Would you go on this holiday?

[Rollerful]

Elderly parents, until recently have been those impressive sprightly older folk who won't slow down.

Recently Dad has starting falling and is now quite frail and Mum has been in hospital for the last 2 weeks with a mystery problem that means she can't walk more than a few steps. Fairly well in herself.

Local relatives are me and my two (just) adult sons. One of them drives. My sister lives 200 miles away, has a FT job and a young family.

Mum thinks she'll be coming home today/tomorrow and further tests will be done as an out patient. I'd have thought some OH involvement and possibly a care package was needed to make that a safe discharge....but what do I know? They seem to think not.

I'm supposed to fly on Thursday and be away for a week...

DC would do what they can. DSis says she'll find a way to come in an emergency.

Wwyd?

If you would be happier staying home, stay but if you want to go, it will be OK.

They should do a care assessment on her before she leaves hospital and if needed put in short term care for her. But if she says she doesn't need it and that she has enough support at home already they can discharge her without any of that especially if your Dad agrees to it, I think they wouldn't just take her word (hopefully).

I think a lot depends on how well your Dad can manage himself and her. Is he coping ok at home on his own now? When you say your mum can walk a few steps does that mean she can get to the toilet and manage that, shower herself or whatever? Can he help her enough to do those things. How about food preparation etc.

If you were at home would you be able to provide enough support?

I don't think he can do any of those things, not well anyway. They only have upstairs bed and bathrooms. I'm not sure how much help I'd be (or want to be) either tbh, but id be there to advocate.

I'm really surprised they're talking about discharge without support.

Honestly I would go. It’s hard because your heart says stay, but you’re unfortunately probably at the start of a long haul of providing more care. I would give your DSs strict instructions to contact their auntie if any issues with DPs.

I'd be speaking to the ward sister and/or the discharge planning team/occupational therapist/physio with your concerns, the fact there is NO support for them(don't mention your sons etc).

Years ago I worked in a hospital and it was amazing how much people would stretch the truth or blatantly lie to get home. One woman said that her daughter helps her often- the daughter lived in Canada and hadn't been in the UK for 5yrs!

Its hard when they have capacity, but I'd still want the team to be aware- there is no down stairs loo, they cant get to the shops, wash etc etc. I'd be asking for a care package as a minimum.

Trust me. Go on the holiday, so that you ARE NOT there at this crucial stage. This is going to sound very cruel but it comes from experience. I know you love your family and you want the best for them, and I know you mean to advocate for them / organise, not "do". However, the various services within the multi-disciplinary team who allow discharge (Drs / OH / Social Care etc) are under so many different pressures and need to maximise their resources, meaning allocating them to people who have no other option. This means when they hear / see that there is "family" there who can help, they will let you do everything you choose to do and you will never escape. Your relationship with your parents will no longer be as their child. It will be as their carer and you will all resent it. Make it clear that you are not in a position to offer care, because you are not. I'm not saying don't do things like like help with online shopping and banking etc, answering calls and organising patient transport or lift etc as needed (I do, and once a week visit - for fun and company as a daughter - but where I pick up on anything the carers need or need to know which they were unable to progress with my fam). If you, (and at the moment your Dad), however, start re "oh, I'll help mum get dressed", "I'll do lunch"... They will say that no homecare or less homecare is needed. And so your burnout and the mutual resentment will set in eventually.

So will there automatically be a discharge planning team involved? At what point do they become involved. The doctor has told them Mum can go, but is it possible that all changes when someone else hears about it?

They'll be furious (devastated) if I interfere and she can't come home.

You MUST go and parents must be honest about their lack of local support. The less family help they have, the better, in terms if social services etc input.
Plus, you deserve a holiday!

This sounds wrong, but if you go and son's aren't able to help, then she's more likely to get the support she actually needs. If SW get a whiff that there are family members ,"to do", they are likely to drag their heels and provide as little as possible. Not because they're bad people but just down to having a lack of resources. So if you and your sons providing consistent care and support isn't something which would be manageable long term, go on holiday.

But how would SW hear?

There is usually a team who authorise discharge when there's a question over it being "safe" and Social Care are part of that. If you're visiting ask reception or a nurse or anyone who you can speak to re your parent's discharge as you have some concerns, or phone the ward and someone will phone you back. It's possible your parents (through understandable wishes to be discharged / not quite accepting things as they are yet) will stretch the truth about what you and your sons are able to offer.

You tell them, ‘I’m going away and there is no emergency support’. Hopefully they’ll assess prior to discharge and put carers in. They can also arrange lifeline/Telecare support quickly for discharge if your mum agrees.

No way.

it’s totally unfair to put it onto your children

I’ve been in this position and I didn’t go , I’d do anything for my mam and dad, unsurprisingly my other siblings do nothing and it’s usually a fly by visit every few months to show they’ve did there duty.
some people do not have good relationships with there parents and if this is a factor I’d go , hospital are terrible for lack of support on release so make sure there’s plenty in place

You need to contact social services for an assessment.
i would also email the hospital (paper trail) and ask them to clarify what the discharge assessment has indicated needs actioning and is being done in preparation.

Where I am, when patients who are elderly, infirm etc they're referred before discharge to the hospital assessment team consisting of SW,OT, Physio. Patient is assessed in hospital, then again as soon as they get home. Often they go home with carers up to 4 times a day, who go in for a period of time (2-4 weeks) to assess what people can safely manage and what they need support with. At the end of that assessment either service is withdrawn or package of care is put in place. In the meantime physio/ot have assessed for and supplied equipment etc which is needed. Have experienced this several times now with my gran who is very elderly but usually well. And my dad who unfortunately is not a well man.

Did they investigate your dads falls? Low calcium can cause this or he could be low in B12. Go with your gut on the trip. If you can enjoy it go if not maybe postpone it

My mother had a six month hospital stay. She was in critical condition many times over that period and looking back really probably wasn’t ready to be discharged even when she finally was. The hospital was desperate to het her out as they saw that i was visiting her daily, bringing food etc. at one stage they even asked if i coild take her home to live with me. I work full time and have young children - my mum had basic toileting issues and could barely walk the length of herself. I insisted on full assessments each time sending her home was mentioned and told the team that i would not allow my mother to be a failed discharge- basically stats on who bounces back into hospital after being sent home. When finally discharged she had a full care package which was very needed but you have to push for it.

No, there won't. My elderly single neighbour was recently discharged with no assessment or care package. He couldn't walk. It was ridiculous. One fall three hours after discharge, and another 36 hours later, with nobody but neighbours to help. We got him sent back to hospital by ambulance on the second fall.
He was in hospital another week while they arranged a care package. The Discharge to Assess team came to assess exactly what care he required. The assessment was done two hours after he arrived home.
To note, this was very recently, and while he was more mobile and stronger on his second discharge, things have rapidly declined, so don't assume it'll be an even upward trajectory.
I would have your holiday, but I would contact the hospital or Discharge to Assess team, and tell them your father won't cope with caring for someone who, it sounds like, won't even be able to get upstairs to the bathroom.
If a care assessment isn't done, it could be very stressful for all concerned.

She should have a care needs assessment, their home needs to be checked for suitability - stairs, toilet, showering etc - and the discharge team at the hospital need to be told in no uncertain terms that at the moment, it would be an unsafe discharge. Tell them that no matter what your parents say, they are both too frail to cope without support, and that no, family will not be there to help all the time.

Honestly, I would go. Was in similar situation with my Mum re hospital release & care requirements & home set up with beds & bathroom upstairs, hospital just wanted Mum out & Mum kept saying ‘oh my daughter will do that’ when I really couldn’t. Feels selfish but have some time to yourself before you won’t be able to x

Your sister needs to be stepping up. She can take leave. I assume you have had to do so in the past.

Often when the Dr says ready for discharge they mean medically fit for discharge. That doesn’t mean ready from a physio and occupational therapist perspective. Ring the ward or ask when visiting.

Can your Mum get in a car to get home? Is she using any mobility aids and how far can she walk? Can she get in and out of a chair/bed on her own? Can she get upstairs to bed? Can she get to the bathroom or will she need a commode?

If she is saying you will be helping, the occupational therapist should speak to you to confirm this. Sounds like she at least needs a home visit to assess her at home and identify needs. There are re-enablement care packages that are short-term that can be put in place quickly but she’s likely at the point of needing a longer term plan.

This with bells on xx

Sorry to disagree with most other posters, but I couldn’t have gone away if my mum had been in this position. Whether or not you can provide much practical support it sounds as though your parents really need you to advocate for them.