Unsafe discharge from hospital

[PaintYourDreams]

I hope someone can help me with this one please. My MIL was taken into hospital a few weeks ago and it was a nightmare to get her there. She was very unwell but also extremely hostile to any medical intervention and it was very upsetting all round but once she was there and being treated she's accepted it and doing better but still quite a lot wrong with her that will need ongoing treatment.

The problem is that we've been told by a discharge person (not a nurse, I don't think) that at some point they will discharge her by either us collecting her or them taking her home where they will do a two hour 'assessment' to see if she can cope at home. So the assessment will be done once she has already been taken home. MIL will say yes she can manage fine but she was in a terrible mess and not coping at all when she went into hospital and we think that daily carers and a stairlift are the minimum needed. None of this will be in place if they just bring her back and then decide she doesn't need help. Or if they decide that she can't manage, then she's had all the trauma of being taken home and then taken back to hospital.

So I guess my question is whether this is the normal way that an assessment is done or does this mean that they've effectively decided she is discharged back to her house as it is even though we don't think this is safe.

So I just wanted to say- it should work.

And if it doesn't please don't hesitate to ring your local social care team - (out of hours) "oohs" if it is an over weekend discharge without any care- and GP surgery or oohs GP - and also complain to hospital PALs team (or through whatever complaint system is in place at that hospital) about an unsafe discharge.

No one wants failed discharges or people to be unsafe and struggling.

mischance
Was it right that I, as someone with a slipped disc, had to muddle through to my detriment (and danger) and that of my OH?

They should have asked you to speak to a hospital SW or discharge team to identify if you would need care support, if you were struggling with p/care and mobility on the ward. Please please ask them to refer you for discharge assessments and care planning next time if it ever occurs again. You can also ring up social care when you get home to self refer if you find you can't manage even if you initially thought you would. I hope you got through it ok and are ok now.

Up until my mum was taken into hospital in 2019 I had cared for her for 7 years. I cooked every meal, made every drink, put to her to bed and dressed her but no one at the hospital asked for our input into her discharge and she said that she was capable of caring for herself. And no one would listen to us.

Thank you again for all the advice and I'm sorry to hear of some upsetting negative experiences.

And if it doesn't please don't hesitate to ring your local social care team - (out of hours) "oohs" if it is an over weekend discharge without any care- and GP surgery or oohs GP - and also complain to hospital PALs team (or through whatever complaint system is in place at that hospital) about an unsafe discharge. thank you that's very useful to know as a back-up if any problems

You need to speak with the ward and ask if the hospital social work team and check that a discharge notice has been sent to them from the ward. This will then place a duty of care on the team to complete a discharge to assess assessment of need.

That will include gathering information action from the occupational and physio therapists and staff on the ward, as well as family.

A decision will them be made in conjunction with your MIL and you as family re discharge plans. This my include a respite stay due to the shortage of home care support.

@Ikeptgoing

mischance Was it right that I, as someone with a slipped disc, had to muddle through to my detriment (and danger) and that of my OH?

They should have asked you to speak to a hospital SW or discharge team to identify if you would need care support, if you were struggling with p/care and mobility on the ward. Please please ask them to refer you for discharge assessments and care planning next time if it ever occurs again. You can also ring up social care when you get home to self refer if you find you can't manage even if you initially thought you would. I hope you got through it ok and are ok now.

As a previous hospital social worker, this was of course the first thing I did. I then spent the next 10 days battling with them and banging my head against a brick wall. First they offered 6 weeks care at home, then they withdrew it (he needed too much care and they could not supply this); they refused continuing health care funding (which he qualified for and which was granted on appeal - after he had died); they then turfed him out with NO care in place. All we had was a commode - great, but if there is no-one at home able to get him on and off it...?

Ringing the LA social care team was a joke - first you have to try and speak to a human, rather than get sent round and round; then you have to persuade that person that help is needed; then when you get to see that person you have find a polite way to explain to them that they are telling you stuff that is incorrect, which they were.

The care services are a joke - so many people involved; no coordination.

• OT says you need a specialist neuro OT - so we wait for that, then wait for the equipment - which takes several weeks.
• Physio says we need a specialist neuro physio - so we wait for that - and then wait for the standing aid for several weeks.
• District nurse says she cannot deal with incontinence and - wait for it - we have to be referred by our GP to the B&B service = bowel and bladder service. We wait to get hold of GP, then wait for her to make referral, then get a letter offering us an appointment at a clinic in 2 weeks. I ring them and ask how I might get him there - they offer a home visit - we wait for that. She arrives on the day before a bank holiday weekend and she has brought us 2 convene catheters - just the 2, and the wrong size. So we then have to get hold of GP and ask her to prescribe these - we wait a week or so for that to happen.
• District nurse says she cannot provide an enema and it has to be done through the GP. I ring her, she prescribes it, we wait for it to arrive, and then for District Nurse to appear and administer it. She doesn't. By that time OH is in serious acute pain and we have to go via ambulance service to get them to ring someone to come and do manual evacuation.

And so on and so on.

Do not let anyone think that the discharge process works - it does not. Do not take on the care of a loved one discharged from hospital until you have everything you need. And be prepared to fight.

@Mischance

There will always be equipment that is not essential for discharge that the person may need to wait for once at home. As long as they can be cared for safely once at home

So who does that caring in the absence of the care awaited? And who assesses whether that care is safe? - for the patient and for those providing the care.

Was it right that I, as someone with a slipped disc, had to muddle through to my detriment (and danger) and that of my OH?

There is no way that a system that dumps patients at home without the full care and equipment necessary can be right. The government wants you to believe this because it can then tick the bed-blocking box and say they have done something about it. You are serving a corrupt system.

Hospital discharge was my "specialist subject" for many years and the principles will not have changed: if there is no proper care in place, the patient stays where they are until it is, or is offered a community hospital place in the interim. I know bed-blocking is a problem, but professionals on the ground are duty bound to put the safety of the patient and their family ahead of political considerations. Just because the government does not properly fund the NHS and social care there is no reason for any social worker or OT to be complicit in unsafe discharges. They are pawns in a game that destroys their professional judgement and leaves vulnerable people at risk.

Where how did you conclude from my list that I think sending people home without care is acceptable? I said some equipment is not essential for discharge. Which it isn't. Of course a suitable care package should be in place. I made that clear in my post.

And @Mischance I take real issue and offence at you saying I'm "serving a corrupt system". There are plenty of posters on here who've tried to explain how D2A works. It's not dumping people at home. It's getting people out of hospital in a safe and timely manner back home where they are at far less risk of acquiring new infections/ deteriorating further. You'll find plenty of evidence that shows shorter hospital stay and community rehab / reablement have much better health outcomes for people, especially those who are older and frail.

@parabalabalabala

And *@Mischance* I take real issue and offence at you saying I'm "serving a corrupt system". There are plenty of posters on here who've tried to explain how D2A works. It's not dumping people at home. It's getting people out of hospital in a safe and timely manner back home where they are at far less risk of acquiring new infections/ deteriorating further. You'll find plenty of evidence that shows shorter hospital stay and community rehab / reablement have much better health outcomes for people, especially those who are older and frail.

I'm all for hospital stays being as short as possible - good for the hospital and good for the patient. But the reality is that this is often achieved at the expense of the patient and their relatives, and this is simply not right.

The system is wrong - it is underfunded to a degree that is totally unacceptable. There is no need for you to take offence - I am sure you and your colleagues are working your tripe out to do the best for the people in your care. But I know, from bitter experience, that it does not feel that way to those on the receiving end. That is not your fault - it is the fault of a underfunded and under-quality-checked system. So much that looks fine on paper is not fine on the ground.

All the things that I have listed as having happened to me are I am sure things that you would regard as unacceptable. And they are just the tip of the iceberg.

I think it is important that anyone reading this with a loved-one due for discharge from hospital should know the reality of what actually happens to families, and the toll it takes on them.

My OH finished up in a nursing and was of course the youngest person there. It was not what I or the family wanted. Had an efficient system of care been available, he would have been able to end his life at home.

The system is chaotic - the right hand does not know what the left hand is doing, and the carer in the middle of all this is trying to get the best for their loved-one whilst juggling dozens of balls in the air and banging their head against a brick wall. I lost count of the number of people who came in and out of our home each day - every one of them wanting to help, but working in a complex system with one hand tied behind their backs.

I have no gripe with the people on the ground - they were all genuine and caring people - but they all kept apologising for the system - "we know he needs x,y,z, but I am sorry it will take an eternity - he will be dead by the time you get this , we are no longer allowed to do x,y,z, even though we are happy and qualified to, there is a crazy bureaucratic system for getting what we know he needs. etc. etc."

I am sure that the people you organise care for are people for whom you are wanting to do your best - but in practice the system does not work in the long term, and sadly for us in the short term it did not work either.

I spoke to so many other carers who were in the same situation and were tearing their hair out as we were.

And this is before you even start to talk about the finances. In the end I had to sell my home to achieve the quality of care I wanted for him, even though that was in the end in a nursing home, which was not what any of us wanted.

I am so sorry to hear your experience mischance

(Also Apologies as I misread one of your posts earlier and thought you were also talking about a separate discharge of yours (after a slipped disc) but you weren't. )

Your OHs situation went wrong from what you describe mischance. I do hope you raised a complaint with both hospital, health (GP surgery & primary health team) and social care teams, so that they all took action as quickly as possible and also looked into what happened in detail to learn from.

It doesn't generalise that it happens regularly - at least not in our LA areas- as part of D2A process. As said by many PPs, that to get to D2A already initial plans for discharge needs (carer support, referral for nursing support and crucial essential equipment) will have been made whilst in hospital after clinical team assess the person as medically fit for discharge.

Discharge to assess is about ongoing rehab and ongoing assessment of needs with what might be better defined as reassessing or fine tuning by MDT in community settings (because people can be different once at home or out of the ward due to a variety of reasons) and sometimes longer term adaptations will also be identified as beneficial.

Several of us have said it generally does work well, as we see it every working day and we definitely remember and worry about the unusual cases where something didn’t work and want to understand why and how it can be quickly resolved. (Whether it wasn't set up well or that something changed that was unanticipated).

What's important for OP is that - if she suspects her DM is being unrealistic to her discharge team about what she was or can independently manage and what family will support with- if it's related to potential capacity issues- that OP contacts the hospital discharge or s/w team to give them family information and perspective. That can form part of the background information drawn upon in capacity assessment. It is also useful context even if the person is assessed as having capacity. The MCA 2005 has clear processes and statutory guidance.

The other important aspect for OP is to be reassured that there are community social care teams and MDT health teams who all work incredibly hard and can be contacted if things aren't working well at home.

People are wonderfully complex, so no one person (or case) is ever the same nor follows exactly the same path. It's why there are multi disciplinary teams in both hospital and community.

I have a great deal of empathy for people on this forum. Not only being in the field but also having been an informal carer myself on 'the other side'. Those professionals have families too.

If you want to talk about when things didn't work well and how people used to have far shorter prognoses, you only need look back 30 years ago when patients were still routinely moved into long stay hospital wards. The old community care act, superseded by the care act, literally saved a tremendous amount of lives. I used to be in research, still read research papers about improvements to clinical outcomes. These policies have a basis in sound clinical research and continue to be evaluated as that's how policies develop or change.

I don't disagree that we all as a society would love a bigger health and social care budgets though! Who wouldn't? But to do that which other area will money be taken from? Education? Policing? Infrastructure? Armed forces? Those areas equally fight for more funding, as it's all balanced by tax levels which is a much wider debate. When people say they want social care to have more funding, i always suggest they consider writing to their MP as well. Because that's how change of funding priorities can happen when there's an overwhelming national push for it.

Thank you Ikeptgoing

It was clear from conversation with MIL last night that she is telling the hospital that she can manage fine at home. We've explained all the previous issues to the staff so we will just have to wait and see what support is put in place then take the steps you've suggested if needed.

I do appreciate the info and help you've provided, it's such a worrying and upsetting time so knowing more about how it all works is a big help

OP - I hope that you manage to sort something out for your MIL.

It is very common for patients to say they can manage when relatives know darn well that they can't!

I think you need to be very clear with the hospital that she cannot manage without help; and you need to state exactly what you can and cannot do. It is worth understating what you are able to do to be on the safe side.

I am sorry if my posts seem off-putting, but it really is worth knowing what often happens on the ground - forewarned is forearmed! I know that my experiences are not unusual from talking to other people in the same situation, and also to the paid carers themselves. And to the professionals who came in - they too felt they were fighting the system and were very frustrated by it.

I hope you manage to find suitable care for your MIL and that it all goes smoothly.

Paintyourdreams
Oh that's a lovely update- and I'm glad that PPs and I have been able to offer a little bit of general background public available type info about how the discharge processes may work.

It is a terribly worrying time, I really understand where you are coming from.

It's not uncommon at times for certain 'fiercely independent and determined' people (that's a different phrase for what some relatives may describe in their words as "stubborn" !! ) for someone in hospital even with full capacity to be a tad unrealistic about what they can do as they may desperately want to go home and hope things will be 'magically' a bit easier at home and not prepared to listen to any recommendations. So If DM needs care support, I hope she accepts the reablement carer service if one is offered if evidence suggests that.

It's brilliant you have taken time to share background & your perspective with the ward staff as they will have taken note of that- even if DM has capacity and they cannot over ride her wishes- as ward discharge team will attempt a little bit more discussion (persuasion ) if they can on basis of your info , if MIL is agreeable and consents. So please don't think they haven't listened. (Ie. It may be a capacitated MIL that is choosing not to listen). Or it may be that you provided crucial information that changes the picture that they can explore with her around her capacity to decide on discharge plans.

It is worth you looking up online the local social care website for your mums area. Some LAs have an incredible amount of useful information on there. Our LA's social care website is like a 'guide to most things you could ask' including so much about social care process and possible service options that might be considered of relevant, financial assessments, and general useful community information. Lots of local voluntary agency stuff like luncheon and social clubs on ours. It really varies from LA to LA. (LA = Local Authority, meaning social care dept in the LA).

I wish you and your MIL all the best. From what you said in your OP, MIL sounds a 'fiercely independent and determined' lady !!! You can only do your best and be open and honest with hospital and social care staff (where your MIL lets you be involved if she has capacity to decide on consent to share information).

If you get a chance it's is worth exploring if MIL will agree to letting you apply to set up lasting power of attorney (LPA) finance and property, and LOA health and welfare, for the future, if you haven't already.

That's a nice helpful post mischance especially as you describe such a difficult past experience & have reason to feel angry and frustrated.

I think mischance and I said a similar thing about sometimes the person themselves is actually being a bit unrealistic, but we said it from different perspectives! And that's ok.

I really respect that some PPs on here have taken the time to share their bad experiences and what they learnt in those circumstances and from their talking to others who also may have had a bad experience.

It is always better outcome when the most involved relatives/loved ones have a voice and their perspective is heard, especially if they are the main informal carers. That's not easy when someone is in hospital especially with covid restrictions on visiting, when you used to be able to go in with them and give a background picture from outset, or to easily chat to the nurses whilst visiting your loved one on the ward.

@Ikeptgoing

I am so sorry to hear your experience mischance

(Also Apologies as I misread one of your posts earlier and thought you were also talking about a separate discharge of yours (after a slipped disc) but you weren't. )

Your OHs situation went wrong from what you describe mischance. I do hope you raised a complaint with both hospital, health (GP surgery & primary health team) and social care teams, so that they all took action as quickly as possible and also looked into what happened in detail to learn from.

It doesn't generalise that it happens regularly - at least not in our LA areas- as part of D2A process. As said by many PPs, that to get to D2A already initial plans for discharge needs (carer support, referral for nursing support and crucial essential equipment) will have been made whilst in hospital after clinical team assess the person as medically fit for discharge.

Discharge to assess is about ongoing rehab and ongoing assessment of needs with what might be better defined as reassessing or fine tuning by MDT in community settings (because people can be different once at home or out of the ward due to a variety of reasons) and sometimes longer term adaptations will also be identified as beneficial.

Several of us have said it generally does work well, as we see it every working day and we definitely remember and worry about the unusual cases where something didn’t work and want to understand why and how it can be quickly resolved. (Whether it wasn't set up well or that something changed that was unanticipated).

What's important for OP is that - if she suspects her DM is being unrealistic to her discharge team about what she was or can independently manage and what family will support with- if it's related to potential capacity issues- that OP contacts the hospital discharge or s/w team to give them family information and perspective. That can form part of the background information drawn upon in capacity assessment. It is also useful context even if the person is assessed as having capacity. The MCA 2005 has clear processes and statutory guidance.

The other important aspect for OP is to be reassured that there are community social care teams and MDT health teams who all work incredibly hard and can be contacted if things aren't working well at home.

People are wonderfully complex, so no one person (or case) is ever the same nor follows exactly the same path. It's why there are multi disciplinary teams in both hospital and community.

I have a great deal of empathy for people on this forum. Not only being in the field but also having been an informal carer myself on 'the other side'. Those professionals have families too.

If you want to talk about when things didn't work well and how people used to have far shorter prognoses, you only need look back 30 years ago when patients were still routinely moved into long stay hospital wards. The old community care act, superseded by the care act, literally saved a tremendous amount of lives. I used to be in research, still read research papers about improvements to clinical outcomes. These policies have a basis in sound clinical research and continue to be evaluated as that's how policies develop or change.

I don't disagree that we all as a society would love a bigger health and social care budgets though! Who wouldn't? But to do that which other area will money be taken from? Education? Policing? Infrastructure? Armed forces? Those areas equally fight for more funding, as it's all balanced by tax levels which is a much wider debate. When people say they want social care to have more funding, i always suggest they consider writing to their MP as well. Because that's how change of funding priorities can happen when there's an overwhelming national push for it.

Clearly governments have to make decisions between competing claims on the public purse - that is a given. But what I am saying is that social care is underfunded - whatever the reason might be - and that people using the system often have bad experiences. And that they need to be aware of what they are getting themselves into.

And there is huge wastage of money - OTs, physios, district nurses all came round over and over again. Different ones saying different things. We used to joke that they "hunted in packs", as they did not come alone - why not? - because it needed two to move my OH! - but I was having to do it on my own! They would come in, assess what was needed, then vanish into thin air! Provision of what was needed fell between the cracks of all these different people, who were trying to get things done within a very cumbersome system.

OP does need to be reassured that there are systems for care in the community - but I think she also needs to know that the system is imperfect and that if she and her OH do not make it clear what they can and cannot do, MIL will finish up with insufficient care. I know how hard it is for them as it is also likely she will turn care away.

I actually think that there were good things in the previous system as well as bad. Community hospitals played an important role in helping people to get home - they were a refuge, a stepping stone. The rush to get people out whether they are able to manage or not is not an improvement. There were good, properly managed residential homes run by the LAs where rehab could happen and the SWs could have confidence that there were properly trained and supported staff.

I am sure that good stuff does happen, but my experience (from my own and talking to other carers) is that it is achieved at the expense of the family - if I had not fought every inch of the way my OH would not have had what was needed. And it took a huge toll on me and my DDs.

And no - I have not raised any complaints - you may rest assured that after fighting his corner for months on end, when he died all I wanted was some peace. Further banging my head against a brick wall with the statutory authorities was the last thing I could cope with. And doing so only to be gifted with the inevitable platitudes would not have helped one bit. I let my appeal against the refusal of continuing fare funding run and it was granted posthumously - not a surprise as he clearly fulfilled the criteria and there had been unprofessional conduct on the part of the assessors.

Please remember that when a "case" is closed - bed cleared, patient gone home, job done - the family have to battle their way through the system to make sure that needs are met into the future. And I can vouch for the fact that it is very hard indeed.

One of the problems with the concept of capacity, is that legally people are allowed to make decisions for themself over and over again, no matter how stupid or dangerous it is - until someone steps up to say that they DON’T have capacity after all.
Your MIL will do everything she can to avoid being moved. (Makes sense.) She will lie to whoever asks. You need to speak to the head nurse now and explain that no neighbours will be doing meals or helping out, and you will NOT be stepping in.

I agree about capacity. It is often very hard to assess, especially if it is done on a one visit basis. It is very frustrating to have someone pronounce that someone has capacity when you are aware of what happens day-to-day.

I would exhort people to talk with their elderly relatives about organising a Power of Attorney (or indeed do it for yourself for the future) - it was a godsend when I found myself in a difficult situation with OH. It does not override the concept of capacity but it does mean that you have to be consulted.

mischance
I appreciate you have had a terrible experience and have anecdotal evidence of others who have had a bad experience too. It is really sad that you personally felt so worn down that you didn't put in a complaint. Is it too late now?

However I work in this field as do other PPs who have replied similar - and I and any professional in these field can assure you we wouldn't be quiet and complicit in any unsafe system.

It's that we in our many teams work with thousands of people - over the country that'd be hundreds of thousands of people - and we all see how beneficial it is and that it usually works well, so I have to disagree respectfully.

We can see the unusual times for various reasons that something did go wrong. It isn't a huge proportion of times compared to most discharges and we work incredibly hard to jump on top of those cases. It does really worry me that you and your OH had such an awful experience.

In terms of CHC funding it is a health (CCG) decision not social care department one, whether someone is eligible, with strict criteria. It may possibly be that your OH ultimately was awarded possibly a different type of CHC, the fast track (end of life and deteriorating rapidly ) CHC funding that would have relied on a consultant (health) or GP identifying that and their being willing to sign off on fast track CHC application to the local CCG. Or different if it was awarded in complexity and the original evidence supplied didn't support it but more was requested and did support it. But none of that is social care led it is entirely a health CCG CHC specialist decision.

Anyway mischance you are absolutely right to share that you had a terrible experience. I am so sorry to about your distress.

CHC is indeed a health responsibility. I am aware of the fast-track route, which he got briefly while he was alive (well, as near as dead really). I know the system inside out as an appeal requires you to have detailed knowledge, or it would not succeed. The appeal granted the funding from the start of his illness's acute phase - about a year - because it had been wrongly refused twice. How many people would have known the system well enough or had sufficient awareness to put in the appeal? It was a vast effort on my part. SWs need to make sure that people have information about this and support to appeal where appropriate. The SW involved in the assessments of my OH just lay down and capitulated to the health assessor's decision. When the appeal was heard it was granted on the spot as it was so blindingly obvious that a wrong decision had been made. The SW was complicit in this, so, although it is a health decision, the SW is usually involved, as it is a decision about which authority is taking responsibility.

I do think that part of the problem is that professionals do not always grasp what is really going on with families. They have gone through the process, the box is ticked, their line manager has signed it all off, but truly those of us living this experience do not feel it is sorted.

Whenever this issue crops up on here or on Gransnet, the advice to family members is "Do not agree to do anything." It is good advice.

I have talked at length about the bad experiences I had and I really have to say that I am not alone - the hope that mine is an isolated case truly is a vain one.

However I work in this field as do other PPs who have replied similar - and I and any professional in these field can assure you we wouldn't be quiet and complicit in any unsafe system. I hear that - anyone who enters the SW profession does so for good motives. But ........ I can truly say that on the ground, in the home, it is a dreadful experience. And I am not alone.

I appreciate your thoughtful posts but have to say that the experience of those steeped in it day to day is not good - not good at all. And I believe that it is important that professionals do not close their eyes to this, which is what I believe they do.

mischance you did very well to be successful in CHC appeal. As it was backdated a year then that wasn't fast track end of life CHC or it was a bit of both "complex etc" and "EOL fast track" CHC grounds. S/W do only the social care assessment for CHC, which is an important but limited part of the MDT assessments as most of evidence relied on by CCG for CHC decisions is MDT health info. The bulk of CHC assessment evidence is on someone's actual health MDT needs, as it is about having complex, intense, of a nature , unpredictable, health needs. It's wonderful that you got that resolved in a satisfactory way.

I won't comment on the rest of your post, as you are absolutely entitled to have your own views . I said my piece as have other PPs. And what this thread was about, was an OP who was feeling overwhelmed asking for some online support and general advice during a discharge planning experience. Which hopefully - as indicated- she feels has had now.

I think there is a lot to unpack in your experience mischance and maybe that can form a new thread that you may wish to start, as with a different title specific to your experience- as I can't help but think you may find others nationally or globally (whilst unusual for us, in our experiences) and a specific title may be enough to find that bigger potential range of support for you, who would really also appreciate the chance to download and discuss those bigger issues when it doesn't work.

That's what MN is good at, when the title shows what is being discussed and people can see it clearly to choose to participate.

As i said before, I don't doubt you did not have a good experience. I really feel for you as I can hear your frustration and anger about it still. I regret for you that you don't feel you ever got a resolution (even if later) as you didn't feel up to putting a formal complaint in at that time. If it happened in the last 2 years, I wonder if you would feel it may still be worth putting a complaint in? From what you describe there must be some important learning in there.

Anyway, I suspect you have some excellent skills in appeals of CHC decisions. Something none of us realise are important until we have to face it.

My father was discharged from hospital on the basis that he told them I came in every day and took care of everything. He lived on the south coast of England and I'm in Scotland. They are under pressure to free up beds and are much too happy to accept the "story" they are told by an elderly person who wants to go home.
My mother was discharged at 1am and sent home in a taxi. Fortunately the taxi driver realised that she didn't know where she lived and took her straight back to the hospital.
I'm sure there are caring people working in the discharge service and we were unlucky, but I wouldn't rely on them

That's terrible @MotherofTerriers !!
Those things should be easy to double check!

And discharging an older person in a taxi at 1am in the middle of the night, is not recommended practice at all. I'm assuming she was in A&E, was admitted alone and no A&E staff noticed she was confused?

i hope you raised a complaint about both of those poor discharges. Both of those situations should not have happened so please please complain.

Often cases that go wrong simply bypass social care and safe hospital discharge processes because it's not been recognised by whatever ward/ or A&E , as potentially an issue.

I always tell families ring in to the hospital or A&E and insist on giving them the background info. Of course if someone is already a social care case and if we get notified in the community, we quickly jump on those cases and alert the hospital s/w teams

But it's those people without social care involved, or no one tells us, or family don't realise if not under social care already, that we can't alert for.

To be fair I have spoken out of turn, as don't know your mums age or how she presented . It's not usual practice to discharge anyone in middle if night if they may have care needs or present as confused . But I don't know if this was midst initial covid lockdown period when hospitals may have been working differently to avoid admissions due to high pandemic infection risks. So please ignore my initial reaction to that as I don't know context