Discharging an end of life patient to a nursing home

[Rose3434]

MIL has had multiple strokes, and they suspect an underlying lymphoma. She has been in hospital about 5 weeks now. She had a brain stem stroke last week and they called us all in to the hospital to say she wouldn't last the night.

Four days later, she is still with us, but completely unresponsive and labouring to breathe. Initially, the consultant recommended that all medical intervention should be withdrawn to allow her to slip away. The family agreed to this although another consultant involved with care carried on with the medical interventions anyway. Following further meetings with consultants, they are now back to no medical interventions to allow her to slip away. However, the consultant this morning mentioned about discharging her to a nursing home.

Is it likely that she can be as well looked after at this end of life stage in a nursing home as she is in hospital? Very concerned that moving her at this stage may not be in her best interests?

I believe hospice places are extremely scarce., a care home will be able to do just as good a job.

My MIL also received excellent end of life care in a care home, please don’t feel you are being fobbed off with second best.

The staff will have all the meds they need and can administer them when necessary. It’s a far more peaceful environment than a hospital at a sad and difficult time.

Ah joy. We had this with FiL when he was dying of cancer nearly 30 years ago.
We got that they wanted the bed, but to our eyes he was clearly going out in a box within a few days (we weren't wrong) and it just seemed beyond bizarre to us.
FWIW we did nothing beyond looking bemused at them and he died in his hospital bed shortly afterwards.

So, OP, you could just wait until there are actual concrete proposals (when and where they plan to move her) and deal with it then. From the sound of it your MiL will probably slip away before they get that organised.

Wishing you the best in this odd and sad time, whatever happens.

I'm very sorry to hear about your MIL and what you're all going through.

What I would say that is if she's near end of life, nursing home might not take her. MIL went down hill very quickly in last few days. Someone had actually been to visit her from nursing home. However, when they came to collect her a couple of days later, they refused to take her as they felt it wasn't the right thing to do - she was very restless and stressed despite medical intervention to relax. She passed away less than 24 hours later in hospital - it was pre-covid and unfortunately she happened to be on a ward with two others in similar situation. However, hospital staff were lovely, we had four people around her bed (and I suspect next door did) and they left us be with her, other than to offer coffee, check on her when we asked.

In relation to this make sure the hospital discharges with anticipatory medicines (ie end of life medication) and if and when they start using it order the next lot so you always have a “stock” on hand. Hospices usually Carry stock, and if a care home they will have a nominated pharmacy to receive these scripts and the turn around is quick. For this to work make sure as soon as you know where she is going get the gp to change address and nominate the care homes pharmacy. The biggest fall down in prescriptions in care homes is people not sending the correct paperwork to GP and pharmacy.