Hospital Discharge - how do I insist on help?

[DorsetCamping]

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

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?

If your DM is considered to have full faculties then it is her decision about her discharge and your views will probably be ignored. My DM insisted she could be discharged and said "my daughter will look after me/do everything for me" which totally wasn't the case. I work FT and have kids and live an hour away. Fucking nightmare.

Glad you are being well.supported with care & equipment. Agree it is best to get a pre filled pharmacy dossete set up if possible (although in my area pharmacies are cutting back on these at the moment, presumably they are costly and time consuming to fill). But if you can get one, I would do, as it will mean should your mum ever need her meds administering by a carer she'll be all set up. Many care agencies won't give medications from individual bottles & boxes.

That is great news OP and is the new D2A(discharge to assess) model which is slowly being embraced by all! Rather than spernding any longer than you need to clogging a hospital bed and being at risk from all the poorly germy people around you, you are sent home ASAP and assessed at home with immediate care available and equipment all delivered witin 24 hours. People are much better in own environment and OT's can see from the state of the house whether someone normally copes or is neglecting themselves. Glad it all worked out and I would agree with others that there needs to be a long term plan in place for ongoing care. With D2A model they are likely to start that process after a few days with full social work assessment of finances etc and decision as to long term needs.

Glad it worked out OP. Just to add it might be worth having a plan in place or discussion about what happens if she goes in to hospital again. This has just happened with my Gran and we weren’t ready for it, were just improving with the new care system and then suddenly she had a bad turn. She’s now in a care home but it was made very difficult because we didn’t discuss it with her first and couldn’t chat to her on the ward with her level of pain. A backup plan is always a good idea in these times!

It's not being 'embraced by all'. Not everybody is 'assessed at home with immediate care available and equipment all delivered witin 24 hours'.

Like anything else provided by your local authority or local NHS trust, the level of provision you get will depend on where you live. Additionally it will depend on whether you have someone to advocate for your needs and it will depend on the dedication and competency of the OT and care coordinators you happen to have.

Eight local authorities have implemented the measures that allow them to not fulfill their legal care act duties.

I'm very pleased Op's mum's care needs are being taken seriously but nobody should assume that the same is true for everyone being discharged from hospital.

Nobody should forget how deeply down the toilet adult social care was even before this clusterfuck.

My elderly friend has been discharged to a care home. As he isn't safe to go home at the minute. He absolutely loves it there, but when covid is over, I think the social worker is keen to send him back to his flat. This will be a disaster for multiple reasons. I think we are going to have a battle trying to persuade them to let him stay.

langclegs.....I did say ' slowly' !!!
The model does not depend on NORAS &NODS to facilitate discharge as the SW bit kicks in once home which certainly avoids some delay. It certainly works fairly well where I work but needs to go further as currently we have to assess quite thoroughly prior to discharge.

Quick update..DM ended up back in hospital Sunday with cellulitis. Being sent home tonight, not been given time yet . She was violently sick earlier which may or may not be an ABX reaction but not severe enough to keep in her in apparently.

It's such a worry, Have horrible feeling she'll be back there again before too long. We just seem to lurch from one crisis to the next, where I'm waiting for the next panicked phone call.

I think she is declining and now needs a whole different level of care where someone is always on hand to keep an eye on her. The care package is appreciated (by me at least if not her) but the 20 mins they are there isn't enough

Some open and honest conversations need to be had, where hopefully she can take on board the reality of her needs.

Not fair of your DM to keep ringing you when problems arise. Is she really happy for you to be 'on call' indefinitely for her needs like that? My DM ended up on BP medication and antidepressants after years of this with my GM. Ruined their relationship in the end.
Time to take the next step. If you keep plugging the gaps you'll be left to it.
If she insists on going home, Make sure she has social services number and step back.
What she needs now outweighs what she wants.

Good luck with the conversations. It’s worth having plans in place even just as a backup for now. Things like “what if you break your leg?” “What if you are bedridden for a while, would you prefer 4x home care or a temporary care home with staff on call?”

Keep notes. I’ve just sent the council adult care team notes about my gran to hopefully change her emergency care home placement to a permanent one. I had to rely on my memory of her deterioration, notes would have been helpful.

Notes are helpful for a second reason, they seem to be accepted as "evidence" whereas what you say isn't. Anything that happens that you haven't written down didn't actually happen...