Can anyone explain what happens when an elderly parent who can no longer care for themselves leaves hospital?

[squashyhat]

My Dad who has previously lived independently will no longer be able to do so when he leaves hospital. Ideally he wants to go back home and I keep hearing words like 'home assessment' and 'care package' but have no idea what this means in reality and am worried he will be discharged before we have anything in place. Family can help but cannot do the day-to-day care. Who sorts out any home adaptations that need to be made? Can someone talk me through the process?

He should be assessed by someone in the hospital. Different hospitals have different procedures but where I worked patients like this were highlighted to a discharge coordinator who liaised with social services and health professionals to make sure things are put in place. If there is a long wait for care he may be moved to a residential home temporarily to free the hospital bed. I would speak to the OT or nurse on the ward and voice your concerns. They usually meet daily to discuss patients and discharge planning. HTH

Thanks. If he is assessed at one level but we think he needs more (or less) can we just arrange it? Do we get a choice of carers? He has money so can go private. Sorry for all the questions!

He will be assessed by occupational therapy who will draw up a care plan which is essentially a package detailing what he will need to make it safe and comfortable for him at home. It will include anything like adaptations to his home (handrails, moving bedroom to ground floor, emergency alarm) how much care he might need (they will take into account how much family are willing and able to do) in my limited experience they usually involve next of kin in this so you should have a good idea of what is going to happen and be able to have an input as well.

Sorry to hear your dad has been unwell

Should add that he won't be discharged from hospital until all of this is in place.

Get in touch with AgeUK. They will provide lots of advice and information.
Google and look on their website.

Thanks GlossyGlossy that's reassuring.

Yes I am currently looking at the local council social services site and will look at Age UK as well. Thanks

IME, the care package will be the absolute minimum they can - 4 visits a day is about the maximum you get with 30 mins at each visit.
Depending on how much money he has, after a period he will have to pay for some or all of this care.
IME, if you can find someone privately who can do at least part of his care it makes a huge difference having someone who is a constant in their life and not agency carers where you get someone different all the time.

Yes CMOT I agree.
In the old days the OT would come and assess not only how you gor around the home, but if you could make a cup of tea.
This one ability could tell one more, so much more.
These days, it is all professional centrered. Grab rails , ramps , all laudable but doesn't to to the base of whether an elderly person can REALLY care for themselves, ie, keep hydrated, get in and out of clothes, recognise when clothes need changing, things need washing.
THIS is what is coping at home is.
Not the base minimum which leaves people vulnerable to infection and degradation.
Get a social worker. That is my best advice. And push and push if things don't seem right

Usually a social worker will assess your dad and start a care package from there. How much care is required, how many times a day, Specialist equipment, etc. You can still use the care package put in place and take on private carers too.

With private caring, you pick times. It would mean there's a constant stream of carers who are with your dad which can be good or bad depending on how your dad feels about visitors.

I personally would do both and then take it from there.

As others have said your dad will be seen by an occupational therapist, possibly a physiotherapist 2ho 2ill carry out a needs assessment, they may ask the nurses to do a 72 hour care plan which write a down any help he needs each hour day and night for 72 hours. The therapists may come to the ward to carry out a washing and dressing assessment to see how he manages and also what he is like walking, getting in and out of bed, chair, toilet. They can also visit his home to see what equipment be has or may need and what adaptations could be are. He will be allocated a hospital social worker who will probably carry out a financial assessment to see if he will be a self funded, don't get fobbed off with anyone telling you he's not entitled to anything because he has money over the threshold or that you need to organise everything. He is entitled to a free needs assessment, if he does go home they should help you with care agencies but if you don't want to get involved in this the social worker will do it for you. You can have as much help as you want if you pay privately but there is a shortage of carers so these things take a while to organise. The hospital may suggest a spell in respite or a community bed while everything gets sorted out. If he lives alone and you get carers it would be an idea to have a key safe put in so the carers and emergency services can gain access, also some form of careline the social worker will help with this. Does anyone have power of attorney. You will also have to think about meal deliveries, if the carers only have 30 minute visits they don't always prepare meals, hot drinks .

The other thing to ask about is reablement services. This is where the patient will have ongoing rehab either at home with carers or in a unit. His needs will continue to be assessed while he receives rehab to become as independent as possible. Then they sort a care package based on his needs.

If you are going to be paying for it anyway organise it yourself, you will get him home much quicker. If he needs a lot of help consider employing someone directly with agency to fill the gaps. Consistency of carer is so important to the elderly but in my experience an afterthought for most agencies. The likelihood is that he will improve a little once back in his own home environment. The social workers will leave you alone if you look like you are taking ownership of it as they are so overstretched.

Have you got power of attorney? Get it sorted out pdq if you don't. They can be surprisingly confused and still have capacity so it might not be too late.

I found re ablement to be totally pointless by the way.

Also, I wish that I had looked into assisted living (not a care Home) earlier as I think that would have been good for my family.

The care agency manager should also visit to make sure they can meet his needs, have the right staff available, give you a thorough breakdown if costs. A district nurse, community social worker or age uk may be able to help with getting equipment although many community social workers don't usually see people if they are paying privately.

I'd consider how well covered his area is. Carer agencies in my late DGFs area were fully booked and he ended up moving into a care home.

Yes he has both LPAs for which my sister and I are executors (or whatever the word is). Thanks everyone for your advice.

I would look into Attendance Allowance too. It was to late for my Dad as I didn't know about it.

It isn't means tested. It would help with overnight care