Mother in hospital AIBU to refuse to take her home without a care package

[TheoriginalLEM]

Well i know im not BU.

We are at crisis point and despite A&E dr initially wanting to discharge, my refusal to accept prompted a frank discussion and he basically told me "do not walk out of her without a care plan"

So how do i make this happen? What do i ask for? A&E dr has put her down for a multidisciplinary discharge team - he did call it something but im sleep deprived and i cant think straight. This apparently involves social services.

My mum is difficult. This is categorically the understatement of the century.

Her issues are complex and compounded by mental health issues and possible dementia.

Crisis = acute aortic aneurysm with blood clots. Panicking vascular surgeons readmitting to A&E with ensuing chaos, lack of communication and now "an excuse to get a care package in place"

There isa DNR in place and dr suggests palliative care only - im a little wtf about that. She was helping me do her garden at the weekend, in a rare window of lucidity.

My mother is abusive which makes caring for her almost intolerable.

I can no longer cope.

What q should i be asking

Thankyou rosebud. They are useful contacts. I have written a 3000 essay cataloguing this weeks events. I need to know who to send them too.

LEM, I've not read the whole thread here, but caught up with the end, and see you've brought your mum home. You're a bloody excellent daughter, in ridiculously difficult circumstances. Please be kind to yourself. You're a good person.

@TheoriginalLEM send your concerns/complaint to the hospital PALS office, their contact details are usually on the contact us section of the hospital website or use this link to find them www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363

Thankyou xx

Hospitals are not allowed to discharge a patient without an appropriate care package being in place. You need to be insistent about this and to make it clear you can no longer cope. If you say you can keep going in, they will decide she doesn't need care. You need to be clear and insistent.

A care package will then be in place immediately in leaving.

If she leaves without a package regardless of whether she should have had one there is no longer any duty on the hospital to provide anything. You then go into the social services queue via a request for a care assessment. Even urgent assessments can take many weeks. This is likely why the doctor has advised you as he has.

Don't let her leave without a proposal for care you are happy with.

There is a massive problem in the NHS with the way elderly people are treated.

My DM is not well. Shes 83 with hearing problems pains in her head and problems with her legs Her surgery is Virgin Care. My dad had to call a paramedic out last Weds as she was in so much pain. The paramedic spent an hour and a half with her and told her she must go and see "her" GP.

DM duly did so with my dad taking her there. The GP barely glanced at the notes and then she had a go at DM for calling a paramedic, "I dont want to know or particularly care whats wrong You shouldnt have called a paramedic. My dad was with her and there is nothing wrong with his hearing. Its a struggle to get an appointment with this practice and then they treat her like that.

Its obvious to me why this "GP" had a go at her for calling for help when in intense pain. Because they are worried how it will reflect on THEM. Because they have been in special measures for a long while due to past behaviour.

GITS!

I have nothing but praise for paramedics Every time ive come across one they have been fantastic.

LEM I have done this - discharged my mum without a care package in place, simply because she was so bloody unhappy (I did get a letter confirming she could be discharged from the orthopaedic team allegedly in charge of her 'care' though). It worked for a few days - with an awful lot of family input - before it all went tits up again though and we were back in A&E.

All I can advise is getting onto the GP on the phone first thing tomorrow - cry if necessary - and get them to get as much as they can in place ASAP.

I hope it works for you - and I second helena about the paramedics being fantastic.

Yes i can't fault the actual people, although the attitude of a couple of the nurses in the obs ward was questionable. The staff in A&E were wonderful, just stretched to the point where they simply were fire fighting.

However there have been serious lapses of communication that i feel have lead to dangerous ommisions in my mothers care. These need adressing and i still haven't been given a prognosis re the ulcer

when you have the energy you can complain via PALS.

I have to warn you though, we are getting fobbed off left right and centre about our complaint. mum died on Nov 1 2018; we complained in Jan with a response in mid-March and we were told we had only 2-4 weeks to respond - despite the fact that they admitted their late response was due to the fact that they had lost her records!!
We are also complaining to the council about some of the 'care' that came under their remit - which is, of course, different from the NHS trust.

Honestly, you couldnt make some of this shit up...

I hope she continues to get better at home.

I've always found paramedics to be absolutely wonderful. You get to hospital and then things just tend to go ' downhill'
Lots of reasons why and not all nhs staff are horrible of course, but this has been my experience. Doctors are the worst.
I'm sorry to say.
Sorry you've gone through this op.

I agree The 80sweregreat. When DM was ill the paramedics were great with her and, to be fair, so were the doctors and nurses in A&E. It went downhill when she was moved to an assessment ward. When we got there she was completely bedridden, too weak to talk and didn't really know what day of the week it was.

I spoke to the doctor who told me they would be discharging her in a few days so I asked who they thought was going to be looking after her as I wasn't as she needed more care than I could give her. The doctor looked at me as though I was something on the bottom of her shoe and said 'in that case I'll have to involve social services.' Thankfully Mum was moved to another ward where the doctors were amazing and couldn't do enough for her. She died on the day the previous doctor said she'd be going home.

There was no way I could look after someone who was nearly blind, couldn't walk properly and had heart and kidney failure. She'd managed to hide how bad she was from us but once it was clear how bad she was I knew she needed special care.

LEM, good luck with finding your Mum the care she needs and deserves

Further update: i brought my mother home and she is settled at home. Visited her GP who had received zero information from either A&E or vascular surgeon. Absolutely nothing - she was really angry about this.

I had written a four page report/summary of the timeline which is the only information she has at this present stage. She has her secretary chasing this up. I had to contact the vascular surgeon for actual diagnosis/prognosis and treatment plan. Just as well i did as the original plan of blood thinners would have been a disaster. We are to monitor blood pressure which at the moment is at an acceptable level. So no need for meds for this. Prognosis is grim - could drop dead any time or could have no further issues. Too high risk for surgical intervention.

We have a visit from psychiatrist next week to discuss further intervention re sleeping and mood stabilising

I am going to contact social services for care package.

You really are on your own with this

fingers xd LEM and glad the GP appears to be on the case.

"The doctor looked at me as though I was something on the bottom of her shoe and said 'in that case I'll have to involve social services."

And where the fuck has this doctor been Hiding under a rock? The Gov. wants EVERYBODY out at work now. And when the pensioners with younger partners have to go on UC rather than PC there will be even less willing family carers around. It seems this hasnt clicked with some who work in the health service.

They are going to have to get used to it im afraid. Cant have it all ways.

@Soontobe60

Unless you have cared for someone personally you have no right to judge. You have no idea how utterly devastating and awful it is.

My mum cated for my nan and she has literally aged 20 years before my eyes.

It’s heartbreaking

LEM I hope things are going OK