Not sure if I need a hand-hold or a pointy stick....

[Cattermole]

So my mum is an 80 y/old alcoholic with a history of falls at home.
Been sober for a month or so now and has still had 3 callouts, the last of which they were quite rude to her and said "I don't know why you've called us out there's nothing wrong with you" (she hadn't - her GP had)

So yesterday she fell down the stairs and was taken in about 5pm.
2am they discharged her home.
This morning she can't move her legs. About lunchtime she gets a call from the hospital to say she's actually fractured her hip and she shouldn't have been discharged last night.

Ambulance is now on its way but AIBU to think this is absolutely not okay?

It absolutely is NOT OK!! Poor lady. The x-rays should have been properly scrutinised yesterday.

I suppose what I'm thinking is - do I go "well, the NHS are under a lot of strain right now, mistakes happen, it's all sorted out now" and move on - because I am very tempted to get somewhat sweary, or possibly litigious, on them.
The sending her home is seriously not OK. I am spitting about that.
It's what I do now, though.

Totally not ok. That is neglect. Yeah the NHS is busy but there is no excuse for that. I would be making a complaint

Try and speak to her doctor to ask what investigations she had and why she was sent home. 2am is a terrible time. Does she have capacity to make her own decisions about her future care and where she lives. Do they know why she keeps falling, she will need a care assessment while she is in hospital if she agrees. Did you hear the ambulance crew be rude to her. Is anyone at home living with her.

Unfortunately XRays are sometimes misread. This is why there are secondary checking procedures to pick up fractures and such which have been missed on the initial examination. It is absolutely not ideal that such a major fracture has been missed but the checking system appears to have worked as it should. No system or person will ever be 100% accurate 100% all of the time, unfortunately it's just not possible

Well, the update. She's got a fractured spine - there's one fractured vertebra and a number of small fractures.
She's just phoned to say they've moved her to another hospital.
I must admit I'm very concerned about how she's talking. She's saying there's been a cover-up and the nurse who discharged her on the night she was sent home, is having a relationship with "the big man" and she heard them on the phone talking about legal action and mentioning my name.
I'm going to speak to the hospital tomorrow and see if she's on particularly strong medication. Because she was firing on all cylinders when she went in....

Because she was firing on all cylinders when she went in.... Put that in writing, with examples of what she was doing, with dates, make sure it finds its way on to her notes, as well as speaking in person. They see so many elderly people with dementia that they tend to assume that if an elderly person is confused, that's their normal state. If she has an infection, or any other reason for her current state, they need to find out and treat it.

TBH @MereDintofPandiculation I wouldn't even mind confused (I mean, she's an alcoholic, making stuff up when she's drinking is an occupational hazard - I'm used to that!) but the sort of things she was saying about staff members and conspiracies and illegal activities is going to get people into trouble.
I want to be sure that staff are protected as well. I am pretty sure that the staff are not doing the things that mum thinks they're doing, but were she to make the allegations they would need to be taken seriously and they are the sort of allegations that end up with people suspended whilst investigations are carried out.
IYSWIM.
I'm pretty sure, by the way, not just ignoring her concerns, because if they were doing half of what she thought they were doing they'd need 36 hours in a day and two pairs of hands....

Make a complaint to the hospital trust
Look up their website and follow their complaints procedure, write in dates time and brief details.

It'll be a substantiated one

Is it possible she has a UTI? This can often cause confusion, delirium and dizziness in older people.

This could have contributed to the fall, and could also explain the conspiracy theories. It’s very common in older people, but the hospital might just assume she has dementia if she’s not making much sense.

Try to talk to the hospital and explain that she does not have any dementia etc, and ask them to check for UTI and other infections, because of the delirium.
If she does have an infection, once she’s on antibiotics she should be back to normal, mentally.

Thanks all.
I'm holding fire on the complaint until I have some sort of outcome for her. I suspect that the reason she was discharged at 2am is that she's known to be a persistent caller and has been written off as a needy drunk: it's on her records from the last time she had the paramedics out that "no evidence of (the thing that she had called them out with)" and she was quite distressed by the way she was spoken to on that occasion. I can see why they'd be fed up, she's had 25 callouts in 2 years, but she's 80, alcoholic, and frail. She falls. She can't get up. Often she bumps her head. She also has full mental capacity, and is addressing her alcohol misuse. She should not be dismissed as a nuisance.

She's had water infections before and it's definitely one to watch for @JemimaTiggywinkle - again, because she can't walk currently, I'm wondering whether lying in soaked pads for any length might be anything to do with that - when I spoke to her on Sunday she was absolutely fine, so any UTI is since her being in hospital.

but the sort of things she was saying about staff members and conspiracies and illegal activities is going to get people into trouble. It's quite common to make up these types of stories. My father does the same, only in his case it's big corporations rather than individuals. The hospital will be used to them.

I can imagine @MereDintofPandiculation. It's grim, isn;t it?
Not to go into too much detail, but mum's things are silly little things like "I came into hospital with £150 in my purse because I'd just been to the Post Office, and now there's only £100"
The doctor rang me last night to talk about the confusion because "she doesn't seem confused".
Which is sort of the problem really.... they are all such harmless little inventions, they just add up to a bigger picture.

@Cattermole

I can imagine *@MereDintofPandiculation*. It's grim, isn;t it? Not to go into too much detail, but mum's things are silly little things like "I came into hospital with £150 in my purse because I'd just been to the Post Office, and now there's only £100" The doctor rang me last night to talk about the confusion because "she doesn't seem confused". Which is sort of the problem really.... they are all such harmless little inventions, they just add up to a bigger picture.

Sounds like dementia. Aside from that, she's obviously not coping at home. This is your chance to get more help for her.

Go to the new hospital (if you can) or phone, and tell them that she needs care at home. Talk to the Occupational Therapist in her ward. Get Adult Social Services at the hospital involved. Legally, they are not allowed to discharge her to an unsafe environment. Tell them it's a safeguarding issue and that there needs to be a care plan in place.

Take her door keys away from her, so they can't discharge her without you knowing.

Talk to her GP and get them to refer her to Adult Social Services in ehr area, as well.

As for the wrongful discharge, that type of thing happens all the time with older patients. They try and get them out as soon as possible. Definitely complain, but don't blame it on Covid - I've seen too many unsafe discharges of elderly relations.

Sadly she doesn't meet the threshold for additional care or support @Asterion - she was referred by both her key worker and me, and it was rejected by Adult Social Care about a month ago because she doesn't meet the threshold.
She's had at least three care packages put in place over the last couple of years and has disengaged with all of them because - this is the bit that's tricky for professionals, I get that - when she's well she doesn't need them and when she's in crisis she doesn't want them.

It's a pigging minefield I tell you.

Oh god, I know all about those games. You have my sympathy. They'll do anything they can to disengage.

I found that I had to go to all appointments with my relations. Otherwise nothing ever got done.

And the fact is, things change. Things have obviously changed in the last few weeks. Take all her house keys away from her, and tell them they need to ring you before discharge. Occupational Health can't (but still might try to) discharge her without her home being safe. Make sure you speak to the ward's OH, and preferably start an email chain.

And definitely get Social Services in the hospital involved. They are different from SS in the community.

State that her home is currently an unsafe environment. Start emailing, if you can, or it all gets denied and messed up.

My mantra when dealing with the NHS and social care is - The system always goes wrong

Once you realise that, you can plan for it. Hence getting stuff in writing. Phone calls are forgotten or ignored, messages don't get passed on.

When she is discharged, it should be to a Community Care Team. You need to meet them at that point, and tell them how she actually is, not how she present. Start asking for a longer term care package.

Also, make sure it's on her notes in the hospital that she's a Fall Risk.

I know that should be obvious to them, but remember the mantra...