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Elderly parents
Original poster

Elderly dad in rehab

64 replies

Loopylou38 · 08/08/2023 14:40

Hi , my dad had a stroke in May and was in hospital for quite a while then caught Covid/pneumonia which has set him back with his recovery . I’m out of the country at the moment but he was eventually sent to rehab and I’ve been told by a relative that there isn’t much progress due to other health issues
He also has copd so his breathing is pretty much walking is very difficult .
Im returning home next week as the physio would like to discharge him on the 21st aug which doesn’t give us much time

i understand that they will need to put a plan in place but sadly he needs 24 hour care now prior to the stroke he was living independently.

I honestly don’t know where to start with all this it’s going to kill him being told he can’t go home his property is very small so doubt a carer could be there over night

secondly going home would be lonely as carers come and go, I’d love for him to go home but it’s impossible

how do I find a good care home ? The cqc and carehome.com are so confusing I just want the best for him
any advice please ? Can rehab discharge him if we haven’t found a place that we’re happy with ? Thankyou

OP posts:
EmmaEmerald · 08/08/2023 16:23

Is he self funding?

the most practical location is probably the place to start, then make calls. When I was calling around for my late father, I immediately rejected one place because the manager repeated, like a parrot, the importance of him eating meals with others when he was almost bedbound.

so once you start to make calls, you might find you take to some places and not others.

they will ask a lot of questions about his medical needs and see him in order to make their own judgement.

my mum is in respite care for the second time and that particular place made a good impression on us from the first point of contact.

Beautifulsunflowers · 08/08/2023 16:51

If he’s being discharged then the rehab place will have to look at the best discharge destination for him. If that’s a care home then they should be able to source one for a period of assessment. That may not be the place he stays in but from there you can begin a search for the care home you like.
Does your dad have capacity? What he wants needs to be taken into consideration too.

Original poster
Loopylou38 · 10/08/2023 18:43

Thankyou so much for your replies & advice
My poor dad said that he’d love to go home & what did I think
I gently said that he would now need to be cared for I’m so saddened for him
The OT’s have asked for photos of his home , I think that they need to physically go and assess it . I just don’t know what to do , my dads mobility has deteriorated, then there’s the catheter , cooking etc

We have a meeting with the rehab team next week I would love for him to go home but he would be house bound , I’m just wondering if there’s an ambulance that can pick him up to attend a day centre daily if he went home
My head is full of guilt and confusion over what to do for the best .

OP posts:
PermanentTemporary · 12/08/2023 09:09

In the teams I work in the OTs would definitely do a home visit. I think you should ask for this as they are clearly still considering home as an option.

The concern is if he went home would he be stuck in a 'microenvironment' - basically a bed and a chair and being moved from one to another each day? He might still prefer that to a home.

Ask for a video call with the OTs?

Choux · 12/08/2023 09:25

Wanting to be at home is really him saying that he wants to go back to how things were before the stroke. But if it has had a lasting impact on him that isn't possible. The reality is that even if he could manage at home his life would be very restricted and isolated. Would he really enjoy that?

You need to work with the rehab discharge team on the next options for your dad. But you could frame it to him as needing a care home stay to continue to improve and then can see if able to go home. If you find a place he likes being he might then realise that the social isolation in his own home is not ideal and he will by happier to stay in the care home.

I moved mum into a care home 3 months ago as my dad died. I got recommendations from the manager of the sheltered housing where she was living and visited them. They were very different in size, feel, manager's focus, activities and price. I decided which one I wanted for her (she has dementia) and then waited for a place. She seems to really enjoy chatting to the staff, other residents, the activities, the garden etc. She is having a nicer life than when she was practically housebound as dad was so ill.

Choux · 12/08/2023 09:29

Is he self funding? I assume so if he has his own home.

If you can say what location you are looking for a care home in then posters could advise on ones they could recommend or not recommend.

Choux · 12/08/2023 09:36

Also a word of caution about letting him go home with carers, trips arranged to day centers, overnight carers, people delivering his shopping, neighbour doing his lunch etc. it can be set up but what happens when something goes wrong with the complex support system that's been set up.

If you are abroad you can't sort it if there is snow and the groceries can't be delivered or his overnight carer calls in sick one night and the agency can't provide a replacement. And that's before considering what happens if he has a health issue eg UTI, flu etc and his care needs temporarily increase.

Medlady · 12/08/2023 09:43

My experience of a complex home care package is that it does break down - I was frequently having to abandon my work and fill in. I was so relieved when Mum went into a home, not just because of that but because I felt she was safer and happier with 24 hour company and checking

She didn’t want to go - we stressed it was for a short while only as she’d been very illl and needed nursing, but in fact she never looked back and stayed on.

AutumnLeaves5 · 12/08/2023 09:45

You could always move him into a care home for further convalescence - say a further 4-6 weeks. This would give you time to assess your other options and what the care home is really like. I think most care homes allow short convalescent/respite stays.

vdbfamily · 12/08/2023 09:48

It's there only one bedroom at home? A live in carer might be an option if he can afford it, and had a spare room, and has no night needs, and can be managed with one carer only.
I agree that the OT who knows him is your key link here and will explain the options. Photos will be a good starting point for OT and they will decide if home visit is indicated.

vdbfamily · 12/08/2023 09:49

The question about day care will again depend on what he can and cannot do for himself.

Original poster
Loopylou38 · 14/08/2023 08:01

Thankyou all for your advice , it’s so difficult , I have already been through this with my mum her needs were 24 hour care & she had dementia , she passed away 3 weeks into lock down the care home that she was in had a huge turn over of staff . My dad would be self funding although his property value probably wouldn’t last for the rest of his life as it’s a park home .

I fully agree that him going home would be a problem if carers didn’t show up as there’s only me as well . My dad was living independently prior to his stroke but Covid & pneumonia have knocked him right back with his mobility I’m mr sure that he’ll ever really walk again .
We have a meeting with the rehab team tomorrow as I don’t think that he’s making progress he’s exhausted all the time and is also scared of falling during physio .

Im so nervous that if they think a care home is the best option that they select a good one where he’ll be well looked after & would be encouraged to interact with other residents at the moment he’s refusing to do this at rehab he’s in a room asleep . I think they are planning on discharge in a weeks time
it’s all so stressful

OP posts:
cptartapp · 14/08/2023 08:24

I was a district nurse for many years and the quality of life of many people like your dad who insisted on or were encouraged to try at home was often poor. Services are limited and fragmented. And you can't ask neighbours to do lunch. What about your life and mental health? You'd be living on a knife edge. He won't want that for you.
Today is the best he is likely to ever be.
Think long term and make plans for a care home. Some are fantastic.

cheezncrackers · 14/08/2023 08:38

If he needs 24-hour a day care, then a care home is the only practical option, so please try and lose your guilt about it OP. You know his home isn't suitable and his care needs are such that he's going to need a hospital bed, hoist, wheelchair, adapted bathroom, etc, and it sounds like his home would be totally unsuitable.

I completely understand that he wants everything to go back to how it was - it must be heartbreaking to reach this stage of life - but the best you can do as his DD is to make sure he's safe and well cared for and reassure him that you'll find somewhere decent for him to go.

Original poster
Loopylou38 · 15/08/2023 08:27

Thankyou for your replies , I think I’m finding it hard to come to terms with the fact that his life won’t be the same again and agree he would be very lonely at home
I’m so nervous about care homes due to horror stories of neglect , how do I find a good one ? The home that my mum was in has flying colours on the CQC report but I didn’t trust nor like the place I once caught a carer holding my mum down on the bed as she wouldn’t cooperate with being changed .
My dad was with her every day tending to her needs he would arrive at the home around 11am then leave at 7pm .
We have a meeting this afternoon which he will attend as he has capacity I just don’t know how I’ll deal with it & mention care home

OP posts:
cheezncrackers · 15/08/2023 08:54

His life won't be the same again, but this isn't the same as with your DM, because she had dementia and he doesn't. Honestly, I think just try to be positive OP. He will need to be reassured, but at the same time, he's got capacity and can be part of the discussions and decisions. Talk to him about his care needs and the fact that his home is too small, that new equipment will be needed that won't fit, that he'll be all alone with a revolving door of carers at home and that managing that rota and making sure he's properly cared for will be really difficult if he's at home. The term 'care home' puts dread in the hearts of a lot of people, but there really are some nice places with kind, caring staff. My grandparents were in a really nice one that was warm and comfortable and the staff were efficient and kind. As a PP says - get a list of all the local ones and start ringing round - then visit. You'll get a feel for whether they might suit your DF or not. And talk to him about what you're doing and seeing - let him be part of the decision-making process.

LadyGardenersQuestionTime · 15/08/2023 11:22

Is he self funding or will the council be paying?
Have you considered a live-in carer?
Care home is no longer a euphemism for the workhouse you know - most are fine and some are like being on a lifelong cruise with hot and cold running food, entertainment, drink and excursions.

Mum chose to go into a care home and while she would rather have been at home she really quite liked it - sociable, safe, busy, lots of interesting lovely carers to chat to (she liked them better than the other residents). I visited very regularly and she came home to us several times a week.

Original poster
Loopylou38 · 16/08/2023 07:25

Hi , Thankyou all so much we had a meeting yesterday with the rehab team and social services , it’s been decided that because my dad has capacity he can go home
I would love nothing more than this but I can’t see how it’s possible he will have a hospital bed & transferring equipment put into his property he would have to contribute financially for carers after 6 weeks .

My dad does have slight confusion at times I’ve also noticed that he has cognitive decline ,
The physio isn’t going well so he insists on laying in bed . The rehab centre have tried their best with him but he declines he is also eating a lot less now .
If he went home the carer would get him up wash dress and put him in the chair where he would sit all day until bed time watching tv then they would come for the last time in the evening and put him to bed .
This is no quality of life for anyone he sleeps most of the time and I’m not sure if it’s due to what he’s been through or depression he doesn’t talk much

I don’t know what to do as I work and can’t be with him all the time

OP posts:
EmmaEmerald · 16/08/2023 07:33

What does he want? How is his mobility, might he need a commode?
The carers will have a lot of clients like him. If you would feel happier, could you arrange a private carer to go in at lunchtime too?

have a hug if you want one. This is so hard, I know.

Theeyeballsinthesky · 16/08/2023 07:39

Ah OP It’s so hard when this happens. I would contact your local Age UK & see if they have any visiting schemes where someone will come in & provide some company for him

Choux · 16/08/2023 07:53

Was there discussion on how he would go to the toilet, get meals and drinks, etc? Would he be able to summon help if he needed it between carer visits? Was a potential date talked about eg tomorrow, next week?

If these practicalities weren't discussed you need to talk to social services again. Mentioned you want to know he is safe and right now you haven't got enough info to be sure it is a safe discharge. Stress you have a job and cannot do much if anything during the week.

There may be an element of social services not wanting to pick up the tab so you should point out that he has a home he can sell and will be self funding. That might make them more open to suggesting a care home.

Make sure also that your dad fully understands the reality of what going home means - being alone for long periods and expected to toilet himself, make his own drinks and meals (if that is the case). It could be he has to try it to realise it is not really feasible. If so you need to sit on your hands and let the minor issues and problems happen rather than step in - hard I know.

Also try to get the GP to test his memory and check for depression and he will also note his mobility. The decline needs to be recorded in his medical notes and if he is referred for a full Memory Test that will also indicate to social services that capacity may be fading and y they may start listening to you more.

Rocknrollstar · 16/08/2023 08:04

If there is no bedroom for a carer you can get ‘sit up’ carers at night but they would have to be different from the ones there during the day. If he needs 24/7 care then he can’t be left on his own between carer visits. They won’t keep him in the rehab ward. The usual time limit is two weeks. My DM went home with carers four times a day but I had to be there most of the time between their visits and when I wasn’t there she would phone because she needed help. It sounds as if your father needs to go into a care home. Could you put him into respite care while you find the right one for him?

Choux · 16/08/2023 08:27

@Rocknrollstar the OPs dad is deemed to have capacity and wants to go home. So currently OPs view that a care home would be better is not relevant.

Either dad needs to change his mind and agree to a self funded care home or social services need to decide he doesn't have capacity so his wish can be disregarded and a care home is what he needs.

Choux · 16/08/2023 08:28

@Loopylou38 do you have POA? If not you should get it organised before anyone says he has lost capacity.

Hairyfairy01 · 16/08/2023 09:06

I agree with trying to get POA if you haven't already. Many people live in their own homes' immobile with 4 care calls a day. Obviously it's not ideal but your dad has capacity and that needs to be respected. Sometimes places like Age Concern offer a befriending service. You could also look into trying to get him used to an Alexa and a tablet / iPad if he's not already.