I don’t know what to do. Elderly parent

[JontyDoggle37]

Just released from hospital after pneumatic and sepsis, only kept in for 10 days, over eighty years old. Now so weak she cannot stand up from a chair, remain standing without being held up by two people, can’t sit down onto the loo. She was brought home by hospital transport as has to be lifted in over the steps, my husband camein an hour later and found her trying to make tea with mayonnaise. Do I ring the ward, her GP? I don’t even know what they’d do..

Sounds really worrying and stressful OP. Does she have a care package in place or does she live with someone who is caring for her?

Ring her GP and your local social services department for adult care.
I'm so sorry this is happening

I’d take her back to A&E. That’s a poorly planned discharge at best, and they’ll only know how badly they’ve done it if you re-present in short order, or, at worst, she’s brewing another infection.

(I’m an OT who’s worked in acute medicine for most of my 20 year career so decent discharge planning, especially for elderly people, is my bag.)

It sounds like she should never have been discharged. I think (in my experience) hospitals sometimes try to discharge elderly patients as quickly as possible and before they are ready or able to go home.

If you think she's too weak to function at home then I would either call for an emergency GP appointment or call 111 for advice. It sounds like there needs to be a care plan in place before she can live at home at the moment.

I find it so upsetting for you, having been in a similar situation, with a parent sent home to a completely unsuitable environment. It makes me worry for elderly patients without families to fight their corner or organise proper care.

I think she should have a care plan in place if the hospital assessed her before she was discharged? Does she live alone because they should have asked about what support etc she has for when she is at home.
If she's not usually confused it could be a sign of a uti although could be any number of things really. I would ring 111 and let them know how she is.

My dad was extremely weak after pneumonia (sadly he passed 6 months later but he had underlying lung issues), and couldn’t get out of bed. Was she able to get out of bed / do any physio at the hospital? Sounds like you will need to care of her / get some carers in until she’s got her strength back. Really they should have discussed this with you so arrangements were in place. Sounds like she needs to stay with family for now

Older persons social worker here -
I would definitely take her back to A&E. She sounds like she is still medically unwell with a very poor discharge.
Good luck OP.

I know it goes against your instincts but you should take her back to A and E unless you’re willing/able to stay with her for a few days while you get an urgent care assessment from adult social services. It’s really ok to take her back - they never should have discharged her if she’s unable to toilet herself and unable to stand without 2 people to hold her.

look up her local council adult social care and give them a call as well

Take her back to A&E, you cant manage her at home, she needs further input and appropriate discharge planning.

Carers aren’t going to turn up as/when she needs the toilet. They’re scheduled for specific tasks (personal care or meal prep). She has to be able to get herself around between set visiting times, which she clearly can’t.

Get to A&E. This is not an overreaction or waste of resources, I promise.

If confused and wasnt before sepsis id be calling nhs or going to hospital, really cant take any chances with it

How awful OP,such a worrying situation.

If she doesn’t feel well I would 999 it sepsis is very serious.

If it’s not as urgent as that I would -
Check her discharge letter (If they give you one) it should say her current medical state ie medically fit for discharge, might say however with delirium - GP to follow up if doesn’t settle. May also say with 3 day course of antibiotics etc.
Also should give an idea if the ward OT/Physio and Social Worker seen her and what her functional level was in hospital - if deteriorated from letter may definitely be cause for a&e.

Is the chair the same height as the one in the hospital,2arms to push from etc? Was she using a mobility aid in hospital to maintain balance - does she have this at home?

Does she have care support, a lifeline buzzer?

I am asking these as rhetorical questions I’d be running through you don’t have to answer me just look aftee your mum x

Also if she can’t sit on the loo is it due to the height? Has she a commode could be used until a raised toilet seat could be provided? May be worth while looking at local pharmacy

If you think she is ill and her confusion is part of her being ill then ring 111. This sounds like a completely unplanned and unsafe discharge - there should have been a hospital social worker involved to ensure your mum was safe to return home. Ring adult social services first thing in the morning and ask for the duty social worker they hopefully can help with home aids.

The NHS has rest homes, my DH is in hospital and over the past 3 weeks I have seen a lot of elderly patients including those with dementia. They are discharged to rest homes/respite.

She must have told them that she has someone at home. Didn't you have to go in? Yesterday they refused to let my fit, youngish DH go home until I turned up in person,

Sounds like a failed discharging. Back to the hospital :()

I'm really shocked they discharged her, knowing she'd be on her own. The poor woman.

There’s a presumption of Home First in some areas, mainly because a) most people want to go home and b) people can deteriorate rapidly in care homes/unfamiliar environments. It might be that this was the reason for her discharge, but she should have been well enough to cope, with some support in place, and with any equipment required.

Is she normally confused or is this out of character? Was she asked about whether there was anyone to help her out while she recuperates?

Having learned from bitter personaI experience of irresponsible di scharve arrangements I would strongly advise that If she goes back into hospital now or in the future, make sure you look after her house key then she cannot be discharged without your involvement and confirmation of support arrangements being in place.

Back to A&E and do as Suze suggests, so that they can't just send her home. Unless she's already confused, the mayo-tea could indicate an infection or complication of some sort to me, after her illness.