Care home on medical grounds for Alzheimer's and Diabetes?

[Daffy7286]

Hi, I'm hoping that someone more knowledgeable than me can help us navigate care home arrangements for my dad, and what we need to ensure that the local authority recognises that a care home is for him, a medical necessity. He has just been admitted to hospital, and I think it's highly likely that the hospital will refuse to discharge him to his home. He is diabetic, and has Alzheimer's, and he cannot manage his medication himself, nor can his partner (who also has dementia). He has been admitted to hospital for this before, when he moved house, then stopped taking his medication, and ended up being admitted with delirium. The hospital would only discharge him if nurses visited twice a day to administer his medication, which they have been doing for about 18 months. He's been admitted again, after collapsing with low blood sugar. We have recently been told by his GP that he's being increasingly difficult with the nurses, and refusing to let them in. The Dr said he may need to go into a home so he has 24 hour care. I suspect that given that, and the likelihood that he's ended up in hospital today because he's refused a nurse visit, that the hospital will not discharge him home. My question is, how do we ensure that it is on record, as far as the local authority is concerned, that he is being admitted (if that's the right word) to a home on medical grounds, and that it is not our choice? We discussed a care home a few years ago with his social worker, who really put us off. She told us that he'd soon run out of money, and that the local authority would then refuse to pay the fees. Surely if he's admitted to a care home because he is not safe to be at home (because he does not take his medication, and nurses cannot visit), that the local authority would have to pay his fees when his money does run out? He doesn't have a lot, only enough to last a couple of years, and no property. I'm completely at a loss as to how to navigate this properly, so everything thing is done officially, with the proper evidence in place. Can anyone help? Thanks so much!

I am in England, if you are elswehere then ignore this as it might not apply. Short answer - Don't worry, there is nothing you need to do.

"The hospital" will not be making the decision, it's made by a multidisciplinary team which will include a hospital social worker. They are based in the hospital but are part of social services. They will look at what your father needs to live safely and how those needs can be met. Your choice doesn't come into it, the family input into this is how much home care they are able/willing to provide.

Someone can't just decide that they want to move to residential care unless they are footing the bill - they have to have an assessed need for it. It sounds that when you discussed it with the social worker last time your dad did not meet the threshold for residential care. Things change, now he might do. That assessment of need will be done automatically as part of the discharge process, all you need to do is make sure that your father is giving a true picture (not "I have four daughters and they do everything for me" when there's an only child who has a full time job and lives 300 miles away). My experience is that nothing happens until the magic phrase "medically fit for discharge" at which point discharge planning swings into action.

If they decide now that he needs to be discharged to residential care (MIL has diabetes and dementia and it's managed in a residential home rather than a nursing home) then this placement will be organised by social services, they will do a financial assessment and they will contribute when he stops self funding.

Thanks so much for your reply @Knotaknitter , that’s very reassuring. Yes, I thin when we last spoke to the social worker about a care home, he wouldn’t have met the threshold. That was before he stopped taking his medication and before he was admitted to hospital for the first time, so his needs have changed.

Thats great advice, he will also have a capacity assessment to determine his understanding of his care needs and his agreement to moving into a carehome. Do you have power of attorney, if not and they show he lacks capacity a best interests meeting will take place to decide where he should live and how it is paid for

I do have POA yes, so at least that's something!

Thats good, once he is able to have all the relevant assessments then you should be involved in where he lives if he lacks capacity to make that decision himself. They may ask you to look at suitable homes and arrange the payments , sell his home etc. if its decided he would be safer in a carehome.

Have a look at www.beaconchc.co.uk and download the free tool kit- it takes you through the chc funding process and how to appeal if necessary. When my parent was discharged from hospital they got 6 weeks funded before having to pay as they didn't meet the criteria for funding ( this has since changed) be warned that the bar is set extremely high for funding and in my experience there are a lot of health care workers that act as gatekeepers to the public purse.