Can I refuse Mum's discharge from Hospital

[LadyShmuck]

I was going to NC but I'm so tired I can't work out how to, so if you know me, hi!

Background to this issue.
Mum is 71 with undiagnosed dementia which has deteriorated rapidly over the last 2 years and she is now doubly incontinent, unable to care for herself, cannot communicate in any meaningful way and needs 24/7 supervision. She lives with my dad who can't walk and has significant mobility issues. He cannot meet her care needs at this point in my opinion. Up to now they have refused to get carers, instead stumbling from one issue to the next with frequent propping up by me and my siblings.

Over the past 3 days she has had 2 falls (collapses? Can't be sure) and also it has become apparent that she hasn't taken her blood pressure medication and her blood pressure was at 250/118 on Monday night. We have ended up in A&E on all 3 nights, finally this morning a doctor decided to admit her and said that we should expect her to be in for a while for her to be assessed and get things in place so that she can return home safely or go into residential care if that was more appropriate. I left my mum in the Early Assessment Unit at 8am this morning.

Around 12 the hospital called to say they would sort an outpatients physio appointment and for their 'interface' team to assess her with a view to discharging her today. I said this didn't align with what the doctor this morning had said on admission and that I wouldn't support a discharge today on the grounds that she clearly can't be kept safe at home. The nurse I spoke to repeated their plan and given that the call woke me up after being asleep for an hour for the first time in 36 hours I'll admit I wasn't at my sharpest when I took the call.

What can I do here? What should I be asking for, I cannot allow her to go home today, my dad has finally admitted he can't cope and doesn't want her to come home as he can't care for her or keep her safe.

Any wisdom appreciated, I'm panicking at the thought of her coming home today and spending another night with her in A&E to go through all this again.

I totally understand what you are saying but when your mum is deemed 'medically fit for discharge' if she is expressing a wish to go home and is deemed to have the capacity to go home this is what will happen. People have the right to make what we think are unwise choices. They may well put some equipment in place, ie a commode. Depending upon the unsafe things she has been doing they may recommend the gas supply to the oven is disconnected for example, or she is provided with a falls sensor. You and your dad can both say you cannot help between care calls, and that's fair enough. But please bear in mind that plenty of mobile and immobile people with dementia live on their own with a package of care to support. Sounds like she needs a capacity assessment.

We have a major problem in the UK with elderly people not being looked after properly - being dangerously discharged from hospital. The number of times my MIL and FIL were kicked out of hospital inappropriately was disgusting. MIL was discharged - sent home in an ambulance and put on her sofa, despite being in no fit state. She rested there for a bit and then needed the toilet. Upon getting up, she fell and an ambulance had to be called so she was back in hospital. I think that might have been the time she never came back out. FIL was discharged with a mega break that they had pinned. He couldn't move. He literally shat himself. When the carers turned up, they called us and asked could we come clean him up. We live 3 hours away. He should have been in a rehab facility. But we have no places. It's all a total fuckup - families and neighbours can only do so much. My mum had a mastectomy. She never got a bed. Her trolley that she was on in recovery was moved about until I took her home. Our country is totally broken. We need to admit it.

It certainly seems as though we have a very patchy service now especially for elderly on NHS. The govt shouldn’t have cut out convalescence hospitals and now instead our elderly are being left on wards and in all honesty are not equipped to be dealing with dementia patients some of whom will need one to one care especially at night time. Many don’t sleep at night or experience constant waking and dreadful night time incontience. We are basing our expectations on a service that no longer exists. We can’t rely on NHS to look after us or our parents/ grandparents anymore. In some form we are left to fend for ourselves and our families be that through private, at home, charity or benefits. There’s simply no certainty of any level of service now. I think more and more responsibility will be handed back to families going forward

Bring back good old-fashioned cottage hospitals, that's what I say. They worked. The current system doesn't.

Just typed a big long reply and then it got lost.

Anyway, I checked with my Mum's nurse and she has had a capacity assessment and been judged not to have capacity so that's something at least.

She's being treated for a UTI and having physio as she's very unsteady on her feet, although she's refusing to use any mobility aids so I'm not sure the physio is going terribly well. According to the lady in the next bed, discharge Monday or Tuesday has been mentioned although the nurse didn't say that.

The nurse didn't have any record that we'd requested a social services assessment for care so she has noted that, and I said I thought a discharge home would be unsafe so hopefully it'll get looked at before they decide to discharge her.

Mum was in a horrible mood today and was honestly just vile to me so I think I'm going to have a rest from visiting this weekend and hopefully build up my reserves for whatever battles next week throws at me.

Mum was in a horrible mood today and was honestly just vile to me Family bear the brunt of all the fears and frustrations, because they’re not going to just walk away. Try not to take it personally. Think of it as a toddler screaming “I hate you”.

But of course if it does get to you, you are right to stand back.

I think more and more responsibility will be handed back to families going forward

But they want everyone at work and keep putting the pension age up. Tory cunts want it both ways. They can fuck off.

Bet those NHS managers insisting on these unsafe discharges and expecting the families to provide 24/7 care wouldnt let their own staff have time off to do the same for their relatives.

Just an update if anyone is still reading this thread. My mum is still in hospital, signed off by physio now (can't remember if I said she was having physio but anyway), I think she's medically fit for discharge and last time I managed to get an update (Tuesday!) they said she has been referred for a place at an assessment home. On the plus side, she's settled at hospital well now and when I saw her Tuesday she was happy and actually having a lovely time with the other ladies in her bay.

I really feel for the nurses, they're rushed off their feet all day, hence the lack of updates I guess. I can't ever get through to speak to anyone.

Glad to hear that your mum is medically better now. I do hope that they can fin a place to discharge her for assessment, and that you can start to get in place the care package and help that is so badly needed.

Hi all. It looks like my Mum will finally be moved tomorrow, she was due to move last Monday then tested positive for COVID so had to stay in hospital. She's had no ill effects from that and she's had a negative LFT today so hopefully will have another negative tomorrow and be given the green light to be moved into the lovely care home we've found for her.

Her deterioration over the last month is shocking. I'm just so sad about it, she's only 71. It doesn't feel fair at all.

@LadyShmuck It's not fair that at 71 this is what's required. Hugs to both her and to you. Don't beat yourself up. You are doing your v best for your mum. She might rally a little being in a more homely environment.

I hope the move goes well and she likes the home @LadyShmuck , is your dad ok with being home alone ?

My Dad is managing ok, though cycling through feelings of relief and guilt all the time.

My mum is actually worse than I thought, she's in the home now and settling well thankfully but it's very early days. Its a specialist dementia home and my mum seems much worse than the other residents, in terms of her communication skills definitely. One of my friends is a carer at a dementia home, hasn't seen my mum in over 10 years, she came with me to assist with the move and was shocked that we'd been caring for my mum at home. Her opinion is that my mum's condition is really quite advanced. Oddly my mum recognised her straight away.

I'm pleased with the home so far, they've been lovely and all of the staff seem genuinely kind and caring which is a huge relief.

Hi op, only just caught up on this thread. What a journey you've been through. Just another shoulder of virtual support here.

My nan had dementia and had to be moved to a home. She could no longer look after herself. We too left the home later than we should have done due to her not wanting to leave her home. She was only in her 70s too.