elderly care. The vast majority was delivered by the NHS, then they closed them all down.
A rehab ward means you are working in an environment where you expect someone to be discharged, regardless of how long it takes to organise an appropriate care package or placement @EddietheEagle

Many years past the point of being able to get themselves dressed, take themselves to the toilet or be mentally present.

In many cases they don't.... my mum was end of life, they didn't give her any drugs other than pain relief and to calm her (my DB and DS wanted her to get everything... for what end?)

It was all very dignified.

Antibiotics just don't work like they used too.

...which as a life long nurse, she'd have been pleased with, it was one of her bug bears.... unnecessary treatments to prolong life.

The problem with that is "who decides" and at what point do they stop?

Then there is the family to consider, many might agree (if they are in the Will) others might not.

We currently have large numbers of elderly, but politicians and planners know that once the older baby boomers start to die off there will be less need, as Gen X (born 1965-1981 approx.) coming behind them are much fewer in number and are balanced out by the large working population of millennials behind Gen X.

the elderly are set to grow though.

"there are almost 11 million people aged 65 and over in the UK. This equates to around 19% of the UK population. Estimates suggest that in ten years this figure will increase to around 22% of the population being aged 65 or over, or almost 13 million people."

I think the doctors should decide, who has an adequate quality of life to continue and who is frankly using up precious resources that should go to somebody else.

My DM was recently discharged from an elderly care ward. Right from when she was in A&E I was told she wouldn't be discharged without a care plan, so in theory a patient who isn't medically in need of being in hospital can go home and have support for up to six weeks. However, my DM finished the IV antibiotics and was joyful told by a junior Dr she could go home tomorrow. To the house she lived in independently before being admitted. This despite still having a fall alarm so she could even stand up without being told very firmly to SIT DOWN MRS BOLEN and a catheter. My DSis kicked up a fuss and the hospital agreed she could stay until am assume these had been made. DM was then in tears because she had thought she was going home. That day there was covid on the bay she was in, and also flu on the ward. I made the decision to bring and elderly, frail, confused mother home with antivirals rather than risk her catching covid (the next day when I popped by to the hospital three out of six in her bay had covid) we (my family) are not capable of giving my mother care she needs, for several reasons, and it will be next week at the earliest we can get outside care in place. So she didn't bed block, but I completely understand why anyone would let their elderly relative stay in hospital longer than should be necessary, when it's the best option for their relative.

My DM is a long way from dying, the only treatment she really needed was lots of strong antibiotics, so for the poster who wishes our elderly to be left to die, I hope they're prepare to go without life saving antibiotics if they need them, because someone with that attitude doesn't seem to be adding much to the human race.

My mum was running around on the day of her stroke and can do the Times crossword faster than anyone I know. I believe if there had been an ambulance she would have had the treatment that can reverse the effect of strokes. If she had received physio every day as per NICE guidelines she would have progressed as there is limited movement in the 2 limbs that were paralyzed. Whereas instead she has received 2 injuries that have seriously impacted physical recovery (due to lack of care) and is now locked away for 7 day isolation so even less chance of physio. Brain is still unaffected so crossword is still being completed at speed but sadly she is very aware of what is happening.

To those saying she should still receive physio - yes I am well aware of the NICE guidelines. I am also aware people shouldnt be fed food they are allergic to or left with no bell pull in a dark isolation room as no one has been in for hours. Yes of course I have asked about physio. There is not enough staff especially over xmas and they say they have to prioritize assessing new arrivals which makes sense of course. Such a sad situation and could be happening to any of us including our teenage kids after a bike accident for example.

@Cuppasoupmonster And there you go on the slippery slope......child born with Downs, no quality of potential life so no need to live. 95 year old completely with it and enjoying life but needs hoisting and full package of care...not the "normal" quality if life so needs to be gone. Got MND like Stephen Hawking and fully dependent ..but no quality of life despite being an Internationally renowned scientist. Quality of life is relative not absolute.

But they’re not old and haven’t already lived a life. That’s the difference.

How many years past that point?

I don't necessarily disagree but what if Dr's are influenced by their employers, family or are corrupt and evil ?

Its a slippery slope & not one easily put into law.

I just think that we should aim higher, other countries manage.

Sorry but think you are saying basically and child born with any illness shouldn't be allowed to live?? Wow....would hate to be in your family or a friend if someone was ill! And if that's the case, how far do you go...deaf...short sighted...squint....no need to live as may I pact your view of quality of life...

I imagine it would be a panel of 3. You’d be extremely unlucky to find 3 malevolent doctors. With abortions I think you need the agreement of 2 doctors.