Care package

[snowhere]

My DF is due to come out of hospital after a short stay. It has been suggest that a care package must be put on place before he can come out. This will be a few days being actioned. It has been suggested that a responsible person could do his care in the interim is this possible

oh god , Nowt, how awful.

I feel a bit sad that so many of us know exactly the consequences of doing what on the face of it seems a kind, loving and thoughtful thing.

Has the son agreed to your df’s wishes?
I would say no no no, if family do this, why would they rush to get care arranged.
Has the discharge to assess team seen your df ?

My concern would be if the son does agree to provide temporary care he could be doing it for weeks as there is a shortage of care workers. That’s why they can’t put the package together now.

If they aren’t able to broker a package of care by the time of hospital discharge and there isn’t a “responsible adult”, he will go to an interim placement at a care home until care can be sourced which could be for any amount of time. This isn’t talked about enough but if you haven’t already and whilst he (I assume) still has capacity, please get health and well-being power of attorney in place so that you (or someone) can make decisions on his behalf in his best interests. It’s not talked about enough and often is too late by the time people find out about it!

It is very sad, a kind act can turn into a long long wait but… if there is no care available, I mean no care, family or community, people can are discharged to residential homes to avoid bed blocking.
Best of luck.

I would refuse to have him home until a care package is in place. Most hospitals have provide a care package for six weeks after discharge??? Be careful as patients are often discharged early to free up bed spaces. Hold on for a carw package or the responsible adult will be stuck with the caring duties x luck x

I was named on a care package for my late dad. The hospital spoke to me a zillion times to check details and we created the plan together. It’s a big responsibility that can only be done properly willingly. Does he normally have help with his medical needs? Is the person he wants to name also his Next of Kin? Is your dad of sound mind? A realistic, practical plan needs to be put in place and everyone involved really needs to be honest and open about what they can and can’t take on. Definitely do not agree to anything “in the interim”, before you know it he’ll be forgotten about because “he has help”.

Definitely don't do it, they'll use it as an excuse to not give a care package by saying it isn't needed as he is fine without one due to family support.
Make it clear he should not be discharged without the package already in place.

If his son doesn't want to do it then that is that really, no one can force him to. However if his dad has capacity he can discharge himself against advice ie - without a care package, so he may end up coming home anyway. At this time of year hospitals will understandably be trying to free up as many beds as possible for the 'Christmas rush'.

Echo what everyone else is saying- do not do it!
don’t agree to do anything for an ill relative unless you are prepared to do it for the rest of their life. Honestly when in hospital you have some leverage as they want to get them home so they’re not blocking a bed, so you can try and get a care package in place and the hospital will help put this in place, but if you take them home they will wipe their hands of him as their priority becomes patients who are in the hospital.
join the elderly parents board for more info from those of us who have been in this exact situation

Whilst you are all correct in what you are saying I can't help but notice the irony. There is a desperate, desperate shortage of social care and so many elderly, vulnerable people have literally nobody. In my role at work I have had to call crisis response during the night to try and arrange an emergency package of care for the following morning but they just don't have the capacity. I've had to take so many people unnecessarily into hospital for this reason. Meanwhile this thread is full of relatives refusing to provide short-term care and additionally blocking beds in hospital. I mean I understand the complex reasons why but it never used to be like this, it's unsustainable.

@snowhere I have worked in elderly care medicine. anyone saying 'it only takes a few days to sort care package" is a big fat liar. I have had patients stay in hospital for over a year before they could be discharged because of issues with a mattress being delivered!! in the mean time your family will be stuck with inadequate equipment and struggling to provide proper care. i would only consider this if he only needs minimal care eg. meals cooked and shopping done. tbf carers from ss are given such brief time slots, they barely get anything done.

I suspect the relatives on this thread have provided care and know only too well the pitfalls and difficulties of doing it without any support. I know myself how hard it can be to support an elderly relative.

But he didn’t have a care package prior to his stay and he had a short stay, who was helping before ?

Tbh it’s a difficult one. It’s the time of year where everyone has holidays, so could someone not help out?

@snowhere what kind of care package are they thinking of though?? does he just need help getting in and out of bed or is it full on nursing care package?? there are many different levels of care. is it surgical or medical care he really needs. remember, hospitals all try to send patients home before christmas to allow closure or partial closure of wards over the christmas and new year periods.

No, absolutely not. Do not agree. Care package must be in place before discharge. Too many horror stories about discharge with no package in place.

@AnotherVice the comments you see on here are only a snapshot of people's lives and your comments about the irony of lack of care workers do not take into account the stress and upheaval caused. I had already cared for my mother with mobility issues for 10 years - providing all her meals, helping her dress/undress/, washing, cleaning her home, shopping, admin. Then she went into hospital with sepsis following a perforated ulcer.

After two weeks we were told she was ready to be discharged. I was told she was mobile (she wasn't before her illness and I was shocked to hear that she was) and was able to take herself to and from her bed to the bathroom. I still refused to take her home because I was afraid of caring for her, dressing her etc while she was still healing. She was given a reablement package and it was only through them that she was provided with the equipment that she needed - toilet frame, commode - and she was unable to walk even with her frame and assistance.

The discharge team showed zero care for her or for the family. All they wanted was to get her away from the hospital. The trauma of caring for her even with two care visits a day caused me to have a breakdown. I'm still recovering.

Thank you so much for all your advice. My DF son is telling the staff that he can not do any caring. It is a brilliant idea to take the key from the key safe as my DF does know the code. We are going to use the term 'safe discharge'. It is so sad we are in this situation 😔

@snowhere the most important thing to consider is does the patient have capacity to make the decision to have care. If he does have capacity, and this is usually determined by the doctor completing a mental capacity assessment, then he is entitled to decline the care package and go home. You would not be able to prevent this and it could be considered a safeguarding incident. A person with capacity is allowed to make decisions about themselves even if others think they are unsafe.

If he does not have capacity does anyone have power of attorney? If so they are able to then make decisions on behalf of the patient as long as it is in their best interests.

If he does not have capacity and there is no power of attorney then a best interest meeting should be held and the patient would need to have a deprivation of liberty completed to be able to keep him in the hospital against his wishes.

Where I work if we refer a patient for a package of care and they go home before a start date has been provided then the referral is cancelled and they do not get the care.

We do not have power of attorney. My dad is unfortunately telling the staff that he can look after himself which clearly he cannot.
I am concerned that they will believe him and discharge on his word. I feel so guilty not bringing here but I work full time and spend a lot of time away my partner is in a similar industry and travels the world so there would be no consistency for him

I understand the worry but it really does boil down to has he got capacity to makes decisions regarding discharge planning? Does he have a cognitive impairment, for example dementia, a brain injury or stroke, or a delirium? If he has capacity unfortunately he is able to choose to go home without care even if he is not able to manage. They absolutely cannot keep him in hospital against his will.

If you have cause to feel he does not have capacity then I would ask the doctors looking after him to complete a capacity assessment.

Well of course family should help out in the short term, but I have to say I agree with pp that if you do this the very least that will happen is that your df falls right down the priority list.

I am intensely sympathetic to the poor staff in social care and the NHS desperately trying to bodge solutions. They are exploited. But so am I. I'm a working single parent who has an adopted child with SN and I'm carer for my ex who has Alzheimers. Frankly, I should have refused to take on the ex, but I couldn't be that harsh, and that has been endlessly exploited. And the support I get for my child's needs is derisory.

The amount of money carers save the health and care system is astonishing, and we get so little to support us with that. The only power we have is to refuse to take on more. If you can't commit to it for the long term, don't agree to it in the short term.

Do I sound bitter? I am.

People wouldn't refuse if it was genuinely a short term thing though. But people know that it very probably isn't. And they know that that isn't best for them, or for their relative who may need more care than they can reasonably provide.

I didn't refuse to provide short term care, actually, and this experience has informed my response on this thread.

Sorry if you don't like that I would not wish my experience and that of my loved one on anyone.