Not sure where to turn/what happens now?

[99calmbeforethestorm]

Dad is a carer for Mum who has MS, COPD, heart failure and a number of ‘minor issues’. Dad always has health problems including heart and is currently in hospital after having his knee replacement re-done.

My sister is currently doing a lot of the stuff for Mum while she is on holiday, I’m doing some stuff but I’m doing fewer sleepovers as I have a two year old and I’m 6 months pregnant (high risk). My sister also children but they are a little older (13 and 8).

Dad will hopefully be home soon which we will be good as hospital is a 50 min trip each way but then that is an extra person to carer for.

It is always swings and around about where they agree to carers and help but then refuse it.

What do we need to do and try and get into place?

I would speak to the ward manager and ask for dad to have a ot and physio referral, maybe some rehab in the community or reablement at home, it's free for up to 6 weeks. Do they have any help at the moment or had home adaptations made. I would tell the ward that you and your sister need support and cannot continue due looking after them as you did before, you have to be realistic about what you can do. The hospital can arrange care and equipment for dad but not mum but they need to know he is her carer, he wont be able to do the things he did before. For mum I would try and get a home assessment done by social services, the Ms aociery may be able to help with this. If they both have capacity its difficult to make them bet outside care in it the discharge care team can advise you, it's a balance between being independent and refusing help. If dad cannot manage he will need help for him and your mum.

Thanks. At the moment I can only visit on an evening because of my DD (2) will there be someone on an evening to talk too?

Dad has a perching stool and an armchair delivered. They live in a bungalow and have beds that can be raised in various ways similar to hospital bed. Mum has recently agreed to care call button for emergencies.

Mum is normally able to shower, dress and toilet herself but needs someone there when she showers incase she has a fall as she is wobbly.

They have no help at the moment other than a friend who cleans for them but to be honest their friend is also old and they need to get their friend to just do the ironing and to get another cleaner.

I’m not really sure what kind of help they need, probably general housekeeping at the moment. But I’m not sure. The stress of caring for Mum has taken its toll on Dad recently.

They agreed to an assessment 3 years ago when Dad was going to have a big heart op but my parents cancelled it.

I do keep saying to Mum that the more support she has now then the less change something will happen that means she will have to go into residential care.

It can be a challenge. There will be a nurse in charge on tonight and a.lot of wards have planning meetings in the morning so try and speak to them or give them a letter with your concerns and ask if they are having a discharge planning meeting for dad which you and your sister can go to. He will be wobbly with knee so not safe helping mum really so I would tell them that. Do they have key safe to go with the care alarm. If falls are the major worry she can have a falls detector set up, fallsmat, fall sensor, adapted cutlery and stuff that helps if she is a bit stiff. Can they afford to hire a private cleaner, financially do they get help from the council, attendance and.carers allowance.

Yes, they have just got a key safe.

I will ask about discharge meeting. He is in a hospital further away as he needed one with an ICU just in case when he had his op. This hospital seems very good, not many patients and a high ratio of staffing.

Yes they can afford private cleaning and I think they will be self funding for other stuff. I think they have had some kind of carers allowance - I’m not sure. I’m not sure if Mum would be happy with the other falls stuff, she has only just accepted care call button in the last few weeks after a decade of discussing it.

Even if they are self funding they should still apply for attendance allowance as it is not means tested.

Sometimes it takes a mini-crisis to make one realise the need for more help - try to stand back allow the consequences of decisions to become clear, don't be too ready to pick up the pieces. It's similar to your point about support now putting off the day when residential care is needed - allowing them to experience the consequences of refusal of care now means that they won't carry on without help until the stage is reached where you're quite powerless to put things right.

Thanks.

Standing back makes perfect sense to me but it’s not something my sister would agree to. My Mum also has an amazing ability for forget about the worse times but she does have cognitive impairment as a result of her MS.

A falls detector is just a souped up version of a care alarm except it automatically goes through to the responder. You need to look after yourself, dd and new baby, that's your priority. If your sister wants to carry on as before then that is her choice, dont be made to feel guilty or obliged. Id have thought both your parents could benefit from a free care needs assessment, dad in hospital and mum at home. Does anyone have power of attorney for either of them, that would take a bit of pressure of them to sort out money and stuff in the future. I think an honest chat from the doctor or discharge plan nurse often helps people see things a bit clearer, the allowances they are entitled to could lay for private cleaners and just because they have a bit of cash doesnt mean they cant get full needs assessments and possible help with the cost.

Thanks so much for all your help. I will find out about the fall’s detector. Do you know if you can get one suitable for use in the shower?

Have a look at Sure Safe Falls Alarm, its waterproof. Telecare might do one as well, they'll be on Google.