To ask for you advice re: elderly grandma and my dad.

[WhatstheT]

This isn't an AIBU but I'm hoping people will be kind and hopefully give some advice on this!

My grandma is 92, and besides having a cleaner from age concern and my Dad in his 70s and his brother who has a mental disability in his 60s doing her washing and shopping, she had lived on her own in a flat with a warden and never had any problems.

My dad found my poor grandma on the floor of her flat on saturday afternoon, she'd gone to the loo in the middle of the night, legs gave way and she couldn't get up until she was found :(

She's in hospital at the moment having various tests done, they aren't being very helpful with information towards my dad (he can sound quite abrupt/angry at times, he's always struggled socially, and I think they may not be taking to his attitude very well as they don't know him) They are doing the usual blood tests, assessments, but are working quite slowly as she doesn't seem to have any urgent/life threatening issues so it's a case of getting an assessment of her general health and a few problems they have potentially highlighted. I can't get to the hospital myself because I work within the visiting times...

Anyway to get to the point, irrelevant of any results, she is still not right for standing unaided and dressing herself anymore, and it's unlikely to improve by the looks of it (my dad is of the opinion she may deteriorate fast now away from home and in the hospital).

My dad has asked questions to the nurses re: how he goes about with things if she can't live on her own anymore.. and what he does or they do, he's clueless, and has learning disabilities so he struggles getting himself organised or finding anywhere to ask for advice (he won't use the internet despite some lessons). The hospital staff haven't suggested anything at all to him.

How do I point him in the right direction and help him find the best care for my Grandma? Do the hospital set something up for her before she leaves or should we sort it from scratch?. My uncle isn't in a position to offer her any more care, and my dad is not fit enough himself to do more than he already does. (I work full time and have a baby under 1 but help any way I can)

She's a pensioner with no substantial savings for any private care past what her pension can afford. How do we go about looking into care homes, or an alternative such as the care workers who visit peoples homes combined with meals on wheels.

My initial suggestion was for him to ring age concern, as they are the ones who arranged a cleaner for her, but I think it might all be a bit much for him at the moment, he isn't in the best of health himself, so I'd like to gather as much info as I can to help him out.

Just looking for personal experiences, what worked for you? where the best places are for advice or arranging these kinds of things.

We are both completely clueless...

Either you or your Dad should ask to speak to the Hospital Social Worker.

Also telephone her Local Authority to advise them of the situation. They will create a file for her and on her discharge will appoint a Social Worker for her care.

It may seem that the hospital is working slowly and not communicating but there are very likely things going on during the day with your Grandma that you are unaware of.

They will most likely be doing blood and urine tests and it is quite possible that the OTs are assessing her daily. It can be frustrating trying to get answers, but frankly at this stage they really don't know what the outcome for her will be. Hence the tests.

Before release the OTs will want to interview you or your Dad to ask what facilities she has at home. They will then do exercise with her to see if she is able to cope at home. Sometimes the OT does a home visit.

Once she is fit to be released the LA social worker needs to do an assement to see whether she can go home with additional care or whether a residential home will suit her needs better.

You will not have to pay if her savings and income are low. They will take her State and any private pension as a contribution.

I am not sure of exact figures but they make a weekly allowance of about £28 a week for her personal needs. A financial assesment is made and the paperwork is set up by the care home finance office. Ensure that the personal allowance is not taken.

She is also allowed to keep about £14000 in personal savings.

If a residential home is deemed necessary, AND IF YOUR GRANDMA AGREES,
The hospital social worker will give you a list of local places. Ask very direct questions. "where would you put your Grandma" is usually a good one.
They are not supposed to answer. Our Social worker said, I cannot answer that but I am not sure if these have vacancies. Then crossed out three on the list. Which we took to mean don't touch these.

You can visit the homes on spec without an appointment. Our social worker phoned A few times to ask how she was. After 6 weeks we got an opportunity to change our minds and were given a list of other places if we were not happy.

You may decide that you want to move your Grandma to a different LA, nearer to you which you are allowed to do.

If you do not have POA apply now. There is a reduced fee for those on low income. It makes it easier to deal with banks and utilities. You can download the forms and complete them on line.

I think my dad is a little annoyed at the hospital because another ladies medication and name has been on my Grandma's bed for 2 days, and when he brought it up a nurse shouted at him...

Irrelevant of that though....

thank you so much for all the help, and the things we should try and say to them, it's very very helpful, I will write it all down and try and go step by step with my dad.

She is in a hospital 40 min drive away, but our local hospital is on my road and about 5 minutes from my dads house.. I'm not sure why she has to stay there but I think my dad will be hesitant to suggest moving her through fear of it slowing down/confusing things.

thanks again for your help.. gives me a lot of things to look into :)

In all that essay, I forgot to say how sorry I am that you are going through this.

The six weeks is not very clear. What I meant was that my mum was discharged to a care home after hospital and after the initial6 weeks, the situation was reviewed.

You have a lot to worry about, but don't worry about your dads attitude. Staff are used to dealing with stressed carers and make allowances. No one was ruder than my mum's husband. I would let the Social Workers know about his difficulties as that information will help them do their job better.

Thank you.

Seems to all come at once, My grandma and daughter have been in and out of the same hospital, between that and work I don't know if I'm coming or going, just trying to get my dad through it with as little stress as possible, he will be so worried about the unknown and who's hands everything lies in when she eventually gets discharged, it's all so confusing.

Both my grandparents came home with six weeks free care (carers in their home) set up by the hospital. Which gives you time to set up your own carers. You can do this through social services.

If she is unable to care for herself, can't walk etc she should be assessed by the physios on the ward and the OTs who will also do a home assessment. The hospital should also have a social worker. The hospital staff should know all this if she's on an elderly ward as they will do this all the time. Has anyone got POA? As you can only apply for this whilst your grandma is of sound mind.

I would try and get a day off work to go and visit and found out or phone the ward yourself. Yes you can ring age uk for advice.

You might already know this: your grandmother should be getting attendance allowance. It's not means tested, and the lower level amounts to about £80 a week (there are two levels, IIRC).

It would be really surprising if the steps to assign a social worker have not started already - but as the fall happened on Saturday, it might not be until today that this moves on, as she is not an emergency at the moment. When things happen at a weekend, you usually have to wait until the start of the week proper, unless there is some acute medical emergency.

I have had all this with a few elderly relatives - the hospital social worker system is very good, in my experience, and should take a lot of the organising away from you (though you might have to chase to find out what appointments eg with OT have been made).

Just read about attendance allowance - hadn't heard about it. Honestly if it isn't the basics she needs we won't know about it, It probably hasn't applied to her in the past, she was still managing to wash and feed herself..etc she just had family doing chores for her. But it's definitely something that looks like she can apply for in the future...

MY dad mentioned that someone from the social services came around a day ago trying her hour with a zimmer frame and some other equipment, but they got sent away as she needed an x ray, they told my dad they would be back later and they never came back... maybe he needs to chase that up in case she's fallen off the list some how... I'll get him to check at visiting time if anyone came back...

I'll tell my dad not to worry for now and to just see if he can get a telephone number off the hospital or somewhere for local social services to help them explain to him to process and put him at ease somewhat.

He's torn between worrying about organising anything, and trying to convince himself she may not even get to that point.. it's not a nice thing to think about of course but at her age and such a fast change in circumstances he's obviously having to prepare himself for the worse possible outcome...

I used to work in a private carehome, but I know nothing about the system and all the elderly I dealt with had sever dementia and very few family members visited... so I never knew how they got there or how things happened! But my dad does keep asking me about how fast they can deteriorate...etc. I just tell him everyone is different, but obviously it's on his mind.

My mum died about 8 years ago, lots of hospital visits and a LOT of mistakes made in hospitals with her through the years, lots of investigations into it..etc so it's all a bit raw with him and he's not very trusting of the system.

One thing we did find was to be careful about what your grandma is telling the nurses. For example we found that my grandad was telling the staff he didn't need carers as my aunts and uncles were his carers. They weren't, he just didn't want carers in his home. For some reason the staff believed every word he said! They weren't going to send him home with anything!

Jeffreythegiraffe

Yep my dad is trying to get this accross to the nurses but as they change everyday it's difficult.

She hasn't got dementia per se, but she isn't as trustworthy with information about things. My dad went to get her clothes the other day and found she'd been hiding some of her medication for months (nothing that would have greatly affected her health, but still not got down to why she has, because she's taken everything else like clockwork), will tell people there is pain in a certain place, then tell someone else it's somewhere else, lies about how much she smokes....etc.

Because my Grandma is lucid and does answer things well, they are reluctant to keep my dad in the loop in terms of her health and treatment, She's had a few hospital appointments over the month and it's always a hassle him trying to tell them they need to speak to him or they won't be happening..etc.

She's not really a fan of people, so the idea of other people having an involvement in her care, even if she can stay at home they'll need to move her to a ground floor flat (something my dad tried years ago and she refused)

So he's definitely on the ball with that, but like you said, staff tend to believe people if they sound convincing enough! Especially if the alternative is a lot more hassle :)

If you can persuade your Grandma about the POA it would be a good start. It will ease things for you and your Dad.

My SiL is currently suffering from Angina and is on ADs. Her mother would not sign the POA and my SiL,has had horrendous stress for 10 months since her mum went into Hospital and now in a care home. She cannot get rid of the flat, stop the utilities, deal with bank. She on the phone to me in tears.

Thank you, I'll speak to my dad about that now, These kind of things don't occur to you, you just think about leaving a will, but not about things when you're still here but need other people to deal with your things.

My grandma isn't very trusting.. all depends what mood he catches her in. Likelihood is she'll take offence and refuse... but we'll see!

Your SIL can apply for court of protection which is what someone I know had to do as their relative refused POA.

You need to speak to social services- she may be a candidate for intermediate Cate which is short term support to help her, either residentially or in her own home. They have carers, OTs and physio to help her get back to where she was pre-fall, or as close as possible. After that they'll suggest any long term support your grandmother may need. The first few weeks (whilst they do the rehab) is free and after that it's means tested. Call the hospital central number and ask for the social work team or Google adult social care for your grand local authority. Ask that a relative is present at the assessment in case your grandmother is telling porkies/ doesn't want to 'be a burden' and is saying she doesn't need the help.

Intermediate care!

Thank you so much, going to print this off and highlight points to bring up with my dad. :)

You can write to her consultant about her current care situation and have your Dad ask the ward staff to put the letter in her file.

You can also call the ward and speak to your GM's named nurse (this will change depending on who is on duty but it's usually the same couple of people).

You can request a referral to the hospital social worker for discharge planning and follow up with them by phone. You need to make sure that they understand the limitations of the care that can be provided by the family. Make sure someone (you if your Dad is easily riled) attends a care planning meeting.

You also need to understand that unless your GM is not competent to make her own decisions she can refuse care at home or in a residential setting.

It will have been occupational therapists with the walking frame and equipment not social services.

My dad was given the name of a nurse when she moved onto a ward but he said that's changed and it's been a different person each time, thats why he's struggling a bit with whats going on (and the issue of her name and medication being wrong on her bed)

ah my dad mentioned social services... I guess he was wrong.

GM is competent enough to make a decision, as in answer their questions.. but it won't be correct or reliable.. that's the problem.. and it will be my dad picking up the mess left behind from bad decisions and processes that she's encouraged.

Being middle man to a pair of people who aren't quite sure what''s going on and I can't get there to find out what's going on is hard bloody work :(

Re: Attendence Allowance, apply as soon as you can. If you are successful the payment will be backdated from when you first apply.

Keep a list of her prescription medicines. This is one of the questions on the form and also helps to make a case. The fact that she does not take her prescribed meds is a good factor in helping with the claim.

They no longer include the need for housework in the claim, but Meds and personal care are included.