Advice please - mum in hospital

[Moondancer73]

My mum was admitted to hospital last night after two falls in the space of three hours. She is very wobbly, has a history of mental health issues and other ongoing health problems.
I go in weekly and clean for her and my children pop in during the week if she needs anything, my dB takes her shopping weekly.
She was admitted late-ish last night and this morning I've had a call from a physio saying they want to assess her with a view to sending her home today.
I've made it very clear that myself and the rest of the family are not happy for this, that we feel mum is struggling and needs much more support. We feel that she needs to be in supported housing and want to speak to a social worker, we also feel that her health issues need addressing properly.
Can anyone advise me how I deal with this, get her kept in longer and make them listen to me properly?

Ask to speak to the hospital-based social workers about getting an immediate assessment and respite/reablement care plan in place. Unfortunately if she doesn't need to be in hospital for immediate care she needs to be somewhere else: I know that sounds hard but we just don't have the slack in hospitals any more for people to stay in when they don’t need to be there.

Physios and occupational therapists are the people who begin the referral process for care needs in my trust. However it’s probably unrealistic to expect they will keep her in hospital until she is in supported housing as that is a lengthy process. Much more likely is that they will arrange to get her a package of care (POC) which includes carers visiting throughout the day to meet her needs whilst a more long term plan is made of you don’t feel you want her to stay in her home. However, bear in mind that if she has capacity she can refuse all of this despite your concerns. I would speak to the nursing staff and as well to raise your concerns but I would imagine the physios will have escalated this already. I hope you get it sorted. It’s very difficult when you are concerned your mum won’t manage.

Anyone?

Cross post.
Thankyou. I do realise that it's a lengthy process to get her into supported housing but really feel like I've been trying to get help for a long time with no success.
If I can get to talk to a social worker and get a package of care in place then that is definitely a start and a step in the right direction

The magic words are 'unsafe discharge'. Do not, under any circumstance allow her to be discharged until an appropriate care package is in place. Make it very clear you cannot provide that care yourself.

Good luck

Also have they established any reason for the fall? This happened to my mother last week and her head scan showed she has had a stroke, affecting the part of the brain that controls balance.

So she's been referred to the strokes people and the falls people, and put on further medication.

She wasn't admitted though, this time.

Sorry re multiple posts
Also in my local authority you get six weeks' free care post hospital. They call it re enablement but it's rehab, getting her back on her feet, observing making drinks etc.

@Grinchly I hope your mum is ok.
They haven't discovered why my Mum fell, not even had her blood test results back yet. Her x rays show no breaks thankfully though.
They have now said that they are looking at sending her to a community hospital for rehab so that's good in as much as they're not just discharging her but I don't know if that's instead of Carers coming in once she's home or as well as so I need to speak to the physio myself tomorrow (my db) spoke to them today).
It's feeling positive so far though

Good! Keep at it. You have to be brutal. Be very firm that you can't do any more than you are (even if you feel you can) and that you are struggling with the amount you're doing.

The way rehab works (in England) is that you get up to 6 weeks on the NHS. If at any time during that 6 weeks, it emerges that longer term support is required, she will have an assessment of her needs (make sure you're involved - she'll downplay what she needs because she won't want to admit her incapacities) and a financial assessment. The rehab place won't be withdrawn, it'll be kept going until there's the longer term care in place. But she's liable to make a financial contribution from the date it's decided she has longer term needs - you may not get the full 6 weeks free.

If she comes home with carers in place, the value of her home is excluded from the financial assessment. If she moves into residential care of any sort, then her home will be included in the financial assessment.

As clouds says, if she has capacity, it will be her decision as to what happens, not yours. So you need to be quite brutal with her as well, lay down firmly what you can and can't do. A fall alarm may be suggested - sounds great, but all they do is alert you (there isn't a special team to come round and get older people upright again) so you have to think seriously about how often you can cope with being called out to sort her out. And bear in mind that if it's more than you feel confident to deal with (eg a broken bone, and you can't get her into your car) then the ambulance may take several hours to come, and you'll be lucky to be seen within 4 hours at A&E.

So go into this with your eyes open, and be realistic about what you are able to take on.

That said, even though falls are low priority within NHS, social services take them seriously, and if she starts to have them regularly, things are likely to happen.

Re fall alarms, my mother's one triggers a visit to her, call to ambulance if necessary, plus a phone call to me. In fact that is how I was alerted to the latest crisis.

Grinchly Is that a private system or a LA one?

@MereDintofPandiculation - LA. They vary. I heard some have different levels of service to choose from.

@Grinchly Our LA one insists on two local family contacts and is very clear that it's our responsibility to deal with our elder. On an occasion when an ambulance was called - not by us, by the district nurse service - it took 8.5 hours to arrive.

It's good OP that she's going to a rehab hospital. Ask for a social worker (SW) at that hospital (or the SW team linked to that hospital) to assess her needs whilst she is there, they'll do that,noistenbto you (write down your key concerns as many individuals play down / or don't fully explain their needs) and SW will give you the most wonderful advice on what options to support that are available to her at home including telecare (e.g. falls detector), equipment and care, and help you get her onto a sheltered housing waiting list if appropriate maybe even an extra care scheme - look.up her Local borough council housing website to see what they have or ring them for advice but her Saw will know

You can ask for multi disciplinary discharge meeting whilst she is in hospital, that includes all the relevant people especially important to have an OT, physio, SW, ward nurse and family there.

I meant SW will "listen to you" not "noistenbto"

I would say that the family are no longer able to cope and they need to plan her discharge on the basis that you won't be helping - that way they will make sure proper provisions are put in place. Whether she has to pay for carers etc will depend on her assets.

redstapler 's advice is great. It's simple and SW will use that phrase to help access services.

There are certain things that family can do best, such as get money out of bank and arrange repairs on house, that a LA can't do, but those are things that aren't day to day support and it still means you can be involved and supportive but not taking on majority of support.
By the way, even if she is self funding (has assets over £23,500, not including her house if she stays living in it) you can still ask LA to manage and arrange her care support. You get less choice and will likely have to pay a bit extra for it on top of cost if care, but with a high cost care package already the additional fees will be small comparatively and might save you some money by LA negotiating power.

redstapler makes a good point, as SW will use that phrase to help access services. Also if her money is bearing threshold level (£23500 not including her house if she stays living in it) then LA can help as it might decimate quite quickly. Regardless of whether she is self funding or not, you can still ask LA to arrange care and manage her care, they'll charge you small additional fees on top of care costs whilst she is self funding but it'll take stress out of situation and you might find it very helpful to have them involved (they have a lot of negotiating power with care costs. It means letting them decide on care agency).

Sorry, didn't realise first post had saved as it disappeared! 😆

Telecare is interesting.um is doing well so far. She's mobilising to the toilet by herself and tomorrow will be making breakfast under supervision to see how she copes. I've talked today with the doctor and rehabilitation worker about getting a care package into place and they have said they will have someone coming in for a minimum of two weeks for mornings at least.
I haven't seen a SW yet, but I have asked that they look into tests for her cognitive function because I've noticed a definite decline so that's the next step.

Ok, you need to refer to SW somehow. The re-enablement team you have in at home, if unpaid (re enable) care is involved they will be referring if mum has ongoing needs. Just ask them what the process is in your mum's area.
And GP can refer to memory team (older persons mental health team OPMH)