NHS carers at home

[dumpedon]

My Father is mid 80's and due to be released from hospital soon. My mother is early 80's and very worried about how she will cope. He can barely walk in hospital and once he gets home bitter experience shows that he will refuse to move from his chair unless forced to. He has become incontinent since being hospitalised with a UTI and chest infection which turned out to be pneumonia.

O.T. have been out to assess and said they will provide 4 visits per day and that he will have to have incontinence pads at night. My mother is very worried because if he soils the pad during the night, she will be unable to change him due to her own infirmities, but will get no rest because he will just keep on at her to sort him out.

They do not get along with each other most of the time (to put it mildly!) I have no idea what to suggest or what the NHS is able to provide other than what is already being offered. Any advice would be most welcome.

I only have experience of a disabled young adult with a severe medical condition; not an elderly person, but care at night certainly does exist! We have been offered care at night - it's from say 10 pm to 7 am. It can either be a care worker or a nurse, depending on the need!

The agency we were under had day time care workers until 10 pm, which we had too; then the night workers. Some might just sleep in, and wake up as needed;or if necessary the care worker was awake all night. (TBH we were offered care 24/7 as a temporary measure, with 2 carers in the day, while waiting for a specialist residential place)

However, it's rare much social care and support is given without a battle to some extent! Has your father had an assessment of need by social services; or is he getting continuing health care funding? Anyway your mother should ask for a carer's assessment for herself - stipulate there should be a holistic view of both them, not just a focus on your father's problems, with the belief she can do all the care 24/7!

Hi there, is home the best place for him to be going? If his care needs are so great it might be better considering a nursing home perhaps? 4 calls is usually the max per day, unless someone is actively dying and requires Macmillan/Marie curie etc

If she can't cope with his care needs, then she doesn't have to accept him coming home when it comes down to it. But you and she will have to be incredibly firm on it - if she cannot change him and he cannot and will be abusive to her about it, then you have to talk to the social workers about it and use phrases like 'unsafe care' 'risk of carer breakdown' and 'unsafe for both parties'.

Hi. I worked in community care for several years (up until 2016).

From what you have said, I would not expect your DPs to be eligible for anything more than the 4 calls per day they have been given/allowed.

To put it plainly, your DF will be expected to stay in bed between his night time (late evening) visit and his morning visit if he is not safe walking about on his own. He will be expected to keep his soiled pads on until the carers arrive to change him in the morning. SS certainly will not recommend your DM to help him with this if she is unsafe to do so.

In my area, nursing home places are becoming few & far between, as SS seem to be funding them less and less. Several have closed down entirely. They now prefer the cheaper option (for them) of using poorly paid community carers to "help maintain independence in your own home".

This does certainly not work for everybody. For some it is downright dangerous. If you think that your DM will attempt to help your DF, and thereby put herself at risk, you could ask SS how much of a contribution your DF would be entitled to for residential home care, but finding a place might be tricky.

If it's only urine that might disturb him at night, ask about the possibility of using penile sheaths (one well known brand is conveen), it's a sheath that sticks on to the penis attached to a drainage bag, so he wouldn't get wet. The carers could put it on on their evening visit and take it off in the morning. A good alternative to a catheter. Of course if he were to open his bowels it would be a different problem and I'm not sure that much can be done about that.

As others have said, if your mum isn't happy then she doesn't have to accept him at home. Make sure the carers will have a plan so he doesn't sit in his chair for too long (e.g. Get him up in morning, back to bed on second visit, chair for third visit and back to bed in evening). Also make sure correct pressure relieving equipment is in place if his mobility is very poor (mattress and cushion).

A carers assessment is a good idea for your mum.