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?

These people are adults. No family member can make them accept help and support. And we can be just as frustrated as you that they refuse any help at all in spite of clearly needing it.

I remember these existing when i was a young adult, so I did not need them. But they are a great idea.

Many relatives don't even have the conversation then get outraged that once in hospital home carers or a place in a care home can't magicly be arranged in 48hrs.

Of partial help would be if older adults moved to an easier to care for home in advance or in case of them needing help around the house.

A property that is easier to run is helpful.

For example if bedrooms and the washing machine are on the same floor this saves carrying clean/dirty washing up the stairs.

Having seen my parents and in laws struggle to get around and run their homes (even a step or two up to the front door and down to the garden became difficult to navigate) DH and I sold our family house and moved into a good sized flat less than half a mile from tube and the basic shops, but in the same local area.

We then made it easy to get around (walk in showers) easy to reach drawers and cupboards in the kitchen and so on.

Pre moving we took the opportunity of decluttering and now have far less stuff.

We do miss having a garden (although we have a large balcony).

It's also far more secure.

We moved here in our late 50s.

No regrets.

Perhaps we will be able to live here for longer than we would have done in a house and not have to move at a time of crisis?

That's fine if you can afford it. DM had a two bed semi and couldn't have afforded to have downsized to a bungalow.

In my case my DM wouldn't have given up her garden and I don't blame her, she loved gardening. Many people love pottering around in a garden and who can blame them? I live in a maisonette with a garden and I can't think of anything worse than being cooped up in a flat all the time and I don't even like gardening! We did it once, never again.

I also think that more purpose built accommodation needs to allow pets. DM had a cat and another reason she wouldn't move is because she wouldn't be allowed to take him. She would have been better in purpose built accommodation but leaving the home she loved and garden she loved and rehome her cat would have finished her off sooner.

I think there needs to be more sheltered/assisted housing available to rent. Many are put off because they can take ages to sell on and continue to accrue high service charges There is such a development near my mum and she would love to sell her house and move there but there is an approximately 2 year waiting list by which time it's likely we will be looking at a care home. TBH it's probably already too late for her to adjust to the change but because of her alzheimers she doesn't realise.

The entire point of things like the reverse mortgage is that they only apply to people who already have quite significant care needs - in which case it's likely that (a) they were someone who already wanted to be supported to stay in their house and (b) if that was no longer possible, they'd likely actually need residential care as they're unlikely to be sorted out with just a move to a bungalow. However if that is the case, or if a downsize is wanted, they could sell and take the remaining value of their property and use that - and usually there would be a good chunk of remaining value.

If their (or their partners') pre-existing care had used enough of the value that they couldn't afford a new house, then they would be in the same position as many others, in needing to stay put in a somewhat suboptimal home, and/or requiring additional state support care. But at least there would be far more funds in the system, to ensure that they or other people needing help could access it.

Anyone needing significant care is in a residential home or paying private carers. The maximum the state funds is 4 visits a day. If you have significant care needs that is not enough. It gets you up and dressed, put to bed, help with medication and basic food.

I think by reverse mortgage you mean someone whose partner goes into a care home would have to take out a mortgage on their house to fund the partners care? That would be an awful situation and leaves the partner very vulnerable.

But is being euthanised “ gentle eternal sleep “ or any other such euphemism. Surely the process must be similar to lethal injection? They still can’t get that right and some live to tell the awful tale. So whilst the administration of the drugs may be gentler is it really this magical fading away it’s made out to be?

Most people would never choose euthanasia, and nor should they.

The real issue currently is not this, it's that we're putting elderly and ill people through invasive and often painful medical treatment to prolong life at all costs. If more people in middle age saw what life quality is like for people after 'successful' CPR or with severe dementia, they would far more often do what so many medical professionals do, and put directives in place and talk to family to ensure that they are not put through this and that if, for example, they develop pneumonia when in a care home they are not given antibiotics but instead enough pain relief to keep them comfortable through the end.

How on earth would that mortgage be paid?

The state cannot be all things to all people. ‘Better support’ is just 2 words but the cost and planning/implementation would be immense. Personally I don’t think we put enough emphasis on planning for retirement or later life. And people are too nervous to have candid conversations with elderly family members in case of how they react. Nobody wants to be the person to suggest a care home to them.

Isn't something like a lien put on the property so when it's sold, the council can recoup the money owed?

This is not true. People are happy to suggest care homes, many elderly people do not want them until circumstances force it. And I do not blame them. Unless you have loads of money, care homes are expensive and pretty shit.

And how can people plan for old age properly when every government changes the goalposts? You can't.

But that could be many many years.

How do you ‘address the public perception of dying’ without causing major offence and insinuating the sick and elderly should basically be euthanised?

You don’t have. You’d be astonished at how many of those selfish boomers you so love to despise have no intention of carrying on when their quality of life has gone. I’d be first in line to end it all if my life becomes sub optimum.

DH is 20 years older than me so there's a good chance the council would have a long wait in our case. They wouldn't get much either as we have a one bedroom flat with a short lease that's worth next to nothing if we don't extend it.

I read that 82% of the public support assisted dying should their lives become intolerable.

If you don't agree with it, don't have it.

If you're religious or have ethical objections, don't have it.

If you want to hang around until the very last breath for whatever reason, don't have it.

But don't condemn those of us who do want it to live out what's left of our miserable lives in some grotty, understaffed care home being force fed antibiotics and mush whilst charging us £4000 a month. The carers will probably be ex cons by the time we're old because they'll be so desperate for staff. Don't expect to receive any pain relief because it'll be flogged down the pub.

Remember, things only ever get worse.

Yes, this is what councils (in my area) do when a person goes into a care home but cannot fund it but has assets. Any surviving spouse/partner can stay in the home until their death.

Not the case.
If a person needs overnight or a live-in carer, they will fund it. Depends on needs, assessment and the finances/assets of the person needing care. Unclear who funds what council/NHS/DWP.

I read about assisted living places in Thailand, they sound amazing. Far cheaper than UK retirement homes with far higher level of care in stunning countryside and caring staff. And think of the food! Rwanda is also quite nice in its own way but obviously the Thais are better known for their elevated care of the elderly.

It's about personal choice. I don't think are people are educated about what CPR is . They think it's like the TV and you will be fine afterwards. Many people won't even very healthy people. Just a few minutes without air can cause incurable brain damage. A frail person going through that with underlying health issues won't be the same again or recover but try having these conversations and they accuse of murder.

Many people have the conversations too late when they have already lost capacity or in crisis. I don't want to be force fed antibiotics in a care home I will request a DNAR . I will be dying anyway medicine can't make us immortal. That's my choice if they don't want that that's fine, but they should definitely talk about the dying process more in the media. I had no idea until I worked in healthcare.

I presume if a person owns 50% of the property the council would only be entitled to 50% of the value?

I don't know the specifics of how it works.

@PinkSparklyPussyCat that's right. Years ago my dad changed how my nan and grandad owned their property, instead of them sharing 100% ownership it was changed to each having 50%. Reason for doing this was because they were worried my grandad would have to go in a home and there would be nothing left for my Nan if the same happened to her (my grandad was older).
When my grandad passed away (never ended up needing to go in a home) his share was passed to my dad and my uncle. My Nan had to go in a home a couple of years later, the house was sold so my nans 50% was used to pay her care home fees and my dad and uncle shared the other 50%.