What’s the answer to ‘bed blocking’?

[Cuppasoupmonster]

Another day, another article about ‘bed blockers’ (put in speech marks because I know it’s a bit of a goady term).

I was shocked to find out a third of beds are taken up by ‘social patients’ in some trusts, who are medically fine to be discharged but can’t be because the care they need afterwards isn’t in place. I feel irate that the whole point of lockdowns to ‘stop the NHS from being overwhelmed’ needn’t have happened if it wasn’t overwhelmed in this way to start with.

Whats the answer? Early intervention so they don’t end up in hospital in the first place? A rise in taxes to pay for more services? I’m not sure the working population can afford to pay more tax.

The ‘ageing population’ issue means this can surely only get worse?

Do you know how much home care provides? People already pay that amount or more per hour to agencies.

People don't want to pay. That's it really.
I also think there’s a perception that family care is “free”. My mum thought it was free for me to take time off work after her surgery, because (assuming we could find a carer) that would cost hundreds if not thousands of pounds. Except it’s not free, because I didn’t get paid while I was off work.

Or parents who own property will say “if you look after me that means I don’t have to sell the house, so you can inherit it”. Then they need residential care later on, or they don’t make a will, and you don’t get the house anyway.

My relative isn't safe at home @Bramblejoos imo . If they fall again nobody will be able to move them , they are barely eating. They'd be safer in hospital as they are ill but still they sent them home

And if your relatives have retired to the countryside, you may not get carers to visit for any amount of money.

It's a social care problem. Most people have to pay and its expensive, usually people have to sell their homes to pay for it which they can only do if nobody else needs to live there! We need to have a system for free social care for those who need it, but it would be expensive to implement and we're all feeling the pinch. Also we have a tory government and they don't like investing in public services

I don't know what the answer is expect to say that the elderly (and people like me in my 40s) need to get MUCH BETTER at planning ahead for when they can not manage as they can right now. My parents are a case in point. DM is about to turn 80, DH 80 next year. They are wealthy pensioners (very relatively speaking). They live in a very large Victorian detached house that is cold and a bit of a money pit now. They live currently 4.5hrs away from myself, 6hrs away from one of my brothers and the other brother is abroad. My Mum has started to have falls - fortunately none serious....yet!! Generally they are both fit and active BUT I have spoken to DM repeated about moving and what they're going to do. She repeatedly says they are planning and WILL move to be nearer in the next 5yrs (that was 2018). Not moved yet - still got things they need to do to the house before they can sell it. We're about to move and will then be 2.5hrs away - next door to use they are building a new 4 bed house. The area is good and semi rural like they're used to. We are going to suggest they move into the house next door. But I know right now they it'll be met with "we're not ready" and last time I mentioned such a thing "I'd rather go in a home than be looked after by you!" although she may have changed her mind after her own DM was in a home and she thought it was awful!!

Yep I have an advanced directive, pain relief and sedation only , no pureed mush or ensure if there's no hope of getting better. I will make sure my care is planned and mapped out before I lose capacity.

I left nursing 22 years ago, and even then it was difficult to get plans in place to discharge some patients that had more complex social care needs. I have a friend who works for social services and she’s so fed up of it as they just don’t get anywhere and she’s really stressed. DH works for the ambulance service and they are frequently waiting up to 8 hrs outside a&e.

Posted too soon, I think more social care is needed. Maybe convalescent homes are a good idea for intermediate care while plans are put in place for a more permanent solution.

IMO the NI increase should not have been ditched.

And it would take some organising... but what if a bespoke Lottery were set up specifically to help fund the care sector? Would people subscribe?
Care Homes set up by the Lottery Charity. Of course you would always have private care homes but equally the NHS could prioritise clients into Charity run care homes and perhaps have a Commission to oversee them.
Also tax breaks for wage earning families bringing their elderly relation into their homes.
And planning mitigation for home extensions /adaptions to families providing elderly care in their homes

Because carers only get paid for the time in people’s homes, not travel time so less accessible places are less desirable jobs. This is an absolute disgrace and would be an easy way to improve carer’s wages and make care more accessible for all. But it will eat into care companies profits significantly so won’t happen.

This is true. But if people live in rural areas they may not get any carers travelling there for any cost. There is a shortage of carers. I know a woman who works as a paid carer who goes to live in elderly people's houses for weeks at a time. These are almost exclusively rural areas. It costs a fortune and she is well paid, but many of these elderly people do not need full-time care. They just can't get any carers to visit at all.

I am in my fifties. I had pureed mush when very ill in my thirties. I am very glad I was not killed because I had to eat purred mush.

I've had reflux required an operation so needed puree for a little while. I'm talking about dysphagia which is a late symptom of dementia and Parkinson's. I did say if there's no hope of getting better. People with dysphagia at the end get aspiration pneumonia multiple times which they then treat with antibiotics. Nobody is going to kill me that's illegal but it's my right when I have capacity to decide I don't want puree, antibiotics or build up drinks. We have bodily autonomy.

Misunderstood sorry.
All my relatives at the end of their life stopped eating. No one had pureed mush or was offered it. And no alternatives either. Everyone knew they were dying and they did.

More affordable at home care so elderly fragile people can stay in their homes and free up hospital space. Ie cheap labour from Eastern Europe.

Unfortunately, we’ve left the EU and so all the Polish carers/nurses no longer come, there’s a recruitment crisis in the care sector, and so our hospitals are full.

Well done everyone who voted for Brexit without understanding that our economy and social system relied on freedom of movement of people and goods.

Project Fear, not so funny now, eh?

Provision of hospital beds, commodes, etc to be properly resourced and not left to a charity to handle.

To be fair. It was Jeremy Corbyn who called it the Dementia Tax and was against it. It was one of the planks of his election campaign.

But we get carers from all parts of the world that get work visas to work in the care industry. Not just EU workers. Anyone from the EU, Europe and the world are welcome to work in the care system.

Indeed. Many famous actresses, like Jennifer Anniston, live on pure mush, ie baby food, to keep their weight low. I don't know if she'll ever stop eating it but let's not euthanize Jennifer just yet.

I'm not talking about a reversible process or someone who is choosing to eat pureed foods. I don't think you have worked in elderly/pallative care. It's not euthanasia it's banned , it's me saying I refuse for staff to prolong my life they would try to prevent me getting aspiration pneumonia but I would die anyway.

Perhaps draw down on the 1 Million pound house to fund it. Most elderly people don’t have a £1 million pound house.

No but pensioners are the wealthiest demographic and 75% of them have no mortgage on their house. Broadest shoulders?

Then your relatives are very lucky , it's a standard thing for thickened fluids and pureed food to be given towards the end for a lot of people.