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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To fight hospital trying to discharge my Dad to Care Home?

155 replies

FiveShelties · 24/07/2016 19:11

My Dad is in hospital and has been for a few weeks. He was admitted with an infection and is now desparately confused, cannot walk without assistance and now has shingles. He was forgetful before admission but is now seeing things/people, sometimes does not know who I am etc. Hospital have said he needs to be in a care home and I need to find one and have him assessed. I would like to see him in some sort of stable condition before he is moved - I do not recognise the man he has become and am really scared about what to do.

OP posts:
FuriousFate · 24/07/2016 23:50

Adulting - I admire your optimism but our CHC assessment was incorrect. The consultant filed paperwork incorrectly, writing down the wrong condition!!! This was just one of many failings...

DancingDinosaur · 25/07/2016 00:00

Hmm, well if he is really medically fit for discharge I'd want to get him in a decent nursing home to recover. If theres a window of opportunity to get him out of hospital I'd take it. My poor old dad never got the opportunity to get out as he kept picking up infections from other people as he was weak and frail anyway. We lost him in the end. Hospitals aren't always the best places to recover, especially when you're older. Hope you don't mind me saying that but if I could go back in time I would have got him out of hospital the moment I could.

Original poster
FiveShelties · 25/07/2016 00:08

Sorry to read about your Dad dancing.

I do want Dad out of the hospital, but finding a good home which will take him appears to be a little more difficult than I thought. I have realised now that I should have lots more information and hopefully getting more info will make it easier to find a suitable place.

OP posts:
DancingDinosaur · 25/07/2016 00:57

Finding the right place is a challenge I must admit. I'm sure someone has already mentioned it because I haven't rtft, but just in case its worth looking at the cqc website. And go and visit lots. And take more notice of the attitude of the staff and whether they seem kind, rather than looking at flashy facilities. Good staff make the difference over anything else. Is there no way he can come home, with support staff coming in every day? Totally understand if the challenge is too great, you're living it and know how it is. Although if it is possible (and it may well not be) a familiar environment would probably help. Anyway, whatever you do I wish you the best of luck and a good outcome for your dad.

HeartsTrumpDiamonds · 25/07/2016 01:48

Flowers OP. With my dad it was a completely different illness / condition but still enough to make me wish I had gone to medical school. All these decisions one has to make, with no real idea if one is doing the right thing. It's very difficult and very stressful. I feel for you. How is your DM? Look after yourselves. Are you able to take some leave from work while you deal with all of this? It is a lot on your plate.

There are some very knowledgeable and well informed and helpful posters on this thread.

dottycat123 · 25/07/2016 17:28

The content of his needs assessment should have been discussed with you, he will have been 'scored' in areas such as behaviour, cognition, continence, breathing, skin etc. As a mental health liaison nurse I contribute to these assessments and from your description would estimate he meets a criteria of dementia level nursing care at this immediate point in time. This may change if he improves.

AdultingIsNotWhatIExpected · 26/07/2016 21:37

How are you getting on OP? have you had some clarification about his needs?

scaryteacher · 27/07/2016 07:12

My fil had problems with h i s sodium leves, which made people think he was confused. Have those been tested?

PacificDogwod · 27/07/2016 07:42

Sodium will have been one of the first things to have been checked, and will have been part of routine blood monitoring, but yes, low sodium can cause confusion and falls.

I go in and out of local care homes as part of my job and I totally agree about not being blinded by how pretty the environment is. Tasteful wallpaper does not make up for stressed and poorly supported care/nursing staff. Otot happy, well motivated, well trained, genuinely caring staff are worth their weight in gold, even if the curtains are a bit faded.
Good luck, OP, I hope you are a bit further forward in your search Thanks

CarrotVan · 27/07/2016 09:37

I would suggest requesting a discharge planning meeting with you, senior doctors from any team involved in his care (geriatric care, mental health etc), the nursing team from his current ward, the hospital social worker and any physio or occupational therapists involved in his care.

In principle it sounds as though you are not averse to him going into residential care in a setting that is appropriate for his needs but that you don't have sufficient information on what his needs are in terms of rehab, nursing care, personal care etc to find an appropriate setting. On that basis you need it to be clearly outlined and agreed by all parties.

It's also worth asking about intermediate care options and what the medical team realistically expect him to achieve in terms of recovery with appropriate support

It would also be helpful to get the friendly nursing home manager to outline what the highest level of care and nursing needs are that they can accommodate so you can ask the hospital to consider how your dad can be supported to recover to the extent that a nursing home would accept him.

scaryteacher · 27/07/2016 12:07

Sodium will have been one of the first things to have been checked It wasn't for my fil in hospital, hence he was less confused when it was sorted!

Original poster
FiveShelties · 27/07/2016 20:11

Thank you for your help everyone, I really am grateful - I have loads of notes about what and how to do things.

I have vsited quite a few homes and found one which I hope wil accept Dad, they are to assess him shortly - we have found out that Mum knows a couple of the carers in the home so that is a bonus. Home was clean, staff were friendly, knowledgeable and helpful. Patients/residents looked well cared for and it did not smell. I also spoke to a man who had come to visit someone and praised the home and the care.

Only downside is Dad has another infection (hospital not sure what it is yet) and back again on IV - hopefully he will leave canula alone this time. I have an appointment with his consultant tomorrow and around 27 questions for him -most of them due to all your help on here. Thank you.

OP posts:
Musicaltheatremum · 27/07/2016 20:22

Just stopping by to give you a hug. This must be so hard for you. My dad is 84 (today) and in great health. So is my mum (80) the thought of this happening really scares me. I do hope you will find him somewhere that is good for him.

Original poster
FiveShelties · 27/07/2016 20:35

Thank you very much - it has been a huge shock. Very scarey.

Happy Birthday to your Dad and long may he and your Mum remain in good health.

OP posts:
PacificDogwod · 27/07/2016 22:56

Good luck with tomorrow's meeting.

Write your questions down, or at least bullet points - it is very easy to forget something in the heat of the moment.
Write answers down.
Take somebody else with you for another set of eye and ears - it is well recognised that about 3/4 of information given verbally gets almost immediately forgotten after complex consultations.
No dr/consultant worth their salt will mind if you come well prepared.

Thanks
AdultingIsNotWhatIExpected · 28/07/2016 00:14

Sorry to hear about the infection, hope they get on top of it soon

It shouldn't matter, but carers who know the family will help the carers see the person behind the condition.

If you like the place it may be possible for them to accept him even though he's no longer medfit pending him being medfit later x

DancingDinosaur · 28/07/2016 00:16

I hope he gets over the infection soon.

Kwirrell · 28/07/2016 07:57

I hope you get a good place for your dad. The help and advice I received on here over the past 5 years was invaluable. My mum was admitted to a home as an emergency case. Within 2 months she was transformed. With regular medication, food and wonderful care she was unrecognisable from the woman she was. She even learned to walk again and would banter with the staff. Previously she could not hold any sort of conversation.

madcapcat · 28/07/2016 08:57

Have only skimmed the thread so apologies if this has already been said, but could you also ask them to get someone else to review all his current medications just in case the presenting symptoms are being caused by, or aggravated by, an interaction between some of them? (I know several people whose sudden appearance of confusion etc was actually caused by the drugs they were on , and it wasn't until a new doctor took over the case that it was picked up.)

PacificDogwod · 28/07/2016 22:31

How did it go today?

I hope your dad if feeling better again.

Original poster
FiveShelties · 02/08/2016 18:02

Apologies for not returning but I was called into the hospital last week as Dad was really poorly and had another infection and asked if I wanted him to be under a DNR. Yesterday I was told he is again 'fit for discharge' so I had another care home assess him who have said exactly the same as the first one. The complex discharge team are saying that I have to find another home to assess him and reject him and they will then assess again him to see if his assessment is accurately reflecting his needs!

The complex discharge manager assured me he would be at the home's assessment this morning but was not there apparently and now he wants me to find another home and he will attend that assessment. I have said I want him re-assessed and have just spoken to the Matron again who assures me she will look into the assessment etc etc etc. I feel as though I cannot rely on anything I am told. My Mum is really struggling and I feel this rejection could have a very detrimental effect on her.

i am so worried about both of them and really just want to run away - very childish I know.

OP posts:
PacificDogwod · 02/08/2016 18:13

{{hugs}} to you, Shelties, you are in such a difficult position.

I know it is like fighting windmills or some kind of Kafkaesque nightmare of bureaucratic hoops to jump though. AND the hoops keep on changing or different people you speak to advice of different hoops… Hmm

I would encourage you and your mother (if she is able) to accept a DNACPR form to be done for your father. This does NOT mean that he would not be offered whatever treatment he might need to help him get better. It DOES mean that if his heart stopped or he stopped breathing nobody would perform cardio-pulmonary ressucitation which is physically painful, undignified, not likely to be successful and even if he did survive would not improve his quality of life, in fact he would like be worse off because of further brain damage due to lack of oxygenation.
A DNACPR decision is a medical decision made by his doctor, not by you or any other member of the family - please do not feel that this burden is on you too.
But please accept it as the kindness that it is to spare a frail person coming nearer to the end of his natural life the trauma of CPR.

I hope my post does not offend or hurt you.
And I wish I could say anything constructive regarding the care home situation, but no words of easy wisdom from me there.
Wishing you strength and light ThanksBrewCake

Original poster
FiveShelties · 02/08/2016 18:24

Thank you Pacific - not hurt or offended in the least, I am grateful for your comments. I would not want him to be ressucitated - he is scared, has no idea where he is and his quality of life is zero.

OP posts:
augustwashout · 02/08/2016 18:24

Can some one tell me, if a normal brain functioning elderly person can develop dementia ( etc) with urinary tract infections?

FuckitsAndSpades · 02/08/2016 18:27

Can some one tell me, if a normal brain functioning elderly person can develop dementia ( etc) with urinary tract infections?

if it resolves with treatment for the UTI that'ld be delerium not dementia.
However a hospital stay/illness could progress underlying previously undiagnosed dementia.. so it can be a bit of both in some cases.

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