Aibu to request a home visit from the nurse/doctor for my very frail mum

[Anna713]

My mother is 93 and in the last few months has become very frail and unwell. She has several medical conditions related to old age. She never goes out of the house now and I look after her with the help of carers. I did manage to get her to the doctors in a wheelchair a few weeks ago but it was a struggle and she was exhausted when I got her home. I was exhausted too as I'm nearly 70 myself. If the weather is really bad and if its raining I don't know how i will get her there. She now needs another routine appointment (as requested by the surgery) so I phoned to ask if a home visit would be possible, from the practice nurse if not a doctor. They are supposed to be getting back to me but they sounded a bit surprised that I even asked. So my question is aibu in requesting a home visit when I know the surgery is extremely busy.

Our surgery is doing home visits; gps as well as the practice nurses and paramedic. Definitely OK to ask.

If she's genuinely housebound then YANBU - that's precisely when/why we do home visits. They may have sounded surprised because she was in the surgery relatively recently (even though she's deteriorated since then - you may need to make that clear), or they may not have sounded surprised and that's just how you perceived their reaction.

If she 'can't' get to the surgery but goes to see friends for coffee, regularly visits the hairdresser, potters round Tesco once a week etc etc (all things I've been asked to time home visits around ) then you need to get her to the surgery I'm afraid. I know it's hard but we just don't have the resources to visit everyone for whom a home visit is just easier.

Can you book accessible transport ?

Thanks for your responses. She is genuinely housebound now unfortunately. This is quite recent. I think the last time I managed to get her to the supermarket was November but this was in a wheelchair. She isn't always in a wheelchair, she uses a walker at home but not outside.

You need to tell them she's housebound. And keep repeating it.

Don't take her otherwise they'll just insist you take her every time. Tell them her health has deteriorated and she is no longer able to come into the surgery.

Do not back down!

(Have recent experience)

And ask for it to be added to her notes. Do you have POA?

She needs coding as housebound on her patient notes. As soon as that happens she will qualify for home visits. It's rare to get a doctor do a house call though, usually you get a paramedic on the home visiting team.

I don't think accessible transport would help unfortunately. I can get the wheelchair in my car and push her but she's just so exhausted with the effort. I'm also so worried about her falling whilst I'm try to manouver her in and out of the car. I just wasn't sure if home visits are still a thing but it sounds like they are.

We've been in this position with my mum after she had a fall and ended up in hospital.

Call your doctor and insist on a home visit (you have to be really firm) - they can send the district nurse out but it has to be authorised by the GP so don't waste time trying to contact the district nurses directly.

We had to contact Adult Social Care as well, but I'm not sure whether that was because she'd just come out of hospital.

I really feel for you - it seems like there's no-one who will help.

Is it time for her to consider going into a nursing home, OP? You have to think what's safest for her at this point and it's hard to think she's 100% safe on her own when the carers/you aren't there.

Thanks everyone. This is really helpful. I do have poa thank goodness. I'll phone again tomorrow and insist.

My mum's GP sent out a locum who was very good and sorted out a scan at the hospital (my mum's leg was very swollen) and arranged transport in an ambulance.

It's really shocking that old patients are expected to go to the GP - my mum couldn't physically get into a car after she broke her hip yet we were still expected to take her down.

Is she under the district nurses for routine blood work etc?

She may be eligible for continuing care at home if her conditions are terminal and have worsened a great deal in the last few weeks/days.

You do have to be a bit like a stuck record I'm afraid but they will come out, especially if you insist it's added to her patient notes.

We had a GP who did home visits on a bicycle! Your mother is entitled to the same standard of care if she isn't able to come into the surgery as she would be if she were. Tell them that.

I think you need to make it clear to them that she has deteriorated since the previous visit and you haven't been able to get her out of the house since November.

Unfortunately alot of people who don't need them do request home visits as mentioned above so you will need to be clear on why one is necessary.

Why is it really shocking @ICanHideButICantRun - we visit housebound patients. Not those who can get out of the house. We don't have enough time or staff to visit everyone just because they're over a certain age. I have 90 year old patients who walk their dogs twice a day and 50 year old patients who are housebound.

You also get much better assessment and care if you are in the surgery. Lots of things can't be done at home, we are often working slightly blind on home visits.

My practice area is enormous. When I'm on visits for an afternoon I can see a maximum of five or six patients usually and might drive 25 miles in between. In an afternoon surgery I would probably see 15 and maybe some phone calls on top.

It's perfectly reasonable to ask for a home visit if there OP's Mum is genuinely housebound (which she has confirmed to be the case).

I will have to find out about continuing care. I don't think I will ever persuade her to go into a home. Although she's frail she is still mentally competent (more or less) My sister is thinking about having our Mum living with her but I don't know if that would work. It's a lot to think about and it's hard to know what to do for the best. She lives in a retirement apartment so it's sort of a safe environment. Better than being completely alone anyway.

Not appropriate, they pick you up early and don’t come back for hours leaving a frail elderly patient sitting in a hard wheelchair for hours!

Accessible transport is really where the wheelchair occupant stays in the chair and whole thing is transported secured in place, but you do need 'your own' wheelchair. No pushing or pulling of occupant to transfer to car seat. That is tiring both for carer and patient.

In my MILs last years, when she was frail and moved in with us, we had house visits for everything, from vaccinations, eye tests, chiropody the lot. Some of the visits were a bit spaced out more than we would have liked due to Covid, but we couldn't fault the support we got. She lasted till she was 99 which was great, but me and DH were getting old and knackered too. It is hard work so look for and take all the help you can get.

My dad is housebound and he always has home visits from the doctor/district nurses and he had all but one of his Covid jabs at home too. You just need to get it in place with your mum's surgery.

I do take my dad to the dentist and occasional hospital visits but I'm early 50s and it's exhausting getting him in and out of both the wheelchair and my car so I wouldn't want to do it when I'm 70+. I do it when there's no transport available as my mum isn't able to do it.

Always ask but it may be quicker to book a wheelchair accessible taxi and take her

But there are thousands of 'old people' per GP practice. No one would ever get seen if they all had home visits.
As a DN we often visited supposedly housebound people who had just popped to the hairdressers/ Tesco/bingo. Ridiculous.
You sound in real need OP so just let them know.I'd also want to know it was for a genuine medical issue or just a box ticking exercise. Or even something that could be with with over the phone.
Maybe time too to contact social services for some more input. I'm sure your DM wouldn't want you to struggle on if there's an alternative.

You’re not being unreasonable at all. At 93, your mother is very frail, and it’s clear that taking her to the surgery is a huge challenge for both of you. It’s understandable that the surgery is busy, but your mother’s age, health, and mobility make her situation exceptional. Home visits are meant for cases like this. If they can’t manage a visit, perhaps ask if they can offer alternative support, like a phone or video consultation, or advice on community services that could help. You’re doing your best in a tough situation, and it’s okay to advocate for what your mother needs.

Except this thread is two years old so her mum is now 95.