To ask if anyone has any experience of medical repatriation?

[catgirl1976]

DSis, Dbro and I have long suspected DF has dementia. He has refused to engage with GP or any sort of support for years and his doctors have been useless and said he's fine. He is not. He has barred his doctors from speaking to us after previous attempts to get him some help.

To cut a very long story short he has managed to get himself to Benidorm (he has periods of lucidity) however lost the plot when he's got there. We did not know he was going. First we know is a jumbled call from the Spanish police and from what we can piece together he has landed, got a taxi to the wrong city and wrong hotel, lost all his money, passports etc and 2 days later been picked up by police. The police took him to the right hotel where he sat in the lounge saying they had robbed him at knifepoint and that the hotel was holding him against his will.

DBro flew out there on Wednesday but by the time he got there DF had gone missing again from that hotel. DBro got in to his room and found a key card for the hotel in the wrong city, went there, no sign of DF but his money etc was in the room he was in. DBro collected all of that, went to the right hotel - still missing. Then he was eventually picked up having collapsed in the street after wandering round all day in the heat, confused with nothing to drink.

Since Wednesday DF has been strapped to a bed in a Spanish hospital. This morning they diagnosed dementia (we have been trying to get a diagnosis for about a year so some good news I guess although he thinks he's on a boat in Scotland) and said he needs to be medically repatriated with a registered nurse then admitted to hospital for psychiatric evaluation and care. Amazingly he did take out travel insurance. The consulate have also been quite helpful. DBro is now travelling back having been in Benidorm since Wednesday. He's got hold of the travel insurance people who have passed him on to their complex claims people who will call him. Hopefully they will have some answers.

Has anyone experienced anything like this before? How long does repatriation take? Will they take him straight to the hospital in the UK? Who lets the hospital know he is coming? Generally wtf happens next? We've no clue and are just hoping the travel insurance people have all the answers but I just feel so......confused and powerless. DSis will go back out there to accompany him on the repatriation flight if needed but.............I just don't know what happens next. If anyone has been through anything like this any advice would be appreciated.

My DF was medically repatriated a few years ago after an accident. His insurance paid for me to travel out to be with him (and liase with them and the hospital staff as DF was unable) and then when he was medically stable and mobile, they flew a private nurse out to travel back to the UK and onward to hospital. He flew on a normal flight but first class.
I Will say that the insurers did everything they could to wriggle out of paying and you may struggle if there is even a whiff of dementia on his medical records already.

I have some second hand experience with medical repatriation (a friend had to be repatriated), although it was for a physical injury, not mental health.

Your main contact should be with the insurance company. Step 1 is to get them to decide ASAP if he is covered, because that will determine pretty much every other step. If he is covered, then they should take the lead in arranging all the specifics. They should arrange transport, as well as contact a suitable hospital in the UK (either near DF's hometown, or near you or your sublings.

If they decide he is not covered, then it's a different story, but one I'm not able to advise on. The insurance company might though. But hopefully it won't come to that.

Then if the insurance company identify any challenges in helping to get your DF home (for example, will he need a new passport), that's where you might have to come in and liaise with the embassy for example. But really, let the insurance company take the lead, but also pro-actively ask them, if there is anything you need to do to help this go smoothly.

Medical repatriation with a special air ambulance does indeed cost thousands. But from what you say of your dad he doesn't need a special aeroplane kitted out with heart rate monitors and oxygen cylinders. He just needs a medical professional or a "minder" to escort him through the airport, to the gate, onto the plane, off at the other end, through customs. Hand over to family at other end.

I mean, it's still going to cost. But cost the price of new tickets on a charter/commercial flight, and the time of the accompanying minder rather than chartering a whole plane just for him.

And if your DB hasn't heard back from the insurer by now, then he should really phone back and ask to speak to someone from the complex claims department. Since you can't do anything until you have heard from them, it's important to get clarity on your DF's coverage asap.

As for timescale: my friend was repatriated after about a week, but that was in part because earlier repatriation would have been medically unsafe. They might be able to do it quicker than that.

Realistically he'll be on a chartered flight with a nurse, so the cost will be one single and one return flight. Not that it matters. Once you know what airport he's flying back into can you liaise with their vulnerable passenger dept to make sure an ambulance is ready and waiting to transport him?

What a nightmare

they've strapped him to a bed, sedated and wearing a nappy?! That doesn't sound like great care so far. Does he speak Spanish? I would definitely want the diagnosis reviewed when he does get back to this country. I'd also be keen to know that he's getting adequate nutrition and pressure area care, and what they're doing to prevent chest infections and blood clots if he's heavily sedated. Have they excluded all the medical things that could cause a vulnerable brain to have a proper wobble (dehydration, infection, wonky blood sugars, etc)? It may be that if there's a fixable 'medical' thing they could return him to his usual baseline and he'd be ok to travel.

If things remain as they are he may end up on the pricier end of the repatriation spectrum - they will not want him attempting to abscond mid-flight so may well require proper sedation and a medical (anaesthetic) escort. If they think he needs admission to a hospital that needs to have been agreed before he leaves and the current hospital.

Just about to suggest this. Also strapping to beds is not usual practice in the UK. Thank goodness.

I would be questioning with the hospital wether he needs to be sedated and restrained. It seems a bit OTT.

@Greybeardy it sounds like appalling care

Once he's medically fit to leave the Spanish hospital he will need to be refers back to a consultant at his local hospital.
Then the insurers arrange transport.
I deal with this sometimes at work
The insurance company calls the hospital and says Mr X is coming back under the care of Dr x on this date at this time .
Ideally he would go straight to a bed but we normally get them brought to ED now as beds are so few.

Good idea for one of you to go out , he shouldn't be there on his own.

What a sad situation.Ihave not read all the posts so someone may have already said this. The fact that he didn’t have a proper diagnosis before he went out there might be in his favour as it then won’t be classed as a pre existing illness.Good luck with everything.🥰

As suggested above you must be prepared for the insurers to look closely for an excuse to avoid paying.
The Spanish hospital's diagnosis of dementia will cause them to request his UK medical records - it doesn't usually come on very suddenly so they will looking for any such clue. Best of luck with this.

I know different countries were involved but when my brother had a ruptured aneurysm in Bolivia a few years ago, his medical insurers paid to charter a small plane within a couple of days to take him to more advanced medical facilities in Child initially. They then chartered another plans to take him back to Australia where he lived, complete with nursing staff on board. They would have arranged the transfer very quickly, but everything was delayed for several days by a volcanic ash cloud over the far south of the Southern Hemisphere. When he arrived back in Sydney he was taken straight to a major hospital of my sister in law's choice.

All credit to your dad for taking out medical insurance. This must be very stressful for you and I hope you can get him home quickly and with the minimum stress possible for all concerned.

gosh, that sounds really tough.

call the travel insurance. share what the drs said to you regarding need to be under 24/7 medical supervision. he might need to be sedated to tolerate being transported.

fwiw we repatriated a relative who had a badly broken leg and had yo be transported lying down. they used a 'normal' flight, but the seating was adapted to accomodate a medical trolley. relative had a nurse by their side the whole journey from hospital to hospital.
cost us just over 10k.

I agree the care does not sound ideal, and his diagnosis needs to be looked into carefully, only a few weeks ago he was well enough to correctly fill in a medical insurance form. Not saying he doesn't have dementia but it's a rapid decline and that should be taken into account.

I used to work in travel insurance and as long as he didn’t have a diagnosis of dementia before he left, or undergoing any tests for potential dementia (which it sounds like he wasn’t as his dr said he was fine), he’ll be covered by his travel insurance. I’m pretty sure most cover repatriation as standard and sounds like his does if he’s covered for £5mil. I don’t know about the actual process of repatriation though but I hope it all goes as smoothly as possible for you. What an awful situation.

some travel insurance only cover repatriation to the nearest appropriate health facility.

My friend's Mum was repatriated. Travel insurance paid for a Dr to accompany her. My friend was quite reassured / impressed that it was all easier than she'd feared

I guess what help he's entitled to will depend on the terms of the policy

His GP confirmed that he was fit to fly and he was lucid enough to book the trip, arrange additional cover. So there wasn't any fraud/attempt to obtain insurance through giving a false statement. This means that he will be covered by the Insurance.

Once that is confirmed, the assistance company will work with the hospital, the consulate and a repatriation specialist to get him back in the safest way, which is likely, due to the risk of him taking off once he's back, to be to the nearest hospital by private ambulance once he's stabilised enough to fly again.

It may also cover the cost of your DB going out to him and having to find somewhere to stay, along with him travelling back again. Keep all the receipts and submit them - they'll either cover them or they won't.

It'll be OK.

Complex claims have been in touch with DB and are apparently quite helpful. Don’t know much more.

Primary diagnosis is dementia with a secondary diagnosis of behavioural disorder. They’ve done hundreds of other tests and nothing else wrong with him like a uti, He’s had mri scans and all sorts. Opiates were three times the limit as he eats coedine like sweets (another thing his GP has pop pooed when we’ve raised concerns)

I don't want to go into details as it was a painful episode in my life but it cost c£3k to be repatriated from France to uk following the first experience of seizure, for the person I was with. It took around a week to sort. A fabulous nurse flew out and met us at the hospital. I can't express how relieved I was to see her face after a horrific experience that week - both because of the health issue and the attitude of some of the hospital staff. The insurance reimbursed me but I had I not paid up front myself I think I'd still be there. It was as if the health emergency line at the insurer was staffed by the bent metal agents

You mentioned that you have suspected dementia in the past. This may come back to haunt you if the insurers ask for his medical notes. They may say that it was undeclared and void the policy, even if the gp didn’t believe you.

I am glad that I wasn’t giving the wrong information earlier.

A friend who is a nurse used to work for a company that arranges medical repatriations for insurance companies. They used to send a nurse, and sometimes a doctor, to assess patients to see if they were fit to travel and accompany them back to the UK, and the company made all the arrangements with the airline according to what the nurse/doctor felt was necessary.

She accompanied a couple of patients who were having psychotic episodes, one was sedated and brought back to the UK on a trolley, transferred straight to an ambulance on arrival in the UK and admitted to hospital.