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Elderly parents

Care Home, Hospital...Where Next

11 replies

BookmarksAreABoon · 11/04/2023 00:03

My mum, who has Alzeimers and lives in a care home, went into hospital with an infection which was treated and she was moved to a complex discharge ward in another hospital. The talk was that she would be discharged back to her lovely care home. She could walk with a frame and a carer/

She fell out of bed-no injuries but now she cannot walk at all and won't eat. This has been going on for a week. The staff were warned by me that she was a fall risk but she wasn't moved from her single room into her ward until after the fall.

her lovely care home cannot take her until she can get back on the frame, assisted by two carers. Right now, this isn't happening.

They are still talking about discharging her but where?

If she goes into a nursing home, she will lose her place at the care home she likes.

Given that she fell on their watch, should they keep her in the hospital to give her a fair chance at being able to get back on the frame and then back to her care home.

I am very upset and would welcome any advice.

OP posts:
Mosaic123 · 11/04/2023 01:22

I hope they have made very sure she has no injuries to stop her walking after the fall?

Sadly, it might be a appropriate time to move her to a nursing home that she will never have to move from as she may become less mobile in future years due to the Alzheimer's if nothing else.

MereDintofPandiculation · 11/04/2023 08:53

They can’t keep her in hospital if she doesn’t have medical, ie nursing/doctor rather tHan physio needs

MereDintofPandiculation · 11/04/2023 08:58

Sorry, that sounded brusque. I suspect she may need to move on to a nursing home or a specialist dementia care home, which was going to happen sooner or later anyway. I suggest you do some research and have some say in the decision. There are lovely dementia and nursing homes around. Look more at quality of staff and of manager than at facilities.

BookmarksAreABoon · 11/04/2023 09:32

I just want her to have a chance at getting back on the frame-she could walk with it until she fell out of bed. I want them to try and put that right.

The home she is in now is just so perfect and she thrives there-the thought of losing it has left me so upset but, I know you are all right-she will lose it.

I want to clutch at at a straw-hoping that if she stays in hospital or a rehab bed for longer, then she might, just might, be able to get on the frame again.

OP posts:
NotLovingWFH · 11/04/2023 09:40

When something similar happened to my mum she went back to her care home. She didn’t qualify for a nursing home as didn’t need nursing. Why can’t her care home look after her ?

BookmarksAreABoon · 11/04/2023 09:45

It isn't set up for wheelchair users. They can manage if she is on a frame with two members of staff.

OP posts:
IthinkIsawahairbrushbackthere · 11/04/2023 10:24

Have they xrayed her back/hips/legs. My great aunt had a fall in hospital and broke her arm. Five days later when she was still refusing to walk they xrayed her again and found she had broken her hip.

I understand you wanting to keep her where she is happy but if they are unable to cope with wheelchair users it may well be that she will need to move at some point anyway. I hope there's a solution that you can be at peace with.

BookmarksAreABoon · 11/04/2023 10:26

Thank you all for your advice.

I appreciate it and it has calmed me down a bit. I'm on my own with it-my brother is estranged from her and my daughter lives abroad, so just being able to talk about it here has helped.

I hope I can be at peace with it @IthinkIsawahairbrushbackthere and thank you for wishing me that.

Off to the hospital now.

OP posts:
Words · 11/04/2023 12:04

Bookmarks- I had this exact situation with my mother a few months ago. It's so overwhelming, especially if you're on your own with it.

The hospital really must not discharge her if it's unsafe to do so, especially as she lacks capacity. Use the words 'unsafe discharge' and 'fall risk' in your discussion with the hospital, to buy yourself a short time to consider the options, bearing in mind there will be pressure to move her to free the bed. They can't discharge her without your agreement if she lacks capacity but pressure will be brought to bear.

Has her infection completely cleared? That often causes confusion and falls. How old is she?

You should also be put in touch with an adult care social worker, who usually in my trust area at least, acts as liaison between the various agencies.

Your mother should have had a proper assessment from a physio to try and get her mobilising again. She should also be referred to the falls team. Check with the hospital if any of this has been done. I would consider a preliminary discussion with PALS too as she fell whilst in their care having been informed she was a fall risk.

The problem with dementia patients is that bed rails are not recommended as they can cause injuries when the patient tries to climb over etc.

Wherever she goes after this I would look into having her provided with a raise and lower type bed that can be lowered close to the ground, then she can have a fall mattress to the side and foam blocks to support her to minimise the risk of injury.

In my area this equipment was ordered for installation in her care home room via a request from the hospital to the district nurse team as part of the discharge process. I am not sure if this equipment is available on a ward - I doubt it- but it might be worth asking.

Assuming there are no further undiscovered injuries as mentioned above, and if the physio supports it, they might suggest a short stay in a re enablement unit ( the trendy word for rehab).

If it's found she does need one to one care. Is she self funding? If so, look at the funding options. NHS continuing care might be a possibility, but won't I think cover all the cost. It's sometimes possible for funded one to one to be provided in a care home to fund the extra carers needed, but that depends on the home.

Have another discussion with the care home manager to understand their exact position on all this and why they feel they can't manage her. This may well be an entirely sensible safeguarding decision on their part but it's worth checking again what their thinking is, ( I don't quite understand the wheelchair point - a lot of oldies are in chairs but not completely compromised) and if there are any options you aren't aware of.

Have a look around at local nursing home options anyway. If she recovers and goes back to the care home it is still useful knowledge to have for the future.

The information above is learned from my own long and bitter experience with two sequentially ailing parents over a couple of decades . The processes ( which may of course vary somewhat from local authority to local authority) did not always work as they should have done. But I only knew that in retrospect.

Knowledge is power. Good luck, and look after yourself FlowersCake

Words · 11/04/2023 13:31

pS @BookmarksAreABoon - if you want to message me please do, but let me know on here as I nearly always use the app on my iPad.

Guardiansofthegalaxi · 11/04/2023 13:38

If she is medically fit, I would have thought she may be discharged to a community hospital for rehab until she is back on her feet again, to then be discharged from there to her care home.

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