Discharged from hospital -not a good idea

[crazyBadger]

My dad's wife is about to be discharged from hospital after a fall. She also suffers from dementia which is coming on at a scary speed.

Me and my siblings cared for my mum and other family members and made it VERY clear years ago we would only be prepared to care for our dad in the future. (We have a very strained relationship with his wife even before she became ill) so we would not be willing to help with care in any form.

Shes hurt her neck/back in the fall and thus has now limited use of limbs... Can't really grip small things but could just about hold a cup and drink with straw etc. Neck brace on.

Issue for us is dad has Parkinson and is barley able to look after himself, let alone Someone else with that level of need.. ( dementia, need help toileting/feeding/dressing/washing Somone with them all the time etc)

My dad can be blinkered in only hearing what he wants, he believes truly that she will be fine when she comes home.. he was unable to deal with my mum's end of life care at the hospital so I had to sign paperwork and talk to dr. He has agreed with the ot that he will put grab rails up I very much doubt she could even manage stairs...she current can't manage walking to the loo.

Her own family are keeping well back and visit occasionally.

I believe she should be moved into a care home.

I've tried to speak to the hospital but as I am not next of kin or related they said they can't tell me anything, I have emailed my dad's GP. But he cannot stop my dad agreeing that she should come home... I don't really know what to do I gather it will be much much harder to get her moved somewhere when shes back home as my dad won't admit he can't cope.

Can you contact adult Social Services and ask them for an assessment? If they decide your Dad cannot safely look after his wife they would have to do something?

Harsh as it sounds, sometimes people have to go home and fail for the message to sink in that it doesn't work.

If she is struggling that much, is she going to have carers in to help with washing, dressing, feeding? Even just taking the neck brace on and off?

She should not be discharged if she is not being discharged safely.

Escalate at the hospital prior to her leaving the hospital - they have a duty of care.

Was she not discharged with a package of care? Carers going to to administer meds and help her with personal care?

She hasn't been discharged from hospital yet, from what my dad has said she is no longer a surgical patient as no surgery needed. The ot phoned very early morning him and said she will need stair rails on both sides.. he thinks they said someone will come in daily ti sort out the neck brace? But no further mentions of any carers comming in other than that.

As I said he is very confused himself (not eating/drinking/ sleeping well at all) and happily will agree to anything as long as she goes home I'm not even sure he under how much care she will need (my mum died in hospital)

Are you able to visit her in hospital? If so, when you're there make it very clear to the nurse and OT on the ward that your dad does not have sufficient mental capacity to make decisions about the patients care and that you have had to act on his behalf for decision making usually.

If the patient doesn't have sufficient mental capacity herself for these decisions they need to be making a best interest decision with everyone involved including her family members. NOK doesn't get the final say and nether does the hospital.

Ring the ward and speak to someone there, talk about it being an unsafe release from hospital as your dad can barely look after himself and does not have the mental capacity to make these decisions anymore due the the Parkinson's.

Thanks all

I managed to speak to someone on the ward today, I explained my concerns and she checked on system and said that there were no immediate plans to send her home and expect her to be there for at least a couple more weeks...

They were also unaware of my dad's Parkinsons.. I don't know how his tremors are very noticeable and had added that for consideration, So it seems we have a bit of time. I will contact the adult social team on Tuesday.

Good luck OP. You will have to be very firm, and even that might not be enough.

Absolutely make sure that you speak to the discharge team and adult social care and make sure they are aware of the situation and can arrange a care package. Do not assume for one minute that one department will know or understand what the other is doing, you will have to check everything yourself.

In our experience if your dad and his wife say they want her home then they will send her home, and you will be left to deal with the fall out. I wish you luck, you will need it.

Can her children just hang back. Are you able to give the hospital their contact details?

I would try to make sure that you talk to the occupational therapist directly. It would be unusual for them to ask your dad to put grab rails up himself and anyway it sounds as if she'd struggle to use them. So I think pass on what you've heard him say, which with any luck will demonstrate that he's perhaps not taking in what they're saying?

I would say to give the hospital her kids contact details, but you’ll end up not knowing what is going on, so keep talking to them yourself.
Yes to contacting SS, and over emphasise the problems as she’s deteriorating fast. You will need to be firm with SS, and be explicit that you will not be offering any care for her and your DF. They will leave it all on you if you let them.

Could you talk to her family and say that you're not going to absorb this responsibility? They might just be the types who think if they hang around in the shadows, someone else might take it on? Let them know they'll need to coordinate the assessment and additional help.

Another thought...could she and your dad move into sheltered accommodation together?

Hospital also have an Adult Safeguarding Team.

Could speak to them and raise your concerns from a Safeguarding perspective as she is at risk of harm if discharged into your Dad's care - not from abuse but neglect.