FIL in hospital after fall; what do we do now?

[NancyJoan]

FIL, 92, fell at home yesterday. The ambulance took an age to get to him, but they have finally admitted him, and are keeping him in for tests.

MIL has accepted today that she can’t manage any more. He was diagnosed w Alzheimer’s about three years ago, but clearly things started way before that. She’s late 70s, and has been getting up to get him to the loo several times a time, changing him/the bed and everything else besides. She is exhausted.

He has a day centre place three days a week, and SS have just upped the residential respite from 6 weeks per year to 8 weeks, but they have no carers into the home.

She sounds like she’s done. Can’t cope with having him back home. They don’t have the capital to self fund a care home.

What the heck do we do now? Am worried she will be under pressure to have him at home, w carers, but I’m really concerned about her own health now.

I am so sorry to hear this. I am following as we are in a very similar situation and I'd love to hear any advice that we not have thought of.

'Safeguarding Futures Health and Social Care Support' Facebook group have been very helpful as a source of information and advice for me.

I’m sorry this is happening. It must be very stressful for all of you. Before your FIL is discharged, ask (in some areas they might offer, in others you may have to be a bit firmer and demand) that a care assessment be carried out so that your FIL’s needs are properly assessed and that your MIL’s needs are also considered. The hospital will be able to put you in touch with the social worker who will help arrange this, or they may have a proactive care team (usually including an occupational therapist, etc. who can provide support). Insist that this is done before they push for a discharge without a proper assessment or care in place. They will also arrange a financial assessment to see what can be covered. All areas seem to work differently, from just my experience between two neighbouring counties (UK), so you will need to find out the support available in area your MIL and FIL live. Good luck.

Contact Age UK. Their national helpline is spectacularly good. They will get one of their care specialists to call you back. I was honestly blown away by the help I got from one of them. Their knowledge and experience is amazing, and their help is free of charge.

Also phone helpline for Age UK/Scotland/Cymru, depending on which part of UK you're in. They are fabulous.

The NHS webpage does not emphasise enough that you must ensure a care plan is in place before your dad is discharged. Ask to speak to his hospital social worker about his care plan.

www.nhs.uk/conditions/social-care-and-support-guide/care-after-a-hospital-stay/arranging-care-before-you-leave-hospital/

More about care plan:

www.nhs.uk/nhs-services/hospitals/going-into-hospital/being-discharged-from-hospital/

So helpful, thanks everyone. I will call Age UK in the morning.

See if you can get his GP to refer him to a hospice. From experience the hospice can make amazing things happen in particular your FIL needs NHS continuing health care. Once continuing health care is granted any help he needs will be given and will not be chargeable. My dad was provided with a live in carer even though he was living with me. I hope you and your husband have registered as his carers when you do this several agencies should be introduced to you and if your FIL can’t be referred to a hospice hopefully one of them can help guide you to get continuing healthcare for him. Essentially there are many free of charge options of help which you have to be super persistent to uncover.
I feel for you all, dementia is a wicked bitch. Good luck. X

You need to ask to speak to the discharge facilitator. They will contact your social worker and request an increase in funding for a residential placement and will arrange everything. Including assessments from local residential homes.

She needs to be very firm with the hospital that he can't go home. Abs that family cannot and will not be his carers. I had a situation with a friend who the hospital wanted to see home with carers. It was not practical. I stood my ground and he was discharged to a nursing home.

MIL can refuse to have him back (I think) and in any case, FIL can’t leave without a safe home to go to. His home ain’t safe.

The hospital staff will be desperate to get rid and won’t tell you the law is on your side eg he has to have a care plan before they boot him out. Get advice.

IMHO you should push hard for him to be discharged to a care home. Killing MIL with 24:7 care work is likely if he goes home - even with carers arriving every day it’s bloody hard work managing their team too, which she’d be dumped with. Push to get the social workers to recognise the risk to MIL. Remind them she’s done her bit and she’s half dead.

Be firm. I mean, positively crisp if you have to be. If you get any trouble, remind the staff that they’ll be signing letters acknowledging the discharge isn’t safe if FIL goes anywhere near the exit. (Advisers will do this for you.)

Good luck. I’m feeling a bit crunchy tonight cos a major London hospital recently threw both my demented parents, still bleeding, into the street at 4am without telling the family. Or anyone.

Why? We’d pleaded with DMs doc to hang onto them for a few hours till we got nurses in and the house sorted for two very ill, very frail, raging psychotics. So the NHS just booted them & didn’t mention it…

My DM had carers twice a day but when she went into hospital I had a breakdown and we told the discharge nurse that we would not be able to provide personal care. ie I would continue to cook all her meals, do her shopping, cleaning, laundry, admin and keep her company but I would no longer be on call 24/7 to take her to the toilet, help her change after every meal etc. While waiting for a care package it became evident that even 4 care visits a day would not be suitable.

We are in Wales. According to Carers Wales (and as far as I can tell, Carers UK) there should be a Carer's Assessment before the patient is discharged. Any equipment needed should be put in place. In 2019 my mum was sent home from hospital with none of that in place. Two years later when she collapsed and went back to hospital I was still begging for a Carer's Assessment.

What is promised does not always happen. Your husband should be prepared to advocate for your MiL. She needs support.

We were in a very similar situation at Christmas, DF was in hospital and DM at breaking point as she was doing all care as DF refused anyone else to come in. We were told we could refuse to have him home and I did, however, SW then called DM and effectively bullied her into it with promise of a care package that didn't arrive. A few days later DM reached crisis point and was telling us she would tather be dead then go with this any longer as DF was becoming violent. Things escalated and in the end SS had DF sectioned and taken into a MH unit. In all from him being sent home from hospital to going into the unit took 3 weeks, but you have to fight for help as there are few funded care places and SS are overrun with people asking for help. Make a lot of noise and fuss so you are heard.

Thanks so much, everyone. Had a long chat with MIL this morning. The doctor called her 6am (!) this morning, to ask if she would sign a DNR order, and told her his kidneys are not in good shape. I am hoping this means he will stay in until the inevitable happens, but have told her that she must refuse to have him home in no uncertain terms. She has spoken previously to Age UK Cymru, who were v good, apparently, so will get back on to them if anyone starts talking about discharging him.

I'm sorry about your Dad. And Mum. This is what I'm worried about. The social worker is very persuasive, makes lots of promises that don't ever happen. Have said I will deal with SS if I need to.

Be wary of SS promises. Very wary - it’s not their fault if they get broken, there’s not a lot of £ in the pot.

Your best bet is to agree to what they propose after the work’s been done in the home.

@NancyJoan thank you, if you do deal with SS you have to fight, name a pest of yourself and do not give up. We had an appalling SW allocated to us, she was supposed to start assisting us after a meeting at the dementia my dad was in. We heard nothing from her for a month, she insisted we complete financial assessment forms, chased them constantly but had never actually sent them. She was so rude as well! I was advised by staff at the dementia unit all SW actively engaged with them to move clients home or into care except ours who just ignored all calls and emails for weeks at a time.

After weeks of calls and emails and the SW not turning up to a meeting with us and her boss, the senior SW took on my dad as a client. She admitted that because he was in an inappropriate placement he was deteriorating. After 8 months my dad has been moved and he has deteriorated so bad he doesn't know where he is and is dying.

Thank you so much for your advice, everyone. My FIL died in hospital this morning. We are sad, of course, but there is also a feeling of relief.

Oh I'm so sorry to read this NancyJoan . Take care of yourselves.

Your story rings so many bells with me, @NancyJoan . My dad was the same although not quite as elderly, increasingly bad dementia, increasing strain on my mum. We were psyching ourselves up for the battle and guilt trip from social services over why we and mum couldn't do it any more when dad fell and was admitted to hospital, then died after a few weeks.

I completely understand the feelings of relief and you should not feel guilty for feeling that way. Be gentle on your MIL, for my mum it has been difficult to adjust from being welded to dad's side 24/7 because she simply couldn't leave him for 2 minutes, to having her freedom back and being able to go for a walk when she wants or meet a friend for lunch.

Sorry- a relief but just hard after feeling so battered for so long with all the fights for his care
look after yourselves 💐