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?

Bring back Cottage hospitals and Convalescent homes , but you will need to find enough staff and Brexit has ruined that . Oh, and 12 years of Tory austerity while they waste billions.

Tell them they have to leave. End of.

It's not the role of the government to fix every problem in everyone's life. If they need looking after then it's up to them, or family, to sort it. Not Daddy Government.

Sorry. Harsh but true.

I don’t think money is the actual silver bullet

The whole system including the NHS, needs a good looking at but no party, of any politician colour will grasp it, and will just tinker round the edges as the NHS is a sacred cow

Until the nettle is grasped, we will continue to have the problems

Throwing more money at the problem is a good idea, until taxes have to go up to pay for it

Then listen to the howl of protest 😳

@ILoveeCakes Good to know that you will support your colleugues while they are off work caring for their elderly parents by doing their workload as well as your own.

It's not able bodied folk who can't be arsed house hunting. They are discharged.

It's people who's needs have changed massively since admission, and they now either need care at home, rehab, residential care etc etc.. to tell them to get out would result in them coming to harm - which would be yet another admission.

We need to wait for the local authority to assess their care needs (days, weeks - they have up to 28 days), then either allocate a care package (if they have carers available) or seek out a suitable placement for residential care. Most of these are privately run and will happily decline anyone who sounds like they might be hard work.

It takes ages, because we don't have enough social workers to do the assessments and referring legwork, and then there aren't enough carers available to meet demand.

Care costs money. We need to start paying and valuing the people who work in care, rather than allow private providers to continue to rake it in at everyone's expense.

Get rid of the paltry Carers Allowance and pay family Carers a reasonable income replacement to take care of family members. Ensure that family Carers have a pension in addition to the current state pension provision.

The issue is that if family carers were paid, for instance, 26k a year plus pension contributions, everyone would care for their elderly parents or grandparents wouldn’t they? And the system would be open to abuse - I can see an awful lot of people taking the money while doing very little for the elderly person in question.

@CovidTestEvapLine 100% agree. There's a lot of opinions on this thread from people who quite frankly have absolutely no idea how social care works and interchanges with healthcare!

It's all a vicious circle social care underfunded and in very short supply. Carers that stay are hard to come by especially when you could earn the same for a much easier job. NHS trusts closed community hospitals where people could go to continue to recover and not take up space in acute hospitals. People aren't being seen in a timely way by GPs and are ending up jn acute hospital when it could have been prevented by earlier pri.ary medical care.

No they wouldn’t. Nobody would give up their life and provide 24/7 care for £26k. I wouldn’t have done it for three times that amount.

C is not being penalised. C had all the advantages that go with home ownership, including security. And whilst C's desire to leave some inheritance to the next generation is entirely understandable, it does not follow that C should have limitless recourse to public funds in order to fulfil that desire.

I wouldn’t have done it either, it would never have worked with my DM and it would have been even worse with MIL! I would rather my Mum spent every last penny on her care.

Here's a comparison of health expenditure, 16 countries in the world spend more per person on health than the UK. This is despite us having the 6th largest economy in the world.

We do waste some money though in my view, all the public money that goes on on private hospital beds, agency staff, locum doctors and care agencies. I don't want my tax money to be used to line someone's pockets when carers are paid minimum wage for what can be a hard job.

Well, that’s you. It would depend on the level of care needed. Spending 24/7 with somebody with aggressive dementia? Not appealing. Making 3 meals a day, chatting, help with toileting and some housework? Perhaps.

I agree.

@kingtamponthefurred I also think your scenario is why there should be tiers of care home. If you’ve hardly paid a penny into the system and have no assets, it isn’t fair to get the whole thing for free when the person in the next room has sold their house to pay for their care. So there should be sort of ‘packages’, a basic one for those who can’t pay anything and those who can pay should have more of a choice. I’ll be shouted down that that ‘penalises the poor’ but life is essentially unfair and we all have to take accountability for our decisions at some stage.

@slowquickstep , if your father still has all his faculties, why does he continue to accept medication, then? By law he is surely free to decline it.

It’s people who don’t have a full set of marbles, e.g. with dementia, or those who can’t speak for themselves e.g. after a stroke, who are in more danger of being kept alive just because it’s possible to do so, whether it’s in their best interests or not.
Personally I think that ‘striving to keep alive’ can verge on cruelty, especially in cases of later-stage dementia - of which I have seen far too much.

There are tiers of care home in a way as LA will only pay so much so the expensive ones would only take those whose families can afford to top up for them or people who could pay for their own. Also no one gets free residential care in England unless via CHC their pension will be taken except for around £25 a week.

@Cuppasoupmonster And there right THERE is an absolutely beautiful example of cognitive dissonance provided by yourself You do realise that would mean the care worker would be someone who would end up in the lower tier of care home by dint of not being able to pay more in due to WORKING in a bloody care home on a lower wage. And you have also shown your true colours by objecting to people having a proper income replacement to care for elderly relatives. Oh you want them to step up but you dont want your taxes going up to replace their income properly. We see you.

This kind of attitude is why i never believed the "we are all in this together" shit they shoved down our throats during Covid.

So any care worker reading this take note of @Cuppasoupmonster and ditch the care job for a better one if you can.

You know that already happens right?

I worked in a care home over two floors. The upstairs had 14 large rooms, enough for their hospital bed, recliner chair with wall mount tv, display cabinets, build in wardrobe and drawers area, ensuite shower rooms, communal lounge/dining area with multiple comfy sofas and air con unit for the summer, fire place etc. 3 staff member to the floor. Weekly menu choices.

Down stairs had 35 rooms. 3 were double rooms. Standard non hospital single beds (which made pad changes an absolute nightmare), no sitting area in rooms just a basic set of drawers. Shared bathrooms. Communal tv/dining area with basic chairs. Food was as per served. 4 members of staff employed to care for them all plus the duty manager overseeing upstairs too.

Guess which floor was privately funded and which wasnt.

Making 3 meals a day, chatting, help with toileting and some housework?

That’s not what 24/7 care involves.

It isn’t. So do you think that level of care would warrant a carer’s allowance?

To stun you rigid I’m a below average earner.

We've just been through the whole scenario with recently deceased DMIL. Dementia with carers 3x daily at home, followed by what was supposed to be a few weeks in respite while DSisIL had a knee operation, and then Covid and lockdown happened -- so nobody could visit for months. At £4k per month, DMIL's cash dwindled quite rapidly while her house stood empty. By September, it was plain that returning home was never going to be an option, so DH who had her POA took the decision that her house had to be sold to fund her residential care. The dementia advanced and in autumn she fell out of bed and broke her femur, and the care home staff thought her shoulder was broken too. It was 27 hours, lying on a tile floor, before the ambulance arrived. Then she spent six weeks in an acute trauma ward with five other equally demented elderly women (all charts marked DNR) until she was medically "well" enough for discharge back to residential care, where she died six hours later. It was horrible for everyone concerned, but apart from the ambulance, everything worked as it was supposed to. A bit make do and mend at times, possibly but we were always of the opinion that it was her home, her money and her care came first, last and in the middle. It would have been even more painful if there had been no money or house to look after her properly.