Hospital discharge and care

[PinkSparklyPussyCat]

I hope it's OK to ask here as it's my Uncle rather than my parents. He had a fall last week and has had to have the hip replacement he had done 4 years ago repaired. We don't know when he'll be out of hospital but I know he'll need carers. He has a partner who he was caring for before this but he's not going to be able to do that for a long while, if at all.

I haven't spoken to anyone at the hospital yet but I understand that he will be entitled to a 'reablement' care package when he's discharged. He phoned me yesterday and told me that as his next of kin it's down to me to arrange. I asked who I needed to speak to and he doesn't know.

Can anyone give me some guidance about what happens next? I will do what I can for him obviously but won't be caring for him or his partner so something needs to be in place but I don't know where to start. Will the hospital contact me? Will I have to go to any meetings (this could be difficult because of work and the fact he's not counted as a close relative)? DH is happy to help but I'm listed as next of kin so I don't know how much he can do.

Thanks in advance for any help and advice

Contact the ward and ask them to assign a hospital social worker to your uncle. They will take it from there. The social worker will work with physios to ensure a safe discharge. This will involve them visiting his home. If is is unsafe they will arrange the care package.

They will also contact his L A elderly care department. Usually there is six weeks free care after discharge. Do you know if he had POA.

You don't have to do anything if you don't want to unless you have poa and he lacks capacity. He will be assessed by the doctor, nurse, therapists and a social worker who will see what help he needs now and during his recovery. He then either agrees to go to either a rehab unit if they feel it would be of benefit or back home. They can arrange a home visit to see if he needs any equipment which they should supply. The ward will have a discharge co ordinator who may oversee everything. He may also have a financial assessment to see if he has to pay for carers. Is someone looking after his wife now, she will need a care needs assessment to from her gp or social services. Next of kin has no legal meaning really so don't worry about having to make decisions on his behalf.

He’s wrong. Next of kin has no legal status; there is no onus on you to do anything at all. It may have been hoped/assumed by the staff or him that you would, but you don’t. In the spirit of helpfulness can you visit at all? If so ask about the ward/hospital discharge team arrangements. Reablement is generally free, and it’s up to the hospital to sort it out.

Thank you for your replies. I'll try to answer the questions

1. I don't have POA for him and as far as I'm aware no one else does
2. His partner's children are taking it in turns to stay with her
3. I'm happy to visit and I'm planning on going tomorrow evening with DH. I haven't been able to get there this week due to road closures (flooding) and not being well but I've spoken to him every day

There is an added complication (that I forgot, sorry) as although him and his partner have been together for years they have their own separate houses. He spends most of his time at hers, especially since she has been getting frail, so he would want the care at her address and not his.

I'm happy to do everything I can for him but, as much as I love him, I know he will try to get me to do everything as he's incapable of making a decision. He was executor of DM's will and refused to deal with it so I had to. He's been like a second father to me so I'll do what I can, I just won't get taken for a mug!

Hopefully I can find out who I need to speak to tomorrow night, if not I'll call the ward in the week as I can only do evening visits.

There's always a complication isn't there, what will he do with his own house longterm. She will have to agree having any home visit, equipment or carers at her house. Is she and her family happy with that and what happens when one of them needs a carehome or dies, has she got poa in place. Does she need a carer too if he can't manage, can he make a decision or just doesn't like to. You cannot be expected to act on her behalf, he needs to sort that out with her or her family. Just see what the hospital say first.

I know, it's complicated! She will be happy to have the equipment etc. at her house, she did it when he had his original hip replacement. Her family think the world of him so I can't see a problem there. The houses are opposite each other so I think the plan is for him to carry on going back to his own place now and then, although I don't know if that will be possible. It's not something I want to bring up at the moment. They are thinking of having private carers in the future, I've been told I can arrange that as well! His partner's family are happy to help me on that one and we did have carers for DM so I know a bit about that.

I should have said, he's perfectly capable of making decisions, he just won't! He's the most on the ball 89 year old that you could meet, he knows exactly what's going on, hearing and eyesight are fine - it's not that long ago he was dancing in my front garden!

It's all a bit of a shock to be honest - he had his hip replaced 4 years ago and had a new lease of life. It turns out that the cement had crumbled and the joint was loose which was part of the reason he fell. As I said I'll do whatever I can for him, I just need to watch the crafty old sod doesn't take me for a mug!

He sounds a real character.

he's perfectly capable of making decisions, he just won't!

In that case, PoA is irrelevant - thr health one only applies if someone doesn't have capacity.

You can act on his behalf if he gives permission, but are not obliged to.

The hospital discharge coordinator is the first one to speak to. They will be able to give you an idea of timing and details of who else to contact. Before discharge will need an assessment of his own capabilities (occupational therapist/physotherapist tests organised by and carried out in the hospital) and an assessment of his home so see what equipment and adaptations are needed. Again this will usually be organised by/through the hospital in conjunction with social services. And 'his home' for this assessment will be the address he plans to be discharged to, so needn't be his actual house.

Reablement packages are free and not means tested. They last at least 2 weeks, and can be up to 6. If it's home care it's usually either 2 or 4 visits a day, depending on need. (It may also include physiotherapy but that depends on need and area.) After that he will need to pay for private carers to come in if still needed, unless he's below the savings threshold.

I've just had a call from my Uncle and he's going to be moved to a community hospital for rehabilitation when a bed is free. It's the same one MIL was in and they were great with her and got everything in place for when she went home. This is a weight off my mind as at least they're not planning on sending him home before he's ready

That's great news, hopefully he will be assessed there and home soon.

That’s an excellent result this happened to my uncle after a stroke and it meant he was able to self care when he finally got home. Try not to get too sucked in!

Thank you for all your help and advice. I wasn't expecting him to be I hope I didn't sound as though I don't want to do anything, that's definitely not the case. I just want to make sure he gets the care he needs and I don't get pulled into things that I shouldn't be doing.