To try and get my Dad back to the UK so he can die here

[Ataloss23]

I am looking for a bit of support with this, as I don't really know where to start!

My Dad lives in the USA, born in Scotland but moved over in 2019 when he married his wife who he met whilst traveling over there.

18 months ago he was diagnosed with stage 4 pancreatic cancer. He tolerated treatment well, and we have been lucky to get more time with him.

He decided he wanted to move back to Scotland, so he could live out his days here. He sought advice from lawyers and they began the immigration process for his wife, which has been long winded. She has paid all of her fees, including NHS fees and had her embassy interview 9 weeks ago. We have been told it takes up to 12 weeks to get a response.

His treatment over the past few months hasn't gone as well as it has been, and he has taken a real decline this week. I've ended up flying over to America to be with him as we don't know how much time he has left. We are discussing hospice options, and he has said that he would much rather find a way to get back to Scotland, because he still wants to die back home. So I am trying to do everything I can to get him home, but would really appreciate some guidance.

His Dr here has said that he may be able to discharge him for flying, if he feels he would be able to manage the whole flight and we can manage his pain. My concern is how quickly could we access services in the UK? We live quite rurally, so not the same issues for getting access to GP as people in larger populated areas experience. I'm more concerned about how we would access District Nurses, pain relief, stuff like that rather than home support/hospice/care home, as we will be providing his care at home and should manage it all between us.

And regarding the Immigration process - his wife is unable to travel to the UK while immigration clearance is ongoing. Is there a way to expedite this to get him home this week does anyone think? As much as he wants to be here to die, he doesn't want to be here without her. I have plans to phone Immigration in the morning from over here to see what we can do, as I feel this is the biggest challenge we are going to face.

I know this isn't a very common situation, but does anyone have anything similar that they could share with me, or have any professional insight regarding accessing District Nurses or Immigration?

I'm also trying to suss out what services we will need to get him home - private ambulance from the hospital to my house, a hospital bed (can I even get one of these in the house if I don't have access to OTs? Pain management in the community etc. Is there anything else I haven' considered that I need to look into?

I know we are probably chasing something that isn't possible, but I want to make sure I'm doing everything I can to meet his wishes.

Any thoughts or advice would be great please!

Sorry for your impending loss

You cant bring him home to die expecting services. , they arent available , its a post code lottery

Mum went into hospital 5th Feb this year, they scanned her that night in A&E and I saw the results. I knew she wasnt coming out, It took the hospital 10 days to call me to see the consultant to get the diagnosis. I asked there and then for hospice care. Got told not end of life, we are getting a care package and discharging. Mum had a driver for a week, a catheter, then that weekend had a heart attack and was bed bound - we are discharging her.

Mum passed 1st March, and we were so very lucky that she spent her last 48hrs on a macmillan unit, because I refused to bring her home,

At home she would have died in agony , there was no carers in place and certainly no macmillan or Marie curie , and without them your hands, and your GP's are tied

Please dont think bringing him home is the best thing for him

Sorry that's not what you want to hear, but that's how the NHS deal with end of life - you have to be very very lucky to get the care and death you want

Ironically I have just been to visit a close friend whose husband has recently died. He saw his oncology consultant who say told him he had a couple of weeks left. The wheels were put in motion to support him at home, including macmillan nurses, hospital bed, end of life medication etc. it was 4 days before the health visitor visited closely followed by his GP. He died the day after still waiting for pain relief and support.
18 months ago my stepfather was discharged from A+ E back to his care home on an end of life pathway, the GP carried out a video call via a staff members phone whilst we were in his bedroom. He confirmed that yes, my SF was indeed dying and thought he’d be dead by the following morning. So you’ll forgive my being very angry at the lack of end of life care from GPs. The system is broken.

In all honesty a long haul flight whilst about to start hospice care would be horrendous, not to mention jet lag. It sounds like it’s all been left too late. His wife is unlikely to be able to be able to get into UK by the sounds of the visa situation. I think he needs to accept it’s not gonna happen.

https://www.nhs.uk/using-the-nhs/healthcare-abroad/moving-abroad/planning-your-healthcare/

Jesus, there is so much ignorance out there about the special, completely FREE provision for end of life care at home.

My family benefitted from this and I am so very grateful to each of you on this thread who provide such utterly important care. You make such a difference.

I work for NHS Scotland because we provide health care at the point of need to all who need it regardless of their circumstances, no questions asked.
If it turns out after they’ve received the care that they are abusing the system whatever the hell that means so be it and maybe some pen pusher will chase them or their country of origin up for cost of the care but this doesn’t mean that at the point of need they won’t receive what the care they need.
This is how it should be.

He's not moving abroad FGS he's coming home. I despair. He is entitled to NHS care/GP registration from the day he sets foot in the UK.

This is not the thread for the usual MN GP/NHS bashing. Read the sodding room.

I’m also unsure your dad will be eligible for NHS treatment,
if you live permently abroad, although lots of NHS places are unaware of these rules.

www.nhs.uk/using-the-nhs/healthcare-abroad/moving-abroad/planning-your-healthcare/

What I said about access and eligibility to nhs care when living abroad , informing the Gp etc is correct.

I’m very sorry you had this experience and that the system failed your step father and your friends DH. But I know from the extensive feedback from the families I care for whose loved ones died peacefully at home that not everyone has the same experiences as you.
Yes some sadly do experience a broken system but many many don’t.

Seriously are you ok? He doesn't want care abroad. But once he arrives in the UK he is entitled. What are you arguing about?

I know that. My experience has been doubted and questioned- I replied. I lived abroad, I was no longer eligible to free NHS care. When I returned I had to prove I was living in the U.K. permanently before registering with a GP.

Do ensure you won’t have a bill to pay. Gp services are available immediately but hospital bills are not covered. I returned from the USA (British citizen) and 11 months later found a lump, they said i would be charged i hadn’t been resident a year, luckily i was three weeks off so I waited. (Was benign thankfully)

Hang on. If that was that @Soontobe60’s experience, they have good reason to express their own sense that the OP might need to think very carefully before undertaking this move for her father.

Whatever else, there is no need to be rude to her/him.

You insisted that you had relevant experience. Yet your experience is obviously and plainly not relevant to this situation, and your continuing to argue about it is in poor taste. I know this is AIBU, but please desist.

@BurnoutGP it doesn’t matter what we say both from a position of actual knowledge people will come along and tell us we wrong!
OP I reiterate you father is entitled to free care from NHS Scotland, register with a GP as soon s he arrives in Scotland ask for a community nurse to visit ASAP and get an urgent referral to the palliative care team at your nearest hospital. Bring as much info about his condition as you can. I hope wherever he dies be it in a hospital, home or hospice he dies peacefully and that you receive all the support and care that you and your family need.

But it sounds like the OP's dad is already requiring substantial care - someone earlier posted that he would be seen and assessed within 48 hours and equipment ordered to arrive the next dsy, but that still leaves 3 days, plus the flight and onward travel. 3 days is a lot to be without the provision he is currently getting in the US.

You doubted my experience. Of course I am going to respond!

His wife would be allowed to stay in the UK for up to 6 months on a holiday visa. I would see if she can cancel her spousal/immigration application and come over on a “holiday” basis instead if she has no intention of settling in the UK after your dad passes

OP, I hope you're away booking flights (rather than reading this thread) and if your friends have offered to pay for an upgrade, please accept it.

I also work in the NHS, and while it's failing in many areas, your dad's case will be treated with urgency. Even if he weren't eligible (he is), no medical professional would dream of denying pain relief to a dying cancer patient. As others said, call the GP as soon as soon as he lands. My dad died from pancreatic cancer, at home in Scotland, and I understand how important it is to you both to get him home. Marie Curie nurses were wonderful, even though he refused the morphine to the bitter end. You can get 'just in case' medication to keep at home, and a nurse or paramedic can come out to administer it when he needs it.

I'm so sorry for your dad and your situation. It is such a brutal disease. I wish you all the best and I hope he gets his dying wish. Good luck.

Yes, hes entitled to NHS care if he intends to return to reside here

I thought anyone not living in ik
fir the past 12 months was not eligible for nhs care?

You said you have a good GP talk to them. I would happily visit your home before you father returned and arrange for a hospital bed etc to be delivered, an assessment for any personal care he might need would have to be done once he was here but can be started that day. A referral to Marie Curie I would have thought could also be done before he arrives here if someone is able to provide all the necessary info. But he would need to be registered with a GP and as I said earlier I’m not sure if technically you can do this until he actually arrives back in Scotland but your GP may be happy to be flexible with the rules in this circumstance.

Can’t comment on NHS England but NHS Scotland will provide the necessary care to a man who is dying.