Bed blocking in hospitals

[SummitLove]

AIBU to think that actually a lot of this situation is being caused by families taking no, or very little responsibility, in caring for their elderly relatives?

Are we, as a society, now in a situation where many of us our so entitled we just expect social services or the health services to provide everything? Seems to have been a huge shift from families being involved in care to families expecting others to provide care for elderly relatives.

Mooching over this thought today and would love to hear responses from both sides.

Have three elderly people near us (one couple and one single) that we help out as their families appear to have washed their hands of them. They rarely visit, don't organise simple things like online shopping, or come and help with trimming the hedges in the summer. Honestly, it's been so cold these past few days that I would have expected someone to have called or check in on them.

@Zaphodbeeblebox10

"Care for the elderly problems seem to be peculiar only to the predominantly white western world, strange how other cultures take it all in their stride."

This is a myth and actually more than a bit racist - "they look after their own, you know" Suggest you do some proper research before pronouncing.

I've seen many many elderly (and disabled) people in non Western countries begging in the streets.

How many people are really going to want to wipe their mum or dad's bum?
and vice versa.

Personally, I can't think of anything more horrendous than having my children wipe my bum. Especially sons!
Sadly, it must happen a lot.
It's undignified for the elderly person and much better for them mentally to have a stranger do it.

Modern medicine is good enough that she is still alive at 90 but not good enough that she is still mobile, continent and independent at 90. Care is available that is good enough to keep her in reasonable conditions but not good enough to give her a really good quality of life. Her needs are far too great for one person to cope with, but only the most limited financial help is available from the Government, even so.

This, or similar stories, are repeated all over the country in thousands and thousands of families. It's a nightmare that just didn't exist on the same scale 20 years ago, and something drastic needs to happen, because the effects on both the elderly people and the sandwich generation are just awful. I haven't even mentioned my inlaws!^

The whole thing is a nightmare.

My 90 year old grandmother was in a nursing home. She was skin and bones and ready to die.
Whilst there she was offered chemotherapy, a pacemaker and was given antibiotics numerous times

She's worth more to them alive.
Nursing homes are businesses after all. An empty room doesn't make them any money.
That may sound harsh, but in some cases I bet it's true.

Across, I agree absolutely.

People who've never had to live or cope with dementia, often have absolutely no conception of how stressful and exhausting it can be. I wouldn't wish dementia on anyone, but often, when people who have no idea, oh so piously tell us we should look after our relatives ourselves, rather than putting them in care homes, I fervently wish their eyes would be opened by experience.

I would agree that more of us need to plan for our old age. My parents announced recently, in their mid 70's that they had found a buyer for their lovely house in the country and were moving to a 2 bed flat in local town. We were all shocked but mum has looked after several elderly relatives and wants to plan sensibly whilst still able to control things.They both have an advance directive in place re their health and have even bought their plot in the local churchyard. Neither of them are unwell. Inlaws are 10 years older, in poor health, living in falling down,damp house with no heating and it is too much to get their heads round moving, particularly as FIL has dementia and would be very disorientated if they now moved.
FWIW, I work in A&E, managing a team of therapists whose job it is to try and avoid hospitalisation of patients if they are medically fit(IE social admissions) We experience quite alot of pressure from families who have decided their parent needs to now be in a care home and should not go home. Whilst I realise it is annoying to get a call in middle of night re a fall, when you live too far away to react, it is also not your decision where your parents live and unless they do not have capacity, it is their choice. They may choose to live at risk and choose not to wash and choose not to accept carers but it is still their choice. Families need to have these conversations whilst parents are still able and state what they can and can't help with. For example, alot of elderly people will refuse a POC because 'my daughter does it'. D'ter is exhausted and at the end of her tether but not able to say to mum that she can no longer cope.....so they get admitted to hospital for something fairly simple and the carer breaks down and says they can no longer manage. Then the patient sits in hospital for days/weeks whilst care is set up. If daughter had said before that point, mum I am not doing this any more, you need carers....then a simple admission remains that and we can discharge from A&E back to POC straight away. Have these conversations, look after your own health, say no if you cannot manage it and get a proper POC set up as soon as it is needed. THen as a carer, you can step in for the emergencies like an overnight every now and then, but not be exhausted on a daily basis and resenting your parents for it. Sorry....long post but I deal with this several times a day, every day and when people end up stuck in hospital unnecessarily, they do sometimes die because they catch other peoples bugs.

'Start gently introducing care when they're 60ish' - best laugh I've had all day.

It's often that very age group who are running around looking after parents in their 80s and 90s - and frequently helping out with grandchildren as well.

As well as working!

Lol at introducing care in their 60's, my DMIL would have been furious, she was fiercely independent, and only accepted a cleaner once a week once she hit 70.

DFIL would have had one in decades previously, he hates anything like that, and wanted to spend his retirement doing anything but house chores, and he wanted the same for DMIL.

The point is that not all of us can provide the level of support required by elderly relatives. Furthermore why should we not expect high quality social care in old age having paid into the system all our working lives?

Introducing care in someone's 60s?! My retirement age is 67 - I will still be working in my 60s (and possibly having to help my mum, if I am lucky enough to still have her. And refusing to help my MIL, who doubtless still be alive).

vdbfamily I can't echo your sentiments strongly enough. We are facing a generational crisis which must be addressed at every level. Crucially, it needs to be addressed by the elder generation and their adult children so that they are all prepared for transitions which will help ease the burden when things go wrong.

I have extensive personal family experience of family trauma and enormous social care needs, I also have two preschoolers and I live over an hour away from parents with no support myself except for my wonderful DH, who works 60 hours a week and is, like me, at breaking point.

In my experience, mindsets need to change and people accept that social care planning is everyone's responsibility, not just government. That applies to financial decisions too.

it is absolutely imperative that decisions are made when times are good, when trauma or disease has struck it's too late and results in the bed blocking and stories we've read. Fix the roof while the sun shines etc.

The most important things people can do to help themselves is:

• appoint a power of attorney and keep clear and easily accessible records of accounts so that they can be picked up as soon as needed by a family member. Also make sure someone knows where a list of important info such as ID docs and email passwords etc are
• downsize early to a practical home in a location close to people you would like to be with (if you can... if not, talk about how you expect to cope if things go wrong)
• make sure that there are sufficient liquid assets available to cover at least 12 months emergency care costs, possibly through down sizing. If capital is not available for release, review your finances to establish who would need to pay for your social care. If you would be self funded, how will you manage? These are the kind of problems that keep people in hospital beds.
• get regular health checks, get vaccinations, speak openly with people about health concerns, pay for private reviews if you need and can. Many of our older generation are very reluctant to visit a doctor or talk about their health. Again this is a mindset that needs to change, any prevention of sudden illness can only help to reduce demand for hospital care

I think that there will be a trend towards better planning as needs become more apparent. Likewise, it does of course have to be better addressed by government. We also need more retirement suitable properties to be built as well as all the obvious changes to funding. Many people say they would like to downsize but there's just nowhere they want to go.

Long post from me too, sorry, but we can all help to ease the burden by helping our families to make good decisions for their future care even if we can't be there to physically care for them.

why should we not expect high quality social care in old age having paid into the system all our working lives

It's all very well to debate this, and there are provisions for lifetime limits on care spending in the Care Act (if it's ever implemented), but at present in England (and wales?) healthcare is free under the National Health Service and social care is not covered as it's not considered a health need. So you haven't paid into the social care system, you've paid into the health care system. For many, the two are inseparable in reality but from a funding perspective they're separate right now.

I personally think that it's not a bad thing to means test social care in some form, although this isn't the thread for that discussion

I am sure this has been said by others.

We have a generation missing in my family due to losing my mum an only child, so it is down to me and my sister to care for my Grandmother. She is aging - nothing specific wrong but a few niggles and issues occurring.

She refuses to move out of her house, in a village with no transport links, refuses to take a taxi to the shops, has never been able to drive, relies on very kind friends and locals for help.

My sister and I both live over 100 miles away with young families, and jobs. We speak to her regularly, have offered to do online shopping but it is refused. It's a 6 hour round trip for me, slightly less for my sister.

We have tried to offer practical help, we have tried to sort things from afar but it is ignored/refused.

Her neighbours think we are awful - we get a lot of emails from them telling us off. She tells them a very different story to them compared to what we do - she broke her pelvis a few years back, we both offered to go and help she told us not to, I had spoken to my manager and it was in place for me to take time off - she told her neighbours we wouldn't come and stay, not couldn't but wouldn't do it!

So OP I would bare this in mind - what they tell you may not be the full story but their side to it. The emails which have been fired off to us have been pretty harsh over the years.

noodle what a difficult situation for you, I'm sorry to hear. You're totally right, people not accepting help is a major issue too. They think nothing of asking friends, neighbours and family for ever increasing small favours and help without realising that it is burdening people with more than they sometimes are able or willing to shoulder, which is probably why her neighbours write to you.

Stubborn independence is hard work on everyone. Again I think the more people who talk about it, the less taboo care and help becomes but it's likely that change won't happen over the next few years and will be much longer term shift. Unfortunately everyone's life could be better if they were more open to discussion

Mil wasn't really open to discussion. Dh pretty much had to make the decisions. She also didn't want any support whilst she was in her flat, so ended up falling.

Older people need to take responsibility for their old age and plan appropriately. Being an ostrich just doesn't work. It adds so much burden onto relatives.

I also believe that people are being artificially kept alive long after their self care abilities have gone. Quality over quantity. Are people aware that many very frail elderly people are on courses of antibiotics every 4-6 weeks? That isn't a good situation.

We as a society are more selfish and disconnected as ever, that's why. We are are made to think that we all should be out working, anyone who isn't is therefore lazy or making excuses. So now we are all too busy working to care for our families young and old. Stick the kids in nurseries and old folk in homes. Its really sad. Not only that our communities have all but been destroyed and so neighbours don't know each other and don't help each other. I remember growing up that most of my friends kids had parents at home all day, they had the time then to do a bit of shopping for the lady next door, who would watch her youngest while mum went to collect kids from school etc.... When do you see this now?
Bed blocking is a problem because social care and the NHS are not able to work together to create a streamlined system. But most local councils have to email the person next to them to ask a bloody question, which tells you how good they are at communicating efficiently.

oops totally agree

Here's the catch - people who do try to prepare for getting older while they're still fit and healthy are susceptable to being ripped off by "retirement developments". Many of which are built with no consideration whatsoever for deteriating health and increased needs and are a bit of a scam (not all, but many I've seen)

I visited someone recently who moved to a new development and bought her flat off plan (garden flat with direct access outside - great she though, she could potter in a tiny managable garden, take part in the activities in the centre, and be set up for getting older)

1. the "small manageable" garden had two tiny (IMO dangerous) steps up to the patio door and again down to the garden. It was surrounded by weird little half foot high walls, so if you did trip on the narrow steps in and out - instead of a few bruises you'ld probably get a very serious injury when you hit the low brick wall.

1. The firedoors both in the communal hallway to get from flat to main door, and also inside the flat, were on very heavy springs - they were hard even for me to push open, and I don't know how you would manage to get in with bags - would be impossible to manage with a mobility trolly or frame! And there were no automatic open buttons to press, basically you needed MORE help to get in and out of her "retirement" flat than you would a normal flat

1. bumpy path outside leading up to the door

1. massive service charges, which means she had less spare money to pay for taxis or a cleaner etc

1. Difficult to sell due to all the conditions, fees and restrictions.

I felt awful for her, she really regreted buying it, and was REALLY isolated due to struggling with the fire doors. The idea of moving there was to be less isolated and more independant

So please, remember, these places are built for profit. Take an exprienced carer with you to check over the plans and view with you if you consider this option

It's not so much that we are made to feel we "should" work, rather that many of us have to work in order to keep a roof over our families heads.

" I do know the situation with these people, I do know that they rarely contact their relatives - they are quite happy to tell me this"

In which case why are you using one family to generalize and scapegoat other families.

This is the second time ive seen a shitty attitude from an NHS worker towards families and carers on these boards in less than a week.

Smoke and die younger people - (I am targeting 70)

Sorry - a flippant answer to a very worrying and tricky issue

I do not want to be a frail
Old
Lady it really scares
Me . The lack of care and the view that 'well you should be dead anyway'

OopsDearyMe my neighbours help each other a lot. No we're not home all day to do all day caring/childcare, but everyone can knock on doors and get help in a crisis and we all do what we can

You seem to think people are chosing work over caring, and that's not the case

Today 21:46 engineersthumb

The point is that not all of us can provide the level of support required by elderly relatives. Furthermore why should we not expect high quality social care in old age having paid into the system all our working lives?

Sadly we are not
Paying nearly enough tax !

People are not 'choosing' work over caring. People are struggling to stay afloat.

The benefit regulations stop people caring for relatives.