Mum in care home temporarily

[Metoo15]

Hi. Mum had a long stay in hospital after becoming confused and feeling ill. She’s 92 and has been in the care home 4 weeks. The social worker is going to see her next week to decide if she needs to stay,or if she could be moved to extra care housing, or go home.
Mum is so much better is putting on weight and walking much better. I’m afraid the SW is going to send her home, but the main problems are still there, she has postural drop which has
ended up in 3 very bad falls, she’s slightly confused and has occasional hallucinations. Apparently the LA can’t afford to put every one in a care home because of these problems and she’ll be looking for a cheaper solution !
I’m so worried. She wouldn’t be able to manage at home she had carers 4 times a day before her hospital stay. How can I navigate the meeting with the sw. I haven’t got POA so apparently it is her decision whether she stays or not.

If she’s fit to go home, is she fit to sign POA?

You can flag it as an unsafe discharge.

Apparently the LA can’t afford to put every one in a care home because of these problems and she’ll be looking for a cheaper solution

Who said that to you?

If she meets the criteria for residential care then she meets the criteria.

Does 'home' belong to her or is she a tenant?

The care home staff will advise what her night time needs are and if she is at high risk of falls. These are the things that often make the difference between needing a care home and not.

It isn't the social workers decision if your mum has capacity to decide what she wants to happen and the funds to pay for care herself.

Tell the SW you will be stepping back and withdrawing any previous input and support which was no doubt propping up the situation. Think long term. No shopping, no cleaning, no running errands, no visits.
And don't falter.

OPs mum has already been discharged to a care home.

This is how Discharge to Assess works - the hospital discharge to a care home and the NHS pays for it for 4-6 weeks.

During this 4-6 weeks Adult Social Care are supposed to complete all their assessments and help families make the longer term decisions about if a care home remains the right place or if other less restrictive options such as home or extra care housing would be more appropriate.

A financial assessment is also completed and if the person is able to pay for their care themselves they are free to choose whichever option they want. If the state is paying or contributing then the state gets to make the decision about how public money is best spent.

That doesn't mean that people who need residential care are denied it but it may mean they are provided it in the cheapest option available to the council at the time.

If she owns her own home it can be sold to pay for the care home fees. At 92 and with her other problems I really do think she would be better off being properly looked after in care.

She hasn’t got a dementia diagnosis although her GP thinks she has vascular dementia. She hasn’t had a memory test yet although the care home said their Dr would like to do one.
She lives in a LA over 55s first floor flat and doesn’t pay rent the care home would be LA funded. It was the SW that said there was no money available for care homes, but I can’t see an extra care home would be any cheaper? She said to have a look and see if there are any local to where we live.
I know it sounds selfish but I’m late 60s and the thought of having to support her at home again are stuff nightmares are made of ! It’s keeping me awake already.

The reason she’s doing well now is because she’s being looked after in the care home 24/7 and she’s getting all her meals prepared and staff check she’s eaten, so she’s put on weight. If she were to go back home tell SW you feel it wouldn’t be acceptable to send her home, as she wasn’t coping before. It’s bad that at 92 she can’t stay in the care home permanently. Also ask the care home manager her thoughts as SW should take those onboard.

In my experience SW’s will leave you doing the care, so you have to say that you won’t be doing any if she goes home. No shopping, no popping in to check on her, no accepting phone calls if she falls. Pull right back. You have to let her fail to get her where she needs to be.

It was the SW that said there was no money available for care homes, but I can’t see an extra care home would be any cheaper?

Its 'cheaper' because the rent/housing costs for extra care come out of the housing budget as housing benefit rather than the social care budget. Cost to the state is the same but the social care budgets are under immense pressure.

Regardless, unless the social worker has already completed the assessment they shouldn't be making any decisions about what care is needed or basing their decision about care needs on financial reasons. If residential care is the the assessed need then it should be provided.

If the social worker feels she can be moved out of residential care then they need to make all the arrangements to make that happen. They absolutely can't make you start looking for extra care housing placements and sort it all out.

Just be clear in the meeting that you don't agree her needs can be met outside residential care and that you won't be facilitating it to happen. If they want to go to the effort and take on the risks of moving her into extra care/ home then that is their professional responsibility.

Thank you all so much it’s good to talk it over. She’s has 12 hospital admissions during the last four years mainly heart related, two heart attacks and three major falls resulting in long rehabilitation stays . She must have cost the NHS a fortune. I feel we’d be straight back to the same old situation very soon.
But of course that gets the council off the hook but just passes the buck to the NHS.
Mum has done well in the care home, your right, she is thriving, she was only seven stone when she was taken in hospital, through staying in bed all day and not eating and drinking enough. Impossible for me to manage, she’s very strong willed and wouldn’t change her routine for me or her carers .

OP I'm sorry I suggested an unsafe discharge when your mum is already in a care home. I was getting you mixed up with someone else.

You may find this thread illuminating:

https://www.mumsnet.com/talk/elderly_parents/4967638-so-bloody-exhausted-waiting-for-someone-to-die-2

As another poster said upthread, get the POA done as a matter of urgency, before there’s any dementia diagnosis, many solicitors will do a “home visit” so you can get it done while she’s in the temporary care home.

Also as has already been said, push it right back to the SW…you cannot and will not be involved in caring for your mum. The SW budget is not your or your mum’s worry, but appropriate needs based care is her right

hatgirl. Thank you I understand now I had no idea, about funding. It took a while to find this care home I looked around five others. The thought of having to look around extra care facilities fills me with dread !
I think I need to be less available the sw does put a lot on my shoulders and I’m exhausted. I haven’t been able to relax yet, I’ve been visiting a lot to help mum settle and she seems to be getting there.
I’m pleased it’s their decision if they decided to move her. But what if they send her home again. It’s an awful worry.

You don't have to. That's the point.

I completly disagree actually.

LPOA is probably pretty useless in this scenario. It doesn't sound like the OPs mum has any assets so the financial LPOA will just be a pointless expensive waste of time as managing her money sounds like it could be done through a normal (free) DWP appointeeship.

The OP could perhaps get Health and Welfare LPOA if her mum still has capacity to give it, but at the moment its in her interests NOT to have it as holding it legitimately puts the ball entirely in her court on decision making for her mum.

That is all well and good if you have the funds to back up the decisions you want to make but it doesn't sound like OP or her mum do have the funds to pay for residential care privately if the state say she isn't eligible for it through them, so having LPOA would make OP responsible but without the funds to actually facilitate the decisions.

At the moment the OP holds all the cards even if it doesn't feel like it. She has no legal responsibility to make decisions about her mums care which means the state must make and take responsibility for those decisions. If they try and push it on to her she can push it right back.

I am 69 and in your position exactly with a beloved mum of 91. Mum owned her own home and private carers attended 4 times a day on a LA payment plan I fought for meaning mum paid only a small percentage. BUT lots of other things came my way, even if just a light bulb failed - carers do not change lightbulbs and I would be telephoned to attend.i am a widow. I have three siblings . None would assist. Then I got pneumonia, possibly due to being run ragged by the situation. My hospitalisation resulted in the loss of the support I provided and mum was moved to local authority care home. Her house was sold to pay for this but she is safer and better. You have to withdraw your support, but I just couldn’t do it and became ill myself which resolved matters

Isthisblocked. Hi there such a similar story to my own. So sorry you have been so poorly but I can fully understand how it came about. I’m an only one and the guilt is just terrible I know I should withdraw my help but goodness, how awful it all is. I’m an anxious person anyway but this is pushing me to my limit Christmas has been awful this year.
My poor DH is very good but at 70 wants us to have our own life while we can and I don’t blame him. We’ve had holidays,but for the past ten year they’ve been spoiled with worry and lately by calls from the carers.
I’m so pleased your mum is being looked after and you can therefore look after yourself, but so sorry it ended with you being so poorly. Let that be a lesson to all of us carers.

If the OPs mum is receiving housing benefit there is no fee for registering POA (which isn't a lot anyway) and you don't need a solicitor, many people complete the forms themselves so it could be done at zero cost. DH found it invaluable for sorting out his mum's affairs, cut through any aggro, and she was in a similar financial position.

You need to arrange a professionals meeting to discuss the next steps - this should be held at the home your DM is currently in, with her key worker or care home manager, social worker, OT/Physio, yourself and your DM.
Tell the SW that you want the mental health team to assess DM for capacity beforehand. Make sure you take all the notes made by carers who supported her when she was at home, and ask for her hospital notes to be available, showing the state of her health upon admission to hospital.
Make it very clear now that it is unsafe for your DM to return home. I dealt with my stepfather’s SW via email - that way I had a record of all her recommendations. It’s very concerning that the SW has said there isn’t enough money for DM to be in a home - this is very unprofessional. If the info from professionals is not available at the meeting, then postpone it there and then. Do not let the SW railroad you! It took 3 months before we had all the info for my DSF whereby it was agreed he had to stay in a home permanently - the SW kept assuming I’d look after him but I made it very clear that wasn’t possible. ‘There is no one to look after him in his home’ became my mantra.

I didn’t have POA for my DSF but was down as his point of contact. My views were very much listened to.

hatgirl. Thank you you’ve just put into words my feelings about LPOA . I do think it’s useless at this stage. I am now an appointee which was quickly sorted out.
I’m pleased I don’t have to make any decisions it’s actually working in my favour. I’m now ready for the SW I’ve made some notes, and I’ll be leaving it up to them.

It was admin stuff. Sorting FILs (not very big( pension so his mum got the surviving spouse bit was a nightmare until he got the POA sorted so he could confirm it could still be paid into exactly the same bank account that had been joint and was now in his mum's sole name. She ended up being paid 16 months backdated.
It's the stupid things you don't even think about in advance. When MIL had her stroke she was in one of those book clubs that send you a book a month. FIL had a nightmare cancelling that because there was no POA. It was that made him set one up for himself. He didn't sort it for MIL because she wasn't expected to live very long but in the end she outlived him by nearly 18 months. When she went into the care home when he died we couldn't get the LA financial assessment sorted until we got her POA done and all the time they were billing full fees that were going unpaid. We knew she would only be paying in the basis of her pension but it was extra unnecessary stress getting a monthly statement that was well over £30k by the time we could access bank statements.

That’s interesting and not my experience at all. I was able to deal with the finance team at the LA, I had his bank statements which came monthly to show his financial situation, I was able to have his state pension paid directly to me so I could pay some of his care home fees. The only problem was I couldn’t stop and direct debits from his account and his private pension provider couldn’t speak with me, but were very understanding. He had a credit card debt of around 2K which the CC company wrote off once the social worker provided a letter to state he was now in permanent care.
I did end up applying for Guardianship as he has property that needs to be sold.

TheShellBeach. No worries. Thank you for the link.