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Elderly parents
Original poster

Hospital Discharge - how do I insist on help?

61 replies

DorsetCamping · 03/05/2020 17:37

DM (75) is currently in hospital officially with a chest infection (non COVID) but in reality alongside many other problems.
One concurrent condition she does have is severe lymphodema and leg ulcers (diabetes and obesity related). Her feet are also dreadfully cracked and massively painful to walk on. This has been going on for 3 months.
She has been having a (social services) carer come in daily for 30 minutes to strap her legs but that is it. She has been told she needs to keep the weight off of her legs (ie sit down) but needs to get up to prepare meals etc, causing dreadful pain.

The physio has spent 20 mins today to assess mobility and has suggested more grab frames are installed at home but that's it. She also said that because of where DM lives support will be limited Confused

An OT will be seeing her in the morning with a view to discharge. I am petrified they will just let her go home without an adequate plan in place and she will just end up back in hospital. Obviously I can't go the hospital at the moment to discuss a care plan either.

Has anyone else faced a similar situation or has advice on what I should do?

OP posts:
TitianaTitsling · 03/05/2020 20:35

I do agree with hairy if your mum is telling them all is fine and family will help, and she has capacity, they can't just decide not to believe her. Speak to the ward, ask about discharge planning, let them know your are not there to help. I know people love to think we just chuck patients out of the hospital and don't care, we can't put care in for someone who has capacity and tells us everything is fine.

lostfrequencies · 03/05/2020 20:39

Would your mum agree to meals on wheels so she doesn't have to get up to prepare food? Or could she have a perching stool in her kitchen so she doesn't have to stand for long periods?

Inituntiltheend · 03/05/2020 20:53

Sorry to hear about your mum. What region do you live in? 6 week trial is likely to see if they can establish level of care required. You would imagine AM and PM at the least if the straps need removed before bed?

My advice is phone the hospital tomorrow and ask to get out through to the OT dept then ask for the OT covering your mums ward - the likelihood is the OT would ring you anyway but just encase.

It is the OTs job to facilitate a safe discharge from hospital - if they deem
Her as requiring assistance with tasks they will let the social worker know what care to apply for.

Here in Northern Ireland we have a lot of community groups/local shops providing meals to the vulnerable/shielding etc - the hospital staff have lists of the shops. I’m sure wherever you are this is happening?

Hope your mum is ok. Good luck

cptartapp · 04/05/2020 10:56

Methotrexate doesn't necessarily put her in the highly vulnerable shielding category. I'm currently treating many of these patients in clinic,
That aside, if housebound, she needs a DN for the legs.

cptartapp · 04/05/2020 11:03

What did she tell the nurse who rang to see how she was getting on? Did she tell them she was struggling/unable to do the legs? Or that someone else would do it for her?
Did she ask for help? If you wait for it to be offered during overstretched teams during a global pandemic, she'll have a long wait.

Original poster
DorsetCamping · 04/05/2020 11:10

DM was originally admitted to hospital following a
a severe attack of vertigo. She has had several episodes over the last couple of years which alongside dizziness (doesn't seem the right word somehow, more like being thrown around a boat during a storm), results in uncontrollable vomiting and diarrhoea.
The paramedics were called this time as she couldn't be moved and concern regarding dehydration/blood sugar levels.

When I phoned her this morning, she told me she wanted to come home but then went on to say she'd had another vertigo attack 1st thing. Throwing that into the mix In my opinion there is no way she can come out yet. I totally get that hospitals are the last place anyone should be at the present time but I believe she is safer there than at home.

I have told the clinical update team that I must speak to OT/discharge team before any decision is made because I think DM will be pushing to come home.

In the meantime I will contact her GP and be very clear that once DM is home the District Nurse needs to visit regularly to attend to her leg ulcer (which is getting worse)

OP posts:
Hairyfairy01 · 04/05/2020 13:18

But vertigo isn't something the hospital can just 'fix'. Unfortunately I can't see any of your reasons justifying a prolonged hospital stay. She needs to be able to access the right support once home I agree, eg district nurses for dressings (if unable to leave the house), maybe carers morning and evening to help her get in and out of bed, washed dressed / undressed if she is unable to do this for herself. You need to be clear on how a prolonged hospital stay would be in her benefit. If she is medically stable they will want her hone ASAP.

Original poster
DorsetCamping · 05/05/2020 10:45

Quick update, DM is still in hospital but feeling much better. I had a long chat with the OT yesterday who has put in a referral to their 'assist to go home' team. She won't be discharged until the assessment has been carried out and discussed with me.
Big relief as consultant wanted her discharged yesterday morning. It was the OT who blocked it until a support assessment has been done.

Unfortunately DM very cross at still being in hospital. Desperately wants to go home (which I totally understand) but doesn't grasp the risks of doing so too soon or the anxiety it causes everyone else.
As an aside we (DB and myself) have tried to discuss longer term plans with her but she just shuts down and says we're taking away her control. I just want what's in her best interests but she doesn't see things that way. I suspect in an ideal world she'd like to stay in her own home and have me care for her 24/7 Confused

OP posts:
LilacTree1 · 05/05/2020 11:13

Good that she’s feeling better

Need to tackle her expectations of you though obviously!

Inituntiltheend · 05/05/2020 20:50

Glad you have got the ball rolling.

Could you get her a lifeline to give both of you a sense of security?

LangClegsInSpace · 05/05/2020 21:09

That's really good news Smile

Make sure you make it clear to the 'asist to go home' team what level of support you can realistically offer. You need to manage their expectations as well as your mum's.

Friendsofmine · 05/05/2020 21:17

Unfortunately (for you) your mum has capacity to make her own unwise decisions which might include going home with less support than you want in the hope that you will care for her. It sounds like she could do with her package of care increasing to assist with evening meds and personal care for bed? Could you speak to her social worker? Do you have a LPoA in place for health and welfare?

user200000000 · 05/05/2020 21:22

In my experience the only way to get more care for her is to say you cannot provide the level of care she needs and it's a safeguarding issue.

vdbfamily · 05/05/2020 21:27

The really important thing at this stage is that you make it really clear to your mother going forward what help you are able to provide and what needs to come from elsewhere. When she has that info she can then establish what needs are outstanding and need to come from elsewhere. If she gets a short term package of care to facilitate discharge, it is the perfect time to get long term support needs sorted.
It is better for her that she continues to do as much as she is able because it will encourage her to move around a bit at home and not just sit in a chair.

vdbfamily · 05/05/2020 21:29

I do not agree with those saying you should shout about safeguarding. Just be clear to OT and your mum what you cannot help with and they will arrange the support needed around that short term whilst a longer term plan is sorted.

LilacTree1 · 05/05/2020 21:41

I don’t think anyone means “shout” but the word “safeguarding” or “unsafe discharge” need to be said several times to different people

Wasn’t there a poster here whose father or grandfather was put in hospital transport home in his PJs and no coat?

MereDintofPandiculation · 06/05/2020 10:44

Wasn’t there a poster here whose father or grandfather was put in hospital transport home in his PJs and no coat? My Dad was sent home in PJs and dressing gown and one slipper. They claimed he was offered a blanket and refused, he claims no blanket was offered, and that at one point he was left in ambulance with doors open while the took the other inhabitant into his home and settled him - this was January.

LilacTree1 · 06/05/2020 19:01

Mere ah, that’s what I’m thinking of.

Was there an investigation of any kind?

MereDintofPandiculation · 07/05/2020 08:33

Not really, my father didn't want to make a fuss, and since he still had capacity (just about) at that stage, I couldn't initiate a formal complaint. I complained anyway, in the hope it was a genuine error rather than a cynical disregard of patients needs (it was a private ambulance company contracted to the hospital).

I was also annoyed about their having lost one of his slippers - they were a Christmas present, and this was the first week in January!

LilacTree1 · 07/05/2020 11:28

I see....I wonder if the discharge people have any responsibility for making sure someone's properly dressed etc. I have been lucky I've been there to do it for my parents.

Original poster
DorsetCamping · 07/05/2020 11:36

Quick update..DM came home yesterday and within 2 hours of being back an OT and Care manager were there to carry out a risk assessment.

She is now in receipt of:

Hospital bed
Shower chair
Basin chair
Mobile commode (which she keeps looking in disgust at Grin)
Pressure support aids

3 x daily carer for 6 weeks. The OT has also been into the District Nurse to come and treat the leg ulcers.

Absolutely thrilled and relieved; couldn't have asked for more. The hospital has been brilliant and I now feel that both her and me are being supported whilst she recovers. Smile

The only things we have had to buy are a key safe and I'm looking into a pendant alarm.

I also need to buy a dossett box which I would appreciate any recommendations on. It needs to be a really easy one to open as her hands are so arthritic (she broke the last one)

Thank you all so much for your thoughts and advice!

OP posts:
LangClegsInSpace · 07/05/2020 18:43

SmileFlowers

ifoughtforliberty · 07/05/2020 18:48

Have you applied for attendance allowance? You can do this online. This at least will go towards paying for some home help if needed. With regards to dosset boxes if your mum will find them hard to own the pharmacy can deliver meds in weekly dosset boxes. They just have a foil covering over a cardboard back so maybe easier for her to open.

cptartapp · 07/05/2020 19:15

Will she be willing to fund the carer going forward after the six weeks. ?IME if care is free people are quite accepting, but more resistant when there is talk of having to pay. Leave the carers to it.
Chemists can package and deliver medication in pre-loaded trays, you shouldn't need to have any input there. Make life easier for yourself. Ask her chemist.

Soontobe60 · 07/05/2020 19:22

Ask the social worker assigned to get for a financial assessment to be carried out so you can see if she needs to pay after the six weeks.

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