I'm not responsible for hospital's decision

[Orangeblossom78]

My family are making me feel responsible for my elderly dad being sent home from the hospital.

He hurt himself on some broken furniture in his sheltered housing flat. And as it was over the holiday period no-one came for ages to help, ended up going into hospital and getting patched up.

So, nothing major such as a heart attack etc...the hospital rang me (dad had given my number I think as next of kin) Anyway they told me they were sending him home and I asked if it would be Ok for hospital transport as I live far away, and they agreed.

However, my sibling is saying they wished they had been spoken to instead. That they should have kept him in and assessed him more. I think they want him to go into more supported accommodation and this would have helped.

However the hospital physio spoke to me and explained dad was medically fit to go home, if his home was unsafe with broken furniture etc then that needed sorted out at home, and he was mobilising and managing showering ok etc and also they had lots of flu cases and didn't want him catching that.

Also he wanted to go home and I think that needs respected as well.
AIBU? Talking to them further wouldn't have changed things. Feel like now dad is home I am being blamed for this as family nearby now taking time off work etc to help him clear up.

A hospital is no place for a healthy elderly person to be. Physio is right about risk of infection. The physio assessed him as being mobile enough to go home.

contactIng social services like you’ve done is good. if this is what your dad wants. What does the warden in the sheltered housing think?

I do think that, given that his return home was going to necessitate support from your sibling, the least you could have done was to talk to h them first. I think the hospital person was bullshitting you to an extent - it is usually standard to send an occupational therapist to check the home before discharging an elderly person, and as a minimum they should have been checking that your father's home was safe to avoid the danger of readmission.

Thise who are syaing that OP should not had her father sent home. I have worked i the rehab fueld long enough to know that the hospital wont keep someone in just because their family say so. He was medically fit to be discharged so they would not keep him in. Tell your sister to get her facts right first.

He wouldn't have thanked you if he'd stayed and caught the flu! I think you did the best you could and made the best choice available.

@Orangeblossom78 - you are not at fault atall. A hospital won't not discharge a medically-fit patient just because the family don't want them too! It would also not be in your Dad's best interests to stay in a hospital bed when he doesn't need to. Muscle weakness would have increased and he may have struggled a lot more at home. If he needs an assessment of his care needs that should happen in the community.

One of the worst thing about being responsible for elderly relative is everyone else telling you what you should have done. I have LPA for elderly aunt, she went into hospital after a fall the following day I phoned and they said they would probably send her home later. I gave all the reasons that wasn't a good idea, cold day in February and her house would be cold, carer had been cancelled for the day as she wasn't at home, police and ambulance service were complaining about her constant phone calls etc etc etc. I got a phone call two hours later to say she was in hospital transport ((it was a taxi from a firm that had a contract with the hospital) on her way home. Of course rest of the family were saying, "you should have got them to keep her in."

You have my sympathy, if they won't accept carers you can't do anything but everyone will be tut tutting about the poor old soul being neglected.

I doubt they were ringing you to ask your permission for your Dad to get sent home. He could just as easily have checked himself out and got a cab. When I had elderly relatives in hospital they had to be escorted out of hospital with someone or they couldn't leave. Sounds like your Dad could do what he wanted and he did.

teh hospital were bulshitting you they are not supposed to do unsafe discharges ...... so an elderly person who has had a fall is supposed to have an ot/physio assessment prior to or as they are discharged...
they were 'just' stopping bed blocking coz they are so busy but this is very poor practice... I think sibling had the right idea and not letting him be discharged until lassessment has been done (I have been through this multiple times with IL's) - however you're not to know that...
he may find the sheletered accommodation will want him to leave if he keeps refusing care .... so maybe you him and sibling need a frank conversation that if he is assessed as needing care he needs to accept it or he will be in an old folks home......with none of his stuff as thats the future....if he has capacity - he needs to show it by making good decisions (yes MIL am thinking of you...)

we have yet to have MIL make a good decision - so she has had repeated falls, we live 100's miles away ..... thank goodness she has an amazing neighbour who checks on her everyday....

Hopefully your DF will be more sensible - but yes make sure local sib on as NOK as sometimes repetition with SS is needed....
best of luck - its hard, look at the elderly parents thread....

He was medically fit to go home.

He needed support from someone once he got home - it was not going to be the OP.

"I do live hundreds of miles away also and have my own family so can't just rush up there" - but somebody had to.

Ideally the OP should have referred the hospital to the sibling who was going to be responsible for helping out, rather than simply agreeing they should be sent home by transport.

@Orangeblossom that is a very convenient excuse "he will need to engage and not send carers away". They, Social Services, have the duty of care for your father and you need to make it clear that the responsibilities are theirs not you.
I have heard probably every excuse in the book I think.

He did have a physio assessment though it was them who called me.

I'm sorry to hear abut the frail 89 year old though, mine is only mid 70s and in better health. that is awful. "Don't know' indeed.

Sibling is going to get power of attorney will try and refer them to them in future I think, I have learned from this.

Sorry, @averythinline, but that’s not how capacity works. The onus is on someone to prove a person doesn’t have capacity.

Even if the person makes unwise decisions, you have to prove that they do not understand the potential consequences of these decisions. If they do understand, and still want to proceed, the hospital has no right to detain against consent.

It's a very difficult situation, my elderly grandma ended up in hospital for 8 months after a fall at home - she was OK, went in able to walk and had been looking after herself, and she was only taken in to make sure there were no broken bones. The Dr who sent her in expected her to be home that day. For some reason, they kept her and kept her, she didn't walk when she was in there, didn't get physio and ended up with pneumonia. We almost lost her. By some miracle she got through it, and then had infection after infection and had to have a lot of physio to get her walking again. She's now home with a lot of help from carers. Hospital never does her any good, she goes downhill every time she's in. We didn't even think she would get home, we thought she'd have to go into a care home.

He might have been too fit for hospital, but not fit to be home alone & a short stay in a care home needed for example.

I would have thought that broken furniture left where he can trip or hurt himself is surely not a good sign-had he asked for it to be moved or repaired?

One of the signs of my parent needing full time care was that they weren't making good decisions about themselves.

He did have a physio assessment. In many teams, OT and physio do the same job and either one can assess mobility and need for equipment.
It is absolutely not required to do an OT home visit to assess the environment prior to every discharge.
OP, your sibling cannot get POA, it has to be given (set up) by the individual when they are in their right mind. It will not be activated until they are found not to have capacity, so sibling cannot ride roughshod over decisions if the individual still has capacity. Making a poor decision does not indicate lack of capacity.

averythinline, the hospital will discharge if they want to. My aunt had dementia, she was unsafe at home, we were trying to get her into a home but until you can prove they don't have capacity you can't do it, the hospital phoned me, I am 200 miles away, I explained all the reasons for not sending her home to a cold house in February and they just put her in a taxi.

Have a google about what has been happening in Cornwall, came out yesterday that they knew they were putting elderly people at risk but were discharging them as they had no beds and needed them for people who were more seriously in need of them.

If they wanted to discharged him there was nothing the OP could do to stop it.

Even if he does get some carers they will not tidy up for him, that's a totally different job. I had a care package after I broke my knee and my foot but the carers only came round to hep me shower and make me some sandwiches and a drink.
They couldn't help me the shower in the end as they weren't qualified to remove and replace the dressings I had on.

Also if you have capacity you can make bad decisions, people do it all the time people have that extra cake when they know they need to lose weight, they smoke and know it is dangerous, they spend the rent money at the bookies. People with capacity have the right to make good and bad decisions. We might not approve but then we probably do things other people don't approve of.

Thanks for the replies. Yes the warden at his accommodation is recommending the next level up of supported housing but it is full. So hopefully things might change if a place becomes available.

OP, your sibling cannot get POA, it has to be given (set up) by the individual when they are in their right mind. It will not be activated until they are found not to have capacity, so sibling cannot ride roughshod over decisions if the individual still has capacity. Making a poor decision does not indicate lack of capacity

That's good to know

Actually I do think local relatives should been consulted and given awful experiences we had with my late mother I do wonder if the hospital rang you rather than them deliberately. Putting it bluntly we were lied to on more than one occasion. Eg Told she was "medically fit for discharge" when still on continuous oxygen, told she was fully mobile and using the toilet independently - in fact it took TWO staff to help her out of bed, she could not even stand unaided and was still catheterised! My sister was phoned to say mum was "medically fit for discharge" when I was actually on the ward and had been informed by another patient that mum had a seizure less than an hour earlier (confirmed on her hospital records!). On a Friday morning I was told by the doctor that had just seen mum that she would not be discharged until after the weekend at the earliest as she had a severe chest infection and needed IV antibiotics. Was then rung at 9pm by her next door neighbour saying mum had been sent home on her own in a taxi - care package not in place, no shopping done, heating not put back on etc. Rang the ward who said discharge had been agreed with her daughter, Mrs C, ie me!!! Unfortunately she was readmitted the following day after she collapsed - was diagnosed with pneumonia and it was touch and go for 3 days! I could go on.

There is no obligation, indeed no right, for relatives to be consulted
about any discussion if the patient has capacity to make decisions.

The presumption is that people DO have capacity unless there is some reason to think otherwise. Whilst people may make seemingly irresponsible or ill advised decisions, if they have capacity that is their right and nobody else’s. If someone wants to go home to somewhere you might consider unsafe, that is their absolute right to do so.

As someone said, a Lasting Power of Attorney must be given freely whilst the person has capacity. The signing must be witnessed independently. Only after it has been duly registered at the Office of the Public Guardian AND someone loses capacity, does it become effective.

The hospital is not the right place to detain someone who is clinically fit for discharge. That doesn’t mean running a marathon fit but not in need of acute medical care. The risks of remaining in hospital are quite high. People recover better in their own environment.

If your father believes he needs carers, that is for him to arrange or for him to allow someone else to arrange. It can’t be imposed. Regardless of what the family think. Sometimes people are referred to the Court of Protection to stop the family making decisions for someone who is able to make their own still.

My dad was not at all as ill as some of these mentioned, he was able to walk a long corridor with the physio, he told me all about it and he was so much more able to walk than some of the others etc. I'm sorry they didn;t call my sibling also but it was just to inform us what was happening and I guess they can't spend ages contacting all the relatives.

It was not to ask permission but more as a courtesy as dad does have capacity. I was grateful they did the SS referral and organised transport for him. Also they did check his building and that it was clear / safe apparently when they dropped him off in the ambi bus.

@Suze1621 I’m sorry that you and your mum went through that, it sounds like genuinely atrocious care, and worthy of complaint.