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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

this is very poor 80 year old discharged from hospital ( catheta imparied movement) with supposed support care and has had nothing?

51 replies

Humidseptember · 09/09/2016 20:03

So, can anyone tell me what to do> I don't live close by, and he has come out of hospital with the supposed proviso that he gets 8 weeks of care including personal care - cleaning etc, social services....and has had nothing?

A nurse came in yesterday and said its awful and spent two hours phoning round and said - he needs to call the ward that discharged him>

He has severe mobility issues, catheter etc....cant clean has meals on wheels but needs shopping done, etc....he was in hospital for heart failure and other stuff that went wrong = he has a catheter until they put a camera in the bladder - as they damaged him in hospital and now he is at home with it!!

what can I do!! who do I call?

OP posts:
MindSweeper · 09/09/2016 20:58

Because of his heart failure he would be retaining fluid which would cause the ascites (fluid on abdo), when this happens they need to be very stringent in recording how much fluid is going in and out (to prevent fluid overload) so a cath is indicated sometimes. Coupled with his reduced mobility he was probably too exhausted. There's also the possibility he was in urinary retention which is another reason for the cath.

Sometimes this does cause trauma, but not lots of blood clots. That would suggest to me an obstruction which could make the fluid accumulation problems worse

You probably already know this, I just think sometimes it's helpful to have it all down to make sense of it all

Original poster
Humidseptember · 09/09/2016 21:16

Ok, not up on how these things work! (mind)

OP posts:
Original poster
Humidseptember · 09/09/2016 21:18

mind no, I know nothing of this, we visited him but was a flying visit only one night due to cost etc, small dc.

I am very grateful for all thoughts on all of this Smile Flowers

OP posts:
Original poster
Humidseptember · 09/09/2016 21:19

From what your saying Mind - what has happened to him seems to go hand in hand with heart issues? He had heart surgery over ten years ago and I do fear whatever corrective surgery he had done then, is probably nearing its shelf life?

OP posts:
Original poster
Humidseptember · 09/09/2016 21:20

ie flying visit no time to find out what was going on

OP posts:
MindSweeper · 09/09/2016 21:22

If you've never had a reason to know about caths, it's completely understandable humid.

I obviously don't know the man and am not privvy to his condition but I just wanted to give you a few scenarios to explain perhaps why he has it, I hope it's been a bit helpful. I really do think patients should be sent home with a full debrief of what's happened in hospital and why and what's going to happen moving forward, so they can share it with their family if they wish

StressedNHSemployee · 09/09/2016 21:27

So he has been home two weeks?

He must have had care in that time.

Has he deteriorated in the two week period?

Original poster
Humidseptember · 09/09/2016 21:30

At first no one came so he was on the phone and after much confusion got nurse out but he has had no other care bar nurse, ie no help with living at home at all.
he has numerous issues he needs help with.

OP posts:
Original poster
Humidseptember · 09/09/2016 21:30

I understand MIND thank you.

OP posts:
MindSweeper · 09/09/2016 21:32

humid

when the heart starts to fail it can't pump blood around the body as it once did and this means reduced cardiac output which is bad. Because of this the kidneys cause water retention to try to improve that cardiac output. The extra fluid causes increased pressure so the fluid is sort of pushed out of the blood vessels into the tissues and cavities so you end up with swelled limbs, stomach etc. But with that fluid retention comes it's own problems, like the breathing issues as fluid accumulates on the stomach and chest. That's a simplified version but I hope it explains a few more things for you.

The doctors will all be well aware of this, and it'd probably be useful to his family to ascertain what exactly the plan is in regards to this. Heart failure of this manner is a chronic issue and it's more about managing it than curing it.

MindSweeper · 09/09/2016 21:32

sorry cross posted

Original poster
Humidseptember · 09/09/2016 21:39

Mind silly question but nethertheless, if they get his catheta out can he travel - I take all info with pinch of salt but you seem to have some knowledge, is a 4 hour car ride something you would rule out totally, or possible?

I get the feeling the end is nigh - we have suggested visiting him with all his issues but one gets the impression over all he would rather come to us.

I wonder if heart failure is so acute a condition, he needs to stay put? Or whether people can and do travel with it - depending?

OP posts:
Original poster
Humidseptember · 09/09/2016 21:41

Mind the mind boggling Grin thing is - he has had breathing issues for a while and told me he has been waiting for specialist tests at another hospital - after such a long wait he has been there and came back with no definitive ansa, and yet what your describing sounds like what he has -ie - his leg swelled up - and then his stomach etc.

How do they manage this> He has also developed diabetes Sad.

OP posts:
MindSweeper · 09/09/2016 21:56

I think it would depend on how he feels. If he feels up to it, and if he's able to let you know when he needs to urinate I don't see a problem (but worth checking with his consultant)

chronic HF is a long term condition which there is no cure for, but can be managed in the community. There may be times when his condition may decline and he needs hospital help, but it's very often managed at home. Many people live full lives and are able to get out and about, but it depends on the person, the severity of the condition and how their symptoms are being handled.

Management is usually managing the symptoms, so drugs like beta blockers and ACE inhibitors for his heart, diuretics (water tablets) to help with the fluid retention, cardiac rehab programmes. I'm not sure how it works were he lives but in my area we have heart failure nurses who visit people's houses and check on their wellbeing, complete assessments to see how well the patient is managing etc.

Original poster
Humidseptember · 09/09/2016 22:02

Mind I really cant thank you enough for this small window of insight, it helps to put things into focus and perspective. Flowers again. Smile

He has been taking water tablets for a long time, perhaps his condition is so bad now they dont help much. I guess not being able to move much doesnt help.

I was on the cusp of booking to see him in oct half term but can only afford a few nights, however I could give him our accmd money and he could use that to stay near us for at least a week....

Am going to start phoning round asap and then hopefully speak to someone directly about his condition and the plan for him.

OP posts:
MindSweeper · 09/09/2016 22:02

Just to say as well, I am not a doctor. I work closely with doctors as I'm a Physician Associate but I'm not a doctor - there's a lot I dont know especially as I've never met this person, so take everything I say with a pinch and always check with GPs and consultants :)

Original poster
Humidseptember · 09/09/2016 22:04

Mind dont worry!! I understand!!

OP posts:
MindSweeper · 09/09/2016 22:04

No worries, I'm so glad I can be of help. I wish you all the best Flowers

lougle · 09/09/2016 22:05

Catheters can be short, medium, long term or permanent - they get changed but someone can live with a catheter for the rest of their lives quite well. Having a catheter wouldn't rule out travel in any way. In fact, it makes it easier - no toilet stops! However, whether a 4 hour journey is manageable will depend on his overall health. I'd imagine a break or two in the journey would be wise.

MindSweeper · 09/09/2016 22:07

OP said if they get it out though lougle, or did I read that wrong? Blush

Original poster
Humidseptember · 09/09/2016 22:11

Either way really Lougle, in some ways a C is good as he cant go upstairs at my house ...and a while ago he did wet himself when out with us at a restaurant Blush.

I think he really would like to come and see us - so now I have a small modicum more of info on all this will start to make inquiries....

It has literally just been his 80th Bday and to be honest I didn't think he would make it with everything going on.

OP posts:
Original poster
Humidseptember · 09/09/2016 22:12

( as in I have no down stairs loo so would pee outside back door)

OP posts:
TheBouquets · 09/09/2016 22:29

I would wonder if moving an older person with so many problems is a good idea. I have had someone who it seems to me was in a similar state.
I think you would have to have an open and frank discussion with all his drs because they will only be able to discuss their own area of expertise. The kidney Drs will not know so much about hearts as the heart drs. You would need to discuss your plans to move the old man and ask their views on the likelihood of success. It does not sound as if there is much room at his house or yours to combine households. Perhaps you could get Social Work to help house either the old man or you for the duration of his health problems. There should be more care going into him just now such as home helps to make meals and they also keep an eye open for deterioration in the folk they visit. SW can also give an alarm for the old person to press if they need help. It goes to a call centre and they contact named persons given by the old person.

It is not an easy task but it is a marvellous thing to do for an older person you seem very fond of.
There are out of hours numbers for social work that you can contact over the weekend and they could even organise a visit over the weekend. It seems that there is no-one living closer who could help the old soul.
Best wishes

AndWhat · 09/09/2016 23:12

Terrible discharge from the hospital!
I would phone the following:

  1. social services for the area he lives to get emergency carers to assist with personal hygiene needs/meal prep
  2. his GP/district nurses to find out the plan with regards to catheter. He will require supplies from a specialist company such as "leg" and "night" bags, possibly spare catheters and "wash outs". The district nurse can also assist if any specialist equipment is needed. 3)PALs to report the unsafe discharge
  3. local cleaning company for domestic assistance. Hope this helps (I'm a district nurse)
MindSweeper · 09/09/2016 23:17

I'm not sure how it works where you live too, but here when people are discharged like this they are provided with all these services for 8 weeks free of charge but then they have to fund them themselves if they're not eligible for support.

But there's funding from the council available, and OP you might want to look into something called Continuing Healthcare funding. He may not be eligible for it (in my hospital we would fastrack this whilst they're an inpatient if we think they are eligible) but the district nurses can organise a review to see if it's something this man screens in for.