Discharge from hospital to home with Covid?

[SpudsandGravy]

HI all.

My aunt (87 and frail with some dementia) has been in hospital for two weeks following a fall. She didn't break anything but was kept in for investigations into balance issues.

Cutting a long story short, she was diagnosed with (apparently asymptomatic) Covid overnight and moved to a Covid ward.

Cutting it very short again, does anybody know whether it is possible for a person in that condition to be discharged home? My sister and I don't want our aunt to die on a Covid ward and are willing to take the risk of looking after her at home. Again, she's currently (apparently) asymptomatic, but has deteriorated in hospital prior to the Covid diagnosis because she's become dehydrated.

Bumping for you.

Thanks @lightand x

Sorry to hear. I would imagine depends on the active treatment she is receiving? Is she on iv drips and o2? Probably not...unless there's a service to get that sorted and monitored by a qualified professional at home in your area?

Being COVID positive doesnt mean you cant go home but given that your Aunties care needs are complex I guess youd need to talk to the hospital about whether you can manage her needs at home. And obviously, if your aunt has capacity, then you'd need her agreement too.

Sorry to hear about your Aunt. I am in a similar position with my MIL who is 89, hospital admission following a fall, now tested positive for covid.

Whilst I can understand you not wanting her on the ward, my feeling with my MIL is that we have no idea how it will progress, so whilst she is ok now (day 5/6) we don't know what is ahead.

It is difficult not seeing her, she has been in for weeks now and there has always been a risk that she would pass away but bringing her home wouldn't be in her best interests, and it probably won't be for your Aunt. Covid isn't a guarantee of death and she is in a way better with a medical team around who can act quickly and at any early signs. As this is unlikely to be considered in her best interests I would be surprised if they allowed her to be discharged.

Wishing her all the best.

Covid alone won't mean she has to stay in hospital. I had covid in October and spent time in hospital. I was discharged with covid.

However, her other care needs may mean that hospital is where she needs to be to get treatment, particularly if her condition has worsened.

Fine to ask but I imagine economy of scale and specialist care means she's probably better off in hospital, sorry. It's not like cancer where they can be doped up nicely until they stop breathing peacefully.

I would ring the ward and talk to the nurse's station today. Tell them your wishes- explain that you're next of kin- and ask to talk to the ward doctor. The problem with covid is that it can go from ok-ish to bad really quickly. Hopefully, this will not be the case with your aunt. They will be monitoring her sats and her fluids. I am almost certain she's on a drip to increase her fluids. Is she on ANY supplementary O2, OP?
I would get a picture of what they're doing with her by calling the nurse's station. The nurse in charge of her today should be able to tell you what her treatment is like. Just clarify that you're next of kin. They need to know this. They were very funny with me when DH was in ICU with covid and although I'm his wife and my phone number was apparently taped to his bed (just in case that dreaded phone call came my way), I still had to get my own husband's consent to know simply how he was doing.

Get a clearer picture though because a covid ward may be safer than home. She can go from asymptomatic to having breathing difficulties over a short period, OP. And you don't want to be dealing with that at home... for the sake of her comfort, you don't. I know it's hard. But I had a week of DH at home before he was admitted and it went from 'Oh I think he's ok. His covid's not bad' to something I couldn't even manage at home. And DH suffered. I am so sorry to frighten you, but covid is not a linear virus. And your aunt certainly could and hopefully will remain totally asymptomatic (fingers crossed) or symptoms could begin to show themselves. In this case, she'll be more comfortable in hospital with access to supplementary oxygen should she need it.

This is only my opinion though and it's not Gospel.
I wish you luck and I really hope your aunt recovers and remains asymptomatic.

Many thanks, everybody. I very much appreciate your input and advice and experience.

She was (finally) on a drip yesterday on the non-Covid ward when they finally accepted that she was dehydrated, but we were told this morning that she's not on a drip in the Covid ward. I'm sure that's just right hands not knowing what left hands are doing rather than part of a plan.

I don't know about the supplementary oxygen but that's a reallyl good point, thanks - my sister is doing the calls today and I've told her to ask.

Re: capacity, I don't think she does have capacity at the moment because she's deteriorated so much with dehydration over the two weeks she's spent away from home. Even the hospital more-or-less acknowledged that y/day (hence the drip). We have joint LPA for Health & Welfare, though, so as long as they understand and acknowledge that my sister and I should be able to make the decisions she would otherwise be able to make.

Re: coming home, and the risk of her condition deteriorating, I entirely understand what you're all saying. This is of course why it's so difficut. Could be we could get her home and miraculously she'd just remain asymptomatic, or could be she'd go down the tubes very fast. I know she could be dead in days whether she stays there or not, though obvs I hope not. Her care needs were not complex before she went in, except that she'd developed an intermittent balance problem which led to the most recent fall. My sister has been living with her and taking care of her throughout lockdown, and I've been there too as much as possible.

My sister contacted Careline this morning and they've involved a hospital Social Worker, who has been on the phone and has been helpful. She's talking about arranging a Best Interests meeting. Clearly that's a good idea, but we don't know whether our aunt will last until it takes place if it doesn't take place urgently.

Again, I really appreciate your help, and it's good to know that discharge home with Covid is actually a possibility, circumstances allowing. We didn't know whether it was possible or not.

Thanks again, all, and update.

Sister has been told she can go in 3pm to sit with our aunt. We can't swap this so I can't share.

I have only two people in my life as relatives - my aunt and my sister. Please God sister won't get it too, because if she does it's only me left.

OP - sorry to hear your update. Wishing you all strength at this time.

Hope everything goes ok. Maybe their could be a meeting on pexip or something. Is the ward OT involved in assesseding care needs? Quicker the OT is involved quicker the discharge planning can begin.