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.

tinsel that wasn't what I understood from that post at all. The point was being made that people are expected to work more (and need to as noted), that by not working you're seen as being lazy, when actually critical support networks in society are failing because of reduced time and care needs of family and friends are unmet and even neglected as a result.

I also think there are a lot of people who would identify with decreasing sense of community, it is a genuine problem people face particularly in more urban areas where there's a fairly high degree of transcience now too.

Figures on campaign to end loneliness show that 17% of older people speak to family, neighbours or friends less than once a week only, with 11% having contact less than once a month.

That's a very sad, and very real problem

But she's wrong, it's the exact opposite! Prolonging your stay in hospital, simply because you don't want an interim respite bed, is what will make you more likely to get sicker and degenerate and need a permanant nursing home bed

Tinsel you misunderstood my first post. My mother didn't want to go to a care home (for interim care) but of course she would have gone if a place had been available. She wanted to go home, but was deemed unable to care for herself and I agreed with that. As I said, there were no care home places available. On telling mum they were discharging her, the hospital was making the assumption that I could drop everything on half a day's notice and take 10 days off work to look after her. I refused, as it wasn't possible to arrange at such short notice. I did however take most of the following 2 weeks off, moved in with my mother and cared for her during that time.

The problem is that "interim respite beds" seem to be about as rare as hens' teeth these days! If mum had been childless, she would doubtless have remained in hospital for another couple of weeks and, as you rightly point out, she could have picked up an infection or become more ill.

OopsDearyMe what you are describing is the "old order" where mothers stayed home to look after the children and the home and husbands went to work and provided materially for the family.

The price for that way of life was that women had fewer opportunities, were paid less than men and when they returned to work (if they ever did) it was usually part time and low paid.

Having all the children in nurseries and the old folk in care homes is in large part the price we have to pay for gender equality.

80s mum, I know you said there were no interm beds, but the point I was refering to was that you said that she wouldn't have wanted one even if it had been available.

Having all the children in nurseries and the old folk in care homes is in large part the price we have to pay for gender equality.

no it's bloody not, there is not a causation link there
The direct causation for people who are willing but unable to care are things like benefit restrictions, poor housing and inflexible rental culture, social care cuts etc etc
Not equality. That is not the cause (not that we even fully have it)

Having all the children in nurseries and the old folk in care homes is in large part the price we have to pay for gender equality.

It strikes me as ironic then that 95% of work in nurseries and care homes is then done by women who are often part time and low paid.

Oops and 80s mum has it occurred to you that one reason why younger generations for families now have to work and don't have time for other responsibilities is the house price inflation of the past 30 years? Many of those now needing care were very happy to benefit from massive increases in house prices forgetting that their sons and daughters would need a joint working household to pay for their properties. The downside of that is they can't then look after elderly relatives as they are still paying the mortgage off - let alone trying to put some responsible funding for their own old age in place. In the meantime my parents - happily still well in their 80s - disappear off on 4 international holidays a year on savings made from selling the family home and generous index linked pensions.

londonmummy this nails one of the main reasons I think social care should be means tested.

it is means tested but only on cash savings

so you can have a rental income from a second home, but so long as you spend it and don't save - you can be eligible for funding

Someone living in a tiny rented apartment with a relatively small amount of savings has to pay while people sitting on millions in equity don't.

*it is means tested but only on cash savings

so you can have a rental income from a second home, but so long as you spend it and don't save - you can be eligible for funding

Someone living in a tiny rented apartment with a relatively small amount of savings has to pay while people sitting on millions in equity don't.*

Complete rubbish, you don't know what you're talking about I'm afraid

" I've also see families that couldn't give a fuck and when a relative has needed hospitalisation have refused to go and be with them meaning that members of staff have had to accompany their relative to the hospital or they've had to sit alone in the hospital"

Im a full time carer for my DH who had a heart attack 11 years ago. He became partially disabled due to this Im his full time carer. Hes now 66 Im now 43

In the years following he had many subsequent angina attacks which required trips to A and E I couldnt afford to go with him He was on IB back then and after rent and council tax were paid and other bills we had £40 a week left to live on. Which had to pay for food AND prescriptions. I couldnt afford to go with him because i couldnt have afforded a taxi back if he was admitted or to sit up at the hospital all night to pay for a bus fare i also couldnt afford. Carers are human We need sleep too.

However im perfectly aware that many health workers may have seen me as heartless so i made sure that all the paramedics who attended knew the reason why i couldnt go with him. It would have meant us going without food or possibly him going without one of his prescriptions. Pre ESA ppl on IB had to pay.

Some health workers have absolutely no idea No idea at all!

Two and a half years ago he was diagnosed with COPD. They want to close our A and E.

The nearest cardiothoracic centre is now Basildon.

It strikes me as ironic then that 95% of work in nurseries and care homes is then done by women who are often part time and low paid

^Indeed it is, Fruitboxjury and I was one of them! I worked as a nursery assistant for 14 years. My pay went up massively when the minimum wage was introduced in 1997, but my colleagues and I were still paid significantly less than the cleaning staff were.

I'm not buying gender equality as the problem. Most women have always worked, it just that some of us now stand the chance of getting a decent professional wage and career development. What selfish hussys we are, wanting a bit of money and job satisfaction. Plus, the only woman I know who has never worked post marriage is my MIL and I can assure you she has never raised a finger to help anyone in her own family, let alone the wider community. So fuck off with blaming uppity women getting above their station as the root of all social evils, while completely ignoring a whole generation that retired earlier (my mum retired in her 50s!!!) and is living longer. Our systems were not designed for 30+ years of retirement.

Both my mother and my FiL had dementia, both eventually had to go into care homes (funded by themselves) once they needed 24/7 care. My mother had dementia for about 15 years and went on to 97, in a most pitiful state for the last few years, doubly incontinent, not knowing any of her family, unable to hold any sort of conversation, etc.

After that experience, I have made a Living Will to state that if I ever get dementia, or any other condition where I am unable both to care for myself and speak for myself, I emphatically do not want any medical interventions to keep me alive just because it is possible to do so, when Nature might be trying to let me go.

From all I've seen and heard over many years, there is far too much keeping alive of people who are both very elderly and have a very poor quality of life. People are stuffed with medication, in and out of hospital on drips, coaxed and badgered to eat and drink when they no longer want to do so,
prescribed endless fortified drinks to keep them going because they can't or won't eat enough.

For what??

By the time my mother was in later stages and no longer getting any enjoyment out of life, we made it clear that with the exception of anything like fractures, there was to be no hospital - in any case a pretty awful place for anyone with dementia - and no interference if nature might be trying to let her go. Quite apart from any other consideration, we knew it was what she'd have wanted for herself.

With an aunt in a similar condition, when the situation did arise (hospital or let Nature take its course?) we were asked to choose. Of course it's never an easy decision, and I could only ask the GP what he'd do if it were his much loved aunt. He said he'd leave her in the care home, in familiar surroundings, where they'd keep her comfortable.

But I have heard of so many cases where relatives are insistent on keeping someone going, no matter how pitiful the state they're in, and are very angry and indignant if anyone suggests it might be kinder to let Nature take its course.

But I have heard of so many cases where relatives are insistent on keeping someone going, no matter how pitiful the state they're in, and are very angry and indignant if anyone suggests it might be kinder to let Nature take its course

People really need to stop viewing death as the worst thing that can happen to someone.

For some it will be. However for many it's far more torturous to watch the world unacceptable to get part of it

I've been helping care for a friend. You may well call her a "bed blocker" but there was no way she could have gone home. She also can't be trusted not to push herself and I can almost garuntee you shed have ended up lying in the floor fir however long it took fir the next batch of carers to come in.

But she is that stubborn I honestly think she'd have preferred to take her chances as she hates the home.

She still had to wait fir a space and fir funding to be approved and of course she wanted time to make the decision so yes that took best part of a week.

Also been many a time where she's been ready to go home for hours and we have had to wait medication. Except she already had medication we had taken with her and I could have ordered when we git home.

She wasn't actually expected to make it through yesterday. I spent all day with her just in case. If she does make it through this latest infection she's still dying. Seems barbaric to me to bring her back only to have to die again later. Why do we do this to people.

She can no longer do any of what she enjoyed doing. She's had enough.

Unable to be part of it

Dyac

I remember when we were arranging for MIL to go to a care home and break the cycle of admission-and-discharge, and one of the suits at the hospital told me that families often drag their feet in the hope that Grandma will die before it happens and they lose the inheritance.

People really need to stop viewing death as the worst thing that can happen to someone

We will all die. some sooner than others. The decrepit 90 year olds are the lucky ones, having lived a long life. To desperately keep them going is not sensible.

We need an Esther Rantzen type person to start insisting that people write a living will when in their 50s/60s asserting no further treatment after reaching a certain degree of Dementia.
In all those posts I think only one mentioned the elderly patient deciding they'd had enough.
We must plan these things before the nasty fall, or the start of dementia. I don't know if it is something about ageing but most frail and elderly I've had contact with seems to be in denial that they need to make decisions, or possibly unable to make decisions. They want a fairy godmother to come along and sort all their health problems.
Likewise financial plans should be discussed too, especially with the family who are waiting to inherit.

I know an elderly woman who lives in a lovely two-bedroom council flat. Unfortunately it's up a set of very steep stairs and her knees can no longer cope. She gets some social care but most of her care is provided by her niece, who has moved back from abroad and is staying in her spare bedroom.

Everyone agrees that this lady should move to a ground floor flat, and various applications have been made. The problem is that, due to the bedroom tax, the council will only offer her a one-bedroom flat - her niece isn't a priority for council housing, so can't be counted. This means that my friend would lose her main carer since the niece stands no chance of being able to afford private housing nearby (we're in London) and in any case needs to be living in to cope with helping my friend in the night.

So my friend is stuck in a flat she can hardly ever get in or out of, her quality of life is diminished, and she's recently been in hospital as a result.

And I know lots more stories about the impact of the bedroom tax.

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.

Depends what you mean by 'strange'. Personally I think it's incredibly obvious why this issue only exists in such a way in a few countries. It's because of specific demographic and health service access factors that are not replicated globally.

1. In dozens of countries across the globe, average life expectancy is well below UK pensionable age (Wikipedia suggests about 50%). There simply isn't a large cohort of people living long enough to need extensive care. That's not to say there aren't infirm elderly people in those societies, but there's nothing like as many of them.

1. We have lower birth rates than much of the planet and now have done for some time. Combine that with factor no 1, and you'll see that there are fewer working/caring age adults per elderly infirm person in most of the world than there is here. The ratios are different, notwithstanding that there are a few places where there's a hollowing out of younger generations because of things like AIDS and war that don't affect the elderly in the same way.

1. The UK is one of a small number of countries where the entire population has free access to healthcare, whatever their income. There are access issues and generally the rich do better out of it than the poor, yes. But we are one of the few societies where being poor doesn't mean you can't access state of the art medical technology that can keep you alive whilst very ill for a number of decades (and even some rich countries don't have this- eg US). If you have the sort of dementia that people in this thread have described and you're low income with no family who can/will care for you in much of the world, you're going to die pretty quickly. Not necessarily so here.

1. The UK model of care is expensive. That puts it out of the reach of a lot of societies. Much of the world couldn't replicate this even if they desperately wanted and needed to.

1. Countries where it's more the norm to care for people at home usually have, as well as different living arrangements already mentioned, a class of people whose job it is to do the shitwork. That class of people is generally made up of women (and OP saying she doesn't agree it should be the woman's responsibility makes not two shits of difference to this fact). Sometimes, in a few societies, it's poor immigrants rather than the women from the country themselves, but the salient point is they'll still be members of the shitwork class.

There's just no point comparing the UK to most of the rest of the world in this respect. It simply isn't an issue that is equally affecting all countries.

Actually I was looking at health adjusted life expectancy there, it's more like 50 countries with average life expectancy below UK retirement age. The demographics point still stands though, and is incredibly significant to this discussion. As is the concept of health adjusted life expectancy, actually!

Between me and OH we have 3 elderly grandparents (ranging in age from 87 to 95) and I agree with a PP, part of the issue is that in this country people are living longer than (a) before and (b) other countries.

Both my Mum and Dad and OH's Dad are involved in the care, mine both go visit once a week, my Mum does my Nans shopping, washing etc. Does all her phone calls for her. My Dad does the same for his Mum and my FIL visits his mum a lot.

All 3 have been in hospital for various things. One stayed then went into a care home before going home, the other into hospital and is now in a care home and my Nan came home.

The problem was they all ended up in hospital longer than they should have done because the next step took longer to sort out, they have varying health needs that need professional carers to look into and are too proud to want their sons/daughter to spend the time with them showering them etc.

Bed blocking is not about sorting out online shopping etc its about setting up the correct care package delivered by professionals. By parents do all of what you say but they still get carers in and still needed time to sort out the care package.

Many other cultures aren't capable of sustaining an older person's existence until they're in their 90s. It's pretty routine in the 'white western world' for very old people to be kept artificially alive when nature has been trying to claim them.

People just don't understand this when they're criticising, mostly us women, for not being able to care for older relatives.

People who are very old need specialist equipment and knowledge in order to be able to keep them going.

Airflow mattresses to prevent pressure sores
Two hourly positional changes to prevent pressure sores
Hoists for moving and handling
Pressure relieving cushions to prevent pressure sores
A myriad of oral medications
A specialist chair so they can sit in an appropriate position and have their legs raised to prevent oedema and leg ulcers
Bathing/showering equipment
Nutritional supplement drinks/foods to maintain BMI
Continence aids
Constant monitoring for infections - mainly chest and urine
Dressings for any wounds, ulcers or sores
Mobility equipment if they're still on their feet
A suitable and safe environment
Regular medical and district nursing input/monitoring/checks
Help with dressing, washing, bathing, eating, drinking, taking meds
Cognitive input and stimulation
Social stimulation
Keeping them safe so they don't fall

Probably other things which I've forgotten of course.

Now, who has the ability, time and resources to provide all this in their own home?

This is the reality of white, western old age.

Crack on.