Dad not coping in hospital

[Gloopygoggins]

My dad is 87 and has had a second major stroke that's left him paralysed on one side, incontinent and barely able to speak. It hasn't effected his mental capacity at all.
He's been in hospital about 6 weeks and was recently transferred to a specialist rehabilitation hospital. It's apparently excellent but I'm really concerned about the care he's getting. He has other complex medical issues, and suffers from depression; being in this state was always something he dreaded. A few times now when my mum has visited he's been in tears and tells her he wishes he was dead. I know staff are busy, and having spoken to his dr his denture was finally cleaned (after 5 weeks) and other small but necessary things were done, but I just feel his mood is now so low and he's feeling utterly without agency.
We've no idea how long he might be in this hospital or where else he could possibly go. My mum is 80 and although physically very fit she couldn't possibly care for him at home by herself. Currently she's travelling a round trip of 90 minutes to see him for an hour every day.
I just can't stop thinking about him left on his own, unable to move, in pain, no distractions as he's in a single room, and unable to articulate how he's feeling to staff.
Sorry for the long ramble. I guess does anyone have any idea how we could improve things?

Have you spoken to the ward manager and PALS about any essential care he is not getting like having his dentures cleaned. I would ask for a multi disciplinary meeting with a doctor, nurse, therapist and social worker to ascertain his current condition, how much he will realistically be able to do in the future, his current needs and what is the plan for his future care. The staff can carry out a capacity assessment to see if he is able to understand his needs and care, a care needs assessment which will determine how much care he will need and where is the best and safest place for him to live when he is discharged.
If he wishes to return home then the team will have to help your mum with this, getting a home assessment done, putting in equipment, carers etc. If the right choice is for him to live in a carehome then the staff can still Carry out assessments and a financial assessment to see if he will need to pay or if he is entitled to any funding. Do they claim any benefits at the moment like attendance and carers allowances.
You or your mum need to speak to the ward manager and doctor to set up a meeting with a list of questions you would like to ask, with your dads permission if he can give it, does anyone have power of attorney.

Thanks @FleasInMyKnees that's really helpful. Now to persuade my mum that it's OK to ask.

Goodluck. The Stroke Association may offer advice too and also your mum can look at the Carers UK site.

My dad died at home in July after a long hospitalisation in May. He wasn't in quite the state your dad is when we got him out but was in a similar state when he died -- he had a stroke at home a couple of weeks before he died and was only partially continent. My mum was too frail to do any serious caring and we were able to arrange care at home including a hospital bed etc. I also found it very distressing when he was stuck in hospital: from the docs point of view he wasn't strictly "terminal" at that stage but it was obvious to close family and to him that he was dying and he desperately wanted to be at home. We are all really glad that we got him out to die at home as he wanted though it was a lot of work organising it all which fell mostly on me (first few weeks) and then my sister (who took over) as my mum couldn't really manage all the phone calls / admin etc.

Im sorry I cant be much help with practical advice, but given his age and condition its maybe worth circling up on some legal stuff…

If your Dad doesnt wish to live in his current state, does he have an advanced life directive in place (sorry dont know the UK term). So if he has another stroke, they dont attempt resuscitation..if that is what he wants.
Does he have a will
Does he have a durable power of attorney for both health and finances. I would suggest that is not your Mum. Its always better to have someone in a different generation as they are less likely to be having simultaneous problems and therefore be unable to act.

Hope you can find a way to make his life more bearable

Oh yes we did the advance directive thing a couple of months before my dad died - I sat down and did it with them and a neighbour witnessed it - and it was useful at the end. We also applied for PoA though in the end it didn't come through until after he'd died anyway.

Excellent advice above. Do you know anything about your parents’ finances? He is obviously going to need either a lot of carers coming in at home or possibly residential care - knowing if this is going to be self funded or council funded can be very helpful. His council website is likely to have a self-completion basic self-assessment for starters.

When your dad was transferred to rehab, he should have had an occupational therapy assessment with outcomes and goals listed.
Contact the rehab centre and ask for a meeting re how he is progressing.
Also, ask about the intensity and frequency of the therapy input, at what point will this be reviewed, can this be delivered in a different setting, such as in a short term residential bed with community stroke therapy team support. His mental well-being is really important in respect of the progress he will make. If he is lacking motivation because of this then it is likely that his progress will be slower.

Also, check that he is still prescribed his meds for his mental health, these are sometimes stopped by the ward doctors.

I'm wondering if he has seen a speech therapist for communication and what the plan is for that?

I'd agree about making it very clear to the doctors that he wants a palliative approach, ie no curative treatments and only symptoms being managed for comfort. That shouldn't stop him having therapy.