What questions do I need to ask care team

[billybagpuss]

Back in September uncle had a fall and has been in hospital ever since, he also has advanced prostate cancer.

In preparation for him coming out we have cleared his living room, he is a hoarder is a 2 bed tiny terraced it took days, so many piles of things.

We have put a stair lift in and replaced the bath with a shower.

He is hoping to come home shortly and I know there are so many things I need to ask when they put a care package in, he lives alone, we are his closest family, dad (his dB) is older than him.

Please can you lovely mn ladies help me with questions I need to ask.

I’d also appreciate any advice on handling his mental state when he sees the house, he panics about throwing empty envelopes away in case there’s anything inside, there was literally piles of post dating back to the late 80s, but I honestly think he kinda knows exactly what was where and he’s going to come home to a living room that looks normal.

Can you show him a video of the house before he comes home, he might not understand but if he is going to react badly it needs to come out first. Can an OT from the hospital do a home visit with him to assess his needs.

Are you/other family members going to be available as well as the care team or not. If not maybe ask what they don't do - cutting nails is often not done for example. I too think you need to explain about the house clearance before he leaves hospital in that he would not have been discharged as it was. Reassure him that you took great care to check through things and protect his privacy (my mum got worried about identity theft from her address on an envelope). Others will be along with lots of advice, good luck - it is rather a minefield.

Thank you, he does know we had to do it, a video is a great idea once we’re allowed back in.

I do hope a OT cab come round as I know there’s lots of things he might need.

I also didn’t consider the what they won’t do scenario so thank you.

Have you got things like a keysafe in place?

My Dad has a key but yes I think they are already thinking about the key safe and a panic alarm button.

I think he needs aids like a half step to get into his house and maybe some grab rails around.

Push for an it to visit before he comes home. They know exactly what helps

Oops ot......

Sort out things like who orders, collects meds (see if you can get them delievered), shopping for food etc, if carers are doing it goes the money going to be managed? Are you thinking of microwave meals? What are the expectations of meals? Any particular guidance you have for staff? I worked with a lady whose daughter thought of we opened a tin of beans at lunchtime and left half in the fridge, the lady should then have them for tea. You go into someone they say they want xyz and then family say why haven't they eaten abc? If your going to be rigid about meals leave a meal plan. Bins do you have any expectations about when bins should be emptied. I always empty when full but my version of full is when it's overflowing, one family wanted it emptying when it was about 5 cm from top (as that was full to them). Urine bottles, I worked with one gent who always said you ladies shouldn't have to empty them, when I feel like getting up I will empty it, We always said it's part of our job etc, but family would put a complaint in if we didn't do it, but at the end of the day the gent had capacity and if he said no the we had to listen.

My mil paid for her carers 4 x day, we had a recommendation from social services. Then discussed with her a list of what she wanted each time, then typed and sent a list to the care agency. For example the afternoon visit was just 15 minutes and was literally make a cup of tea and help to the loo if necessary.

The agency had an emergency number we could call if a carer didn't turn up,

My husband visited twice a week and did her cleaning and washing, we also did her shopping. She hated the Wiltshire farm foods we ended up getting marks and spencer ready meals and freezing them.

Sorry got post before I could edit, all three of those examples caused loads of stress for the three different families as the family member wanted something different to the client, so I would just be really clear about any expectations and to be possibly told not possible if they can't do it.

Also find out about costs, co payments, what social services will include, they may include the care visits but not a visit for cleaning or shopping and this may need to be funded privately or family do.it.

Also what are the arrange!bets if he runs out of bread milk etc in addition to main shop, do carers need to call you, can money be left so that if they can they will pick it up.

It visits prior to discharge are a rare thing now but try to push for one. If not Can he have a home visit or discharge to assess and manage when he's discharged home.

Can he.mobilise by himself or is he going to be sat in one place between calls? If he's going to be sat does he need pads? Has an ordered been placed with confidence team? When will they be delievered? does a district nurse need to visit- check the district nurse referral has been done (been there too many times having to chase a district nurse for I will injections, to dress sounds and they have never had a referral) can a hot drink be left? Flask? Can he open it?

If he can mobilise can he get in/ out of the chair, on/off stair lift, in our of bed independently? If not independent can he do it with the carers? Have they checked the bed height- is it the same height as what he's been getting on off in hospital. Does he need a pressure cushion if he's going to be for a long period?

Could be go to a rehab bed for a week to help build.up confidence prior to bring discharged? Will be have any therapy needs when he gets home?

OT access visit (without him) sounds like a good idea. They’ll need to make sure that he’ll be able to manage with the height of his chair, bed, sofa etc. Grab rails, shower seat, perching stools etc may be needed.

Re: package of care - what needs to be included needs to be agreed in advance. Does it need to include shopping, meal prep, personal care, emptying bins, housework, laundry etc or is somebody else taking care of some things?

How will carers access the house - is a key safe needed? What about an emergency alarm? How much does your relative know about all of this? If he has a capacity he should be being fully involved in the decision making.

Oh wow, thank you all so much, hardly any of this had occurred to me, I will take a detailed list tomorrow, I think his next review is Friday, hopefully we’d have time to organise before discharge.

Meds. If he is able to take himself then all well and good. If carers are to give them, they need to be sorted in blisterpacks by pharmacy.