Dad wants to go home but ....

[Wegobshite]

Apologies if this is long
My father 72 was taken into hospital in Feb after a severe reaction to his Covid jab . Spent 10 weeks in hospital had pneumonia twice , his diabetes levels were as high as 35 and as low as 3.5 twice we were told he wasn’t going make it through the night .
He then went to a rehabilitation center - to see if they could get him more mobile and assess him for going home he’s been there 8 weeks so far . And he’s actually worse than when he was admitted to hospital in Feb .
He can barley walk, only has the use of one hand , falls over regularly several times a week ( needed a hoist and 4 people to get him up last week when he fell in the shower ) he can’t open a pint of milk and is poohing and peeing him self a few times a week .
He was having 4-5 showers a day resulting in numerous slips and a few major falll until they banned him and moved him to a room opposite the reception so they can see if he is attempting to have his 5 shower by mid afternoon 😂
He also has COPD so trouble with his breathing , badly controlled diabetes & I think only 70% of his kidneys work propetlj
He also Has a hypo at least once or twice a week due to his diabetes .
He can barely see due to glaucoma used to have injections into his eyes every 2 months . When he was at home he was still bloody driving his car until I got my son to remove the car battery
And he is a miserable manipulative bastard to say the least 😂
He had a home assessment last week with the care manager and the OT . I was there to see how it went .
He couldn’t even get over the step to get in the house after five minutes of trying they got him in using a wheelchair . He was absolutely in agony and knackered after being in the house for 15 mins showing them what he couldn’t do 😂
He has every aid possible in the house from a disabled wet room to grab rails, stair lift and recliner chairs.
He decided that he wouldn’t be able to manage at home and the care manager and OT agreed and said it wouldn’t be safe for him to go home and to think about residential care homes .
Next day he sees a social worker who’s suggests that with a care package in place and “ help from the family “ she sees no reason why he can’t go home.
When he was at home prior to his hospital admission he fell over 3 times in 48 hrs - it was me that had to go and try to pick up a man who is 17 stone of dead weight as he can’t even support himself to assist anyone trying to pick him up .

So you lovely mumsnetters . Where do I stand with the SW when I tell them Im not participating in this madness .
I’ve already had a few “words” with one SW but they want to do another call next week
Im absolutely will not do any care at all for my father and I don’t want them contacting me if he goes home . I don’t mind visiting him and doing his shopping washing and cleaning but I don’t want to be in the position of being called to assist the carers if he falls over or he has shit himself - I know this makes me sound awful but I’m past caring . He’s argumentative and to be honest I know that he doesn’t really like me much . When he got his lifeline pendant it was like it was a green light to do what he wanted as he knew that if he fell over he would be able to get someone to come and help .
My dad will need double carers as he can’t dress himself ,can’t stand or support himself without assistance

So What do social services do in these cases where the person has no family support . Or the family are not willing to provide care
I know that my dad will be lucky to last 2-3 days without falling and ending up back in hospital

I have friends who are in similar positions and they are all on their knees with the stress of everything

He owns his house ( well 50 percent of it ) so there would be enough for several years worth of care home fees
My dads even said he knows he won’t manage and he’s scared that if he falls no one will be there but he doesn’t care and is determined to go home

 He has his own house of which he owns 50 percent ( when my mum died she left her half to my sister and my son

So money isn’t an issue as far as care home fees would be self funding

God that was long sorry
Basically if my father has no support from family to do any physical care can he still go home with a basic care package that will most likely not meet his needs
Even though the care manager and OT have both wrote in their reports that it would be dangerous for him to go back home due to the nature of his health and the condition of his house .
Can my father just say well I’m going home ( Assisted by SW)
even though he’s admitted that he knows he won’t be able to manage without falling over pretty much every day

They will push you into providing care.

You must absolutely insist you cannot to be available, and they need to put a plan into place that does not involve you in any way. Spell it out for them in black and white. They will have to find another solution.

SW cannot expect you to do anything - as per Care Act guidance carers must be willing to provide care, not put upon. He has some options. Council could arrange carers (which depending on his income he may have to pay for - off the top of my head I don’t think the value of his share of the property will be taken into account) which would likely be double-ups up to 4 times a day - get him up, get him lunch, get him dinner, put him to bed. Or he could ask for a direct payment to employ a personal assistant for more hours (again, he may need to contribute or cover the cost). But if manager and OT were both saying he can’t cope then I may be tempted to raise it as an unsafe discharge and ask council to convene a multi-disciplinary team meeting so it can be fully discussed whether he can genuinely cope safely at home, even with carers going in.

From the guidance:

10.40 In considering the person’s needs and how they may be met, the local authority must take into consideration any needs that are being met by a carer. The person may have assessed eligible needs which are being met by a carer at the time of the plan – in these cases the carer must be involved in the planning process. Provided the carer remains willing and able to continue caring, the local authority is not required to meet those needs. However, the local authority should record the carer’s willingness to provide care and the extent of this in the plan of the person and also the carer, so that the authority is able to respond to any changes in circumstances (for instance, a breakdown in the caring relationship) more effectively. Where the carer also has eligible needs, the local authority should consider combining the plans of the adult requiring care and the carer, if all parties agree, and establish if the carer requires an independent advocate.

Sorry, just thought to add, if your father has capacity then yes he can decide to go home. He is entitled to make unwise decisions. But there would need to be a back up plan for when things go wrong once he goes home.

Depending on where you are in the country and the value of his share of the property it may not last as long as you think - as a self-finder he’s likely to pay a premium for a care home bed.

Finally, if his needs are significant and he is doubly incontinent and has significant mobility issues, COPD, kidney failure, etc it is worth asking for the social worker to complete a CHC checklist to see if he triggers a full CHC assessment which may see some of his care being part-funded by NHS.

Just keep repeating that you are not his carer and will not be emotionally blackmailed into being his carer.
They have a duty of care to your father - in my experience they just want him off their workload and if family are around to solve the problem so much the better.
Withdraw from discussions, sign nothing.
You are not prepared to be his carer under any circumstances.... and repeat...as often as necessary.
Feel no guilt.
Good luck.

Everything hinges on whether your father has capacity, and can decide for himself, or whether he lacks capacity, in which case it will be decided "in his best interests"

My father is in a nursing home at the cheap end of the scale. He pays £46000 a year. So expect £50 -60k. So half of an average priced house would cover it in total for 2 years. On top of this, if he is self funding he can continue to get attendance allowance (which I presume he is already getting), and there's his pension. So maybe 2.5 -3 years? When money runs out,social services will take over, following a financial assessment.

Wow thank you so much
This info is much appreciated I just needed to get things clear in my head
My father has capacity - although I wouldn’t agree with that I told him not to use the shower because I needed to get it fixed so it had to dry out - he was straight back in there - I had to take the fuse out in order to be able to fix it

He does the most stupid things even though he knows it it good for him.

I’m not going to be bullied into looking after him .
He’s “difficult” at the best of times m
If he actually listened to what people tell him it wouldn’t be so bad but he just does what he wants and then is surprised when it goes tits up .
last year I told him many times that if he didn’t move around get up and about he would end up in a care home or a hospital - and here we are exactly what I said would happen
I’ve told the care home manager that I have no interest in caring for my father
And that they are not to contact me if they want to discharge him

I’m mouthy enough and strong enough 😂 to stick up for myself and not be bullied .
If it comes to it I will just block the SW

“. I don’t mind visiting him and doing his shopping washing and cleaning”

This is what you are offering to provide, but realistically are you willing to do that? If he’s incontinent then he’ll need washing done every day, shopping a couple of times a week, cleaning will depend.
From your post you really aren’t prepared to do this level of care.
So I would just repeat as often as you need to, “I’m not supporting the decision to send him home, I feel it’s unsafe” and the OT report is your evidence of this.
He should have an activity chart or behaviour chart in his rehab place -if not ask for one to be started, this will evidence his daily routine and hopefully prove he will not be safe at home. the next step might be an assessment bed to further monitor his capabilities and I would ask for a mental capacity assessment to ensure he’s capable of making safe decisions.

@Lotsachocolateplease
Thank you I will see about amazement for his mental capacity and ask about his capability - he admits that he can’t do anything but he wants to go home because the SW thinks he can.

Last year I did all of his shopping twice a week - daily shopping - washing his clothes doing the cleaning - washing up
Even now when he is in the rehab place they don’t do a laundry service so I drive 30mins to get his washing wash dry it and take it back that next day doing stuff like this isn’t a problem and I would like to be able to see and visit my father .

I live close - 10 min walk -2 min drive visiting most days isn’t the issue .
What I don’t want is to be getting calls when he falls over every day when he’s shits himself I can’t change him he needs two people to change him .

The last time he fell he was going out at 2am to put the rubbish he fell over and couldn’t get up this was at 3am
I had to call an ambulance to get him up and they had to use one of those inflatable things that they put under him to get him help .
I have no idea why he was putting out rubbish at 2am - i would have done it in the morning .
Same morning at 10am he had a shower and fell in the shower so I’m back down there having had 2-3 hrs sleep to sort him out again .
The following day he fell again off his computer chair . Again it’s another call and another 1 2-hours sorting him out .

This is what I don’t want to be involved in.
He constantly will do stuff that means a fall is inevitable. He goes to bed at 2am falls over and then I get the emergency call . It’s not a case of just going to the house it a case of calling an ambulance waiting around sorting him out afterwards it takes 2-3 hours each time
With him shouting at me he doesn’t want an ambulance .
I can’t do this - I am I a lot of strong medication for my back and the week he had 3 falls wrecked me for weeks .
If it means I have to do absolutely nothing then I will .
But I can do some stuff but I don’t want to be a point of liaison between my dad and the carers as I know what will happen

Amazement - assessment😂

Look at the Age UK website, lots is info that you might find helpful.

He may benefit from an advocate if you do not want to act as a liaison. Not that they can make decisions for him or you but they may assist in him having his views heard.

There was a post a few months ago where the op was living in the same house as her wife and her mil. Her wife died and she was left to look after mil, which she wasn't very happy about. They didn't really have a relationship, just both there in the same house due to the connection with her wife.
SS were very keen for her to continue caring for mil even though she didn't want to do this. I think she had to be very blunt and give no way in for them to say she could do the caring, so no offering to washing clothes of clean etc. I tried to find the post but couldn't, hopefully someone else will remember it.

My fil was discharged from a hospital last year as they said he could do everything. When the ambulance service drove him home, my dh had to help them with getting him over the tiny front step into his house. Dh was furious, as was the ambulance driver. Several phone calls later, because fil didn't want someone to clean him and help him get dressed, they wouldn't send carers to help him with the things he said he needed help with.
My dh had to clean up after his father who was shitting and weeing everywhere on a daily basis. Dh would spend a couple of hours cleaning the whole place to only go back the next day and it was back to the same state. He wouldn't get a cleaner as it cost money and he didn't need one.
All the health professionals dh contacted all said fil had capacity and could look after himself. It was an awful situation, with what sounds like a similar dynamic to yours, with the argumentative behaviour but he was also aggressive.
I think you need to be very firm. You have a back problem. You cannot be on call to help with your father when he falls, not if, when. They need to organise a care package for him and have carers coming in the house at least twice a day. You. Cannot. Help.

Good luck

We are in a similar, but not as bad yet, situation with ILs. I'm afraid that while they have capacity there is bugger all you can do with stubborn elderly parents other than let them find out the hard way. Easier for us as we are an hour away but if they are anything like my FIL they can be very manipulative and tell family and SS completely different stories. FIL has now withdrawn consent for SS to tell us anything as we found his lying out. Send an email to SS saying you are unable to provide any care at all, whatever you are prepared to do don't admit it. Put it in writing that you are not available for emergency cover and let them and him come up with a plan that excludes you. Then, once that is sorted, do what you are happy to do but make it clear it's on a temporary basis. He will still assume you are at his beck and call though.

I think the other thread referred to was started by a poster called joystir.

Rather than insisting that you cannot provide care would it not be better to just refuse to engage with social services at all? Just be completely flakey and unavailable?

Also in this position although mil also alcoholic and aggressive...but has capacity when sober....
We have had to point blank refuse to do anything to both the hospital and the social worker..they finally got once she had refused entry to the carers after 4th hospital admission.
We also complained about repeated unsafe discharges to PALs at the hospital which helped ..
The social worker has been really good and won't outright discuss as mil has refused consent...but will accept emails...
Nothing sorted really but at least they have to try....its hard for all when they don't accept help....

@QioiioiioQ I can definitely do flakey 😂

@longtompot sounds the same as my dad he went home last week for a home assessment - he couldn’t even get one foot over the front door
He was put in a wheelchair to get in the house
I’ve made it crystal clear to my dad that I’m not helping him if he wants to sit in shit and piss all day that’s up to him as he has capacity

Don't offer any care, if you start with cleaning and shopping it will snowball. Refuse everything except a home, can you force the sale of the house? Then he will have the money to pay for care and no home?

The circumstances were a little different with my family but we ended having to just refuse to be involved at all. I understand you feel able to do some things and it's a shit system, there should be a healthy medium of offering some help but not being bullied into taking it all on but there isn't and you may have to refuse to engage.

@QioiioiioQ

Rather than insisting that you cannot provide care would it not be better to just refuse to engage with social services at all? Just be completely flakey and unavailable?

I would be completely unavailable. Totally. Change your SIM/phone number. They come to your house, get your kids or partner to go to the door and say 'She's not home'. 'When will she be home?' 'Don't know. She takes off sometimes.' They show up at your work tell them, 'I told* you I will not provide care. You need to leave.'

We also had our family members in a rehab place with no laundry facilities. My DP were expected to do 400 mile round trips to do fucking laundry. Who the hell thought that was a reasonable situation?

@Ducksurprise

Don't offer any care, if you start with cleaning and shopping it will snowball. Refuse everything except a home, can you force the sale of the house? Then he will have the money to pay for care and no home?

^^ This.

Don't offer to do anything, it'll be the thin end of the wedge and then they'll gradually expect you to do more. Just refuse to do anything at all.