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?

This with bells on! At the mere whiff that a friend or family member will take anything on, SW will pull right back on what is offered.

Is your mum basing her assumption on going home tomorrow on what the doctor said? As someone has already mentioned, she may be fit to be discharged health-wise, but that is very different to being able to look after herself. And more so with the problems that your Dad has. Would they be able to cook and clean for themselves? Are they able to remember to take meds?

I went through this numerous times with my late mother. I would suggest you phone the ward and find out exactly what the plans are and express any concerns you have. I know all services are stretched to the max these days but you need to make it clear if you don't think they can cope alone.

I do get why others hace said what they’ve said and agree you need to express your concerns about their safety at discharge to the physio /OT and be honest about exactly how much help you are willing to provide.

I think considering the steep decline you mentioned I would probably postpone the holiday or go somewhere close to home because you don’t know yet if they are going to now have a steady period at this level of frailty or to continue their steep decline. If they became critically ill or died while you were away how would you feel?

I’d go, it may be your last chance for a while.

How old are your DPs and how easy would it be for you to get back if needed?

I think that would have a bearing as well, as some have mentioned sometimes a downturn in condition can happen quickly, or it could be the start of a long slow decline, or - less likely- they could perk up and be perfectly fine.

Tell the Dr & Ward staff you are going on holiday and cannot support her at home on discharge. Tell them your dad will struggle. Elderly parents hear that they may be discharged, but dont always understand that a social worker and physio team need to be involved and it can take longer than they think. They are sometimes also discharged to a rehab place for this to happen. Which is not the same as going home. They need to know you are not around. I would also put all of this in writing by email to the consultants secretary and ask for the social worker to call you. That way if they just send her home without support because she has said you help her (they all say this!) You will have some evidence that you did tell them you are not available as a carer and to contact you by email or phone whilst you are away. She should also have a free 6 weeks package of care on discharge. This is not dependent on low income. I think you will be home before she is.

How woukd they hear ?
Your parents will have been saying, we are fine, we dont need anybody/thing.
“our daughter lives next door, she is available to help “

They'll only hear if you tell them.

You need to tell them your DM is carer for your DF, that he's not capable of any caring for her, and she has no support at all as you will be on holiday during discharge. You also need to tell them that after you return you are not available to do any caring at all. Ask for an assessment and use the term 'unsafe discharge'. Preferably in writing.

Of course you will help them, but do not tell them that. If they get wind of anything at all, they'll assume you can do anything. For instance, SIL made the mistake of saying she could collect her DMs prescription - SS put it down on the paperwork that she could do all shopping, medical appointments, and 4xdaily administering of medication. She worked full time!

When we were in a similar position, it took more than another week for actual discharge to occur. An assessment was made and carers needed to be put in place.
It was the beginning of a tough period for us.
I would go on the holiday.

IMO they need to get themselves sorted. In our family it would be considered very selfish to allow yourself to get into a situation where you’re getting age related (and therefore predictable) ill health and to still be living in a house where the only bedrooms and bathroom need you do to be able to go up and down stairs. We all help each other out but with the expectation that you have done everything you can to help yourself first. My Mum has recently moved into over 55 bungalow accommodation so that her new home will suit her as she ages, unless she ends up needing a care home. It was hard for her to move out of the home she’d lived in for 50 years and leave my Dad’s grave to move near my sibling but she would potentially be in the same situation as op’s parents if she didn’t.

I live in the middle of nowhere and recently had a health issue that meant I couldn’t drive for a couple of months. It’s a life long issue so there may well be periods when I can’t drive in the future. The first thing I thought about is when I will move somewhere when I will be independent with public transport. We don’t plan to move for another decade and our kids have (hopefully!) left home, as the house suits us well and I would be unlucky to have to give up driving within that timeframe now I’m on medication. But we have viable and thought through backup plans if we have to move earlier than that. I don’t want my children to be hindered in living their own independent lives.

It’s really hard in your circumstances but I would go on your holiday. This is a situation they’ve walked into eyes open. I would also be totally honest with the hospital. It is not fair to the staff to let them be lied to. If your parents would be angry with you if that meant your mother wasn’t discharged, then their prioritises are seriously off and dancing to their tune is going to exhaust you.

I was hoping it was "only" a doctor who had told them she could go home and once the discharge team got involved that would change/delay things while provision was put in place. They're home. The only provision that has been made is that she has a walking frame.

There's no SW involved.

You need to complain. Email PALS. That sounds unsafe.

Did you get a chance to speak to Ward staff before that happened? They could still arrange for an assessment at home as urgent. Is your Mum able to get to her bed and bathroom?

No i didn't speak to anyone. TBF I didn't try, as I knew they'd be furious if I interfered and it delayed the discharge. We have enough to deal with as a family, without a rift.

Someone from the ward wheeled her to the car and Dad drove them home. Whether he's fit to drive is another issue...but "they" will have seen how frial they both are. I deliberately didn't get involved.

She can getting and down the stairs.....on her hands and knees.

This is an unsafe discharge but the staff can only go by what they know and what your parents tell them. Sadly I see this so often and it’s the grown up children that are left worried and trying to balance their parents safety and respecting their right to make decisions. Mostly women in their 50’s, juggling elderly parents, teenage children and menopause while often working full time. Go on the holiday

I've not read all the messages so may be repeating information.
The social worker will be needed to complete financial assessments and have input, if necessary for the correct PoC. Even if parent /s are self funders they can have a Social Worker.
Do both parents need a PoC?
OT will need to assess for single bed(s) to be moved downstairs, provide equipment such as commodes etc.
Commode will need to be emptied by a person who is able to manage stairs to get to the toilet.
Do you have Community Beds in your area? They offer respite and rehab, also gives some time to organise everything.
Good luck x

@Rollerfulwhat did you decide about the holiday?

This is SO true.

Im in perimenopause, work in a really stressful NHS job, am juggling financial stress with DC at uni and so so worried about my parents whose health and safety has significantly deteriorated.
I am permanently panicking internally and i wonder if or when life will ever feel any better.

Go on holiday OP. Your parents want to run their own lives, decide on the discharge themselves etc. then they can manage their own care. You can still love them dearly and help out, but don’t arrange your life (and certainly not your sons’ lives!) around what care they might need. It’s hard enough when elderly parents are on board. It’s near impossible when they resist help from services and expect their busy and overstretched grown up children to step in and do everything.

Do you have LPA? Even if not ask for a care needs assessment and ask that you are included in the assessment. You can ask to speak to hospital social worker.

Look at this group Rightsfor Residents created during covid. Refuse to take your parents home until an assessment is done as once done they won't do or it'll take an age. Go on holiday if you feel your emotions will be OK, don't if youre just going to worry. It's shit and it'll be hard with your parents but you've got this! You are strong and can do this. Off topic but hope it helps.

If your parents are getting frail, do you have a power of attorney? There’s one for health and one for finance. The health one means you can be part of the decision making.