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

[FiveShelties]

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.

If you are sure you want DNR then make sure a community one is done too.

Also you can get a note put on 111/999 for "community treatment only" if you worry about him bouncing in and out of hospital every time he has an infection. Its called an "out of hours message" - he would still have treatment from GP and community teams - oral antibiotics and symtpton control. It's worth thinking about/asking about once you do find a placement for him so that he's not back in the same situation in hospital a few weeks later.

Fiveshelties try not to worry too much- ask nurses if they have requested a social work assessment…usually they have to be the ones requesting it…and make sure they are there. The social workers will NOT be wanting to put your dad in a care home if that is not what he needs. If you let them know what your dad was like pre admission- I'm assuming that you saw him recently and that he was fairly ok- then they are most likely to suggest rehab bed etc. They will probably have to make a best interests decision for him if he is not able to make his own decisions at present, and that will always be for the 'least restrictive option' that is appropriate for him. They are NOT going to be looking to have someone discharged to a permanent care home place when there is the possibility they may improve and be discharged home. The good thing about being discharged to a step down bed (in a nursing home etc) or a rehab bed is that your dad will get much more intensive support than he would in a hospital, and where staff have time to get to know him, and also are generally more up together with looking after older people specifically.

not they are there- YOU are there

I am so sorry to hear about your dad, OP. We've just been through similar with my aunt and recognise the feelings of hopelessness when people are trying to get you to make decisions with no information.

Have a good read around this site caretobedifferent.co.uk/paying-care-home-fees/nhs-continuing-healthcare/ It's very clear about where responsibilities lie and the process that should be followed.

Best of luck and best wishes for a speedy recovery for your dad.

I work in Hospital Discharge Planning & situations like yours occur every day.

I've not read the FF as I've got to nip out so apologies if these questions have already been answered.

Has your Dad got an allocated SW ? They are sometimes very good advocates at ensuring everyone acts in a patients 'best interests' and should have a list of current care homes that can meet your dads needs and have vacancies ?

Are they still suggesting an Assessment / intermediate care bed ? if so this should be fully funded for 6 weeks .

Is he in a specialist Geriatric ward ? Geriatricians are usually very knowledgeable re Dementia /delirium ( ask to speak with his consultant & not a Junior or locum DR who may not have significant experience in this speciality)
As your Dad is deemed 'Medically safe for Transfer' ie not receiving active treatment /diagnostic testing then an acute hospital bed really isn't the best place for him to be as he'll be vulnerable to further infection - sadly its a vicious circle.

IME care homes (not Nursing) are reluctant to accept Patients who need a higher level of care purely due to the fact they can only charge the same £££ as someone with less complex needs.
Push for the CHNC to be repeated ,at the very least he may qualify for the 'Nursing element'' of £112 pw this extra funding meaning that care homes are more likely to accept him (covers the cost of extra staff input)

As said previously ,Delirium can take time to resolve ( long after any infection has cleared) or sometimes infection can trigger an underlying dementia.

Hope that makes sense - I will be back later if you have any q's.