Returning home from hospital - is this normal?

[christmascactus22]

DMum has been in hospital since before Christmas. Various health needs including dementia and delirium (which is slowly resolving, so fluctuates from day to day). There has been talk of her coming home from hospital, but no firm decisions have been made yet. Occupational Therapists have asked if I can be present in the house for two or three days 24/7 if she does get home to help re-orientate her as she has no memories of the flat, despite living there for two years prior to going into hospital. Dad will also be in the flat but has mobility problems. Is this normal to ask a relative to stay for a couple of days? They don't have a spare room so I will have to sleep on the living room floor. Does this indicate she isn't really ready to come home from hospital?

Don’t do this, went through this with my Mil, it will not sort it self in 2 or 3 days, they are just trying to get you to take over the care for her.

i know it sounds harsh and uncaring , but we took my Mil in for a week or two a six weeks later still with us, me working from home so it was considered I could care for her, I paid for my children to go to child minders so I could work. And get given a Mil 😂, joking apart, it would have been fine a week or two, but even after a few days it was apparent she expected me to wait on her hand and foot, wouldn’t/couldn’t even make a drink (unless she wanted to she could then, but that’s another story)

I took her for a weekly doctors appointment, and expressed concern at the wound on her leg not healing, he decided she should go back in for antibiotics drip. I know I sound terrible, but a week later when they tried to discharge her back to us , I refused. I had to be really horrible luckily I had DH support. She eventually went into a sheltered home, which was perfect for her.

I'm in Scotland.

As I understand it, she should have a Social Worker, and in these circumstances should not be discharged until a care package is in place. If they want you there 24/7 even for a few days, then I'd be asking for a 4 visit a day care package, and for other measures to be put in place - care alarm system, for example.

Do not have her home with you being there in place of a care package - or even, if it has to be 24/7, a short stay in residential care which may be more suitable.

You should not do this, OP.
You'll be the default carer, 24/7, before you know where you are.

Just tell them all that you can't do it. You must surely have other things going on in your life - why should you abandon everything else to go and live at your mum's house?

It won't be for a few days, either. You'll end up doing it forever, until she needs to go back into hospital.

Adding my voice to the no don’t agree. It’s just figures to them, one more discharge . Hooray box ticked. Popping in to see her fine if you want to but this is a backdoor way to get you to care as once she’s out it will take a crisis to get her back in. And that crisis could be her falling but is as likely to be you having a breakdown from the stress of it all.

There should be a social work team based at the hospital you could also approach @christmascactus22

www.mygov.scot/help-if-youre-leaving-hospital

Scotland here - I have some experience in this area.
Before accepting her home make sure a care package is put in place otherwise they will expect you/your dad to care for her. Make sure to state categorically that you CANNOT/WILL NOT be there to care for her and that your dad is in no fit state.
Husbands cousin is fighting at the moment to get a care package put in place for her dad who is blind, Diabetic & now on dialysis & they keep saying he'll be fine because her brother lives in the house with him - No consideration that he works shifts full time & you know - has a life !

I do think that having you there when she gets home may help with settling in but I don't know that you would need to be there overnight. You may find that when she gets home and sees the flat and your dad it will jog her memory.

Delirium is a horrible thing - Mother in law had it a LOT & once you've had it once you're more susceptible to it.

Honestly, don't agree to this, They tried similar with FIL and we found that if you appear to be a 'nice, competent family' then there's a lot of pressure on you to do the caring yourself.

The reality is that it's probably an unsafe discharge and once you've 'accepted' DM home then you'll be stuck trying to backtrack on that if it doesn't work out.

Please don't leave without a full care package in place, I know how difficult it can be.

Sorry, I should have been clearer. We have been told there will be a care package in place when she leaves hospital but although it will be four visits a day each one will be quite short - one 45 minute visit and the rest I think were 10 minutes. There was no care prior to going into hospital and we are told Dad doesn't need a carer because although he has significant health needs there is no dementia and therefore no requirements for a carer.

The OTs are taking her to the flat for a visit tomorrow so I will have a chance to speak to them then about what would happen if I said no. Or what happens if she doesn't settle at home.

Absolutely not.

I had this. Refuse to accept any discharge until a full care package is in place. They wanted to send my end of life dad home into the ‘care’ of my 9O year old mum. Immobile but she would be expected to take him to the toilet etc. They just want the bed.

He eventually died four weeks later in hospital still awaiting the promised care package.

If they have no spare room and you'll be sleeping on the living room floor, is that really sustainable/comfortable/okay with you? How old are you? I wouldn't sleep on the floor for anyone apart from my kids and even then I'd hate it. And I certainly wouldn't do it in this kind of open-ended scenario, where if things immediately go south you'll be stuck there until another solution can be found and that could be weeks.

I'm not sure your update is much better the 3 x 10min visits are literally welfare checks. Going from full 24hr care home to just that one good care call and some pop ins daily is quite worrying especially with dementia it should be a bigger package they can scale back on if she improves once home.

Do not do this. I have seen the other side, and it ends with the daughter having a mental health crisis and physically breaking down. If you are there, they will wash their hands of your mother. You will be a permanent carer until you drop. Do not do this.

Don't do it op. They will discharge her to your full time care under the illusion that you've moved in.

Do not do it.

Speak to them about a Red Cross 24/7 assessment

I was in much the same position with my mother who was living with me (also in Scotland). I had a full time job with shift work and after she spent time in hospital I refused to have her return home until a comprehensive care package was put in place. You have to stand your ground or it will all fall to you.

100%. I've seen so much during my own time in hospital. They will do almost anything to get the bed freed up. I saw this happen with one lady and she was left waiting ages and her family really kicked off. The care package she needed was then quickly arranged and social workers all over the place.
If you leave you'll be left waiting much longer and they won't prioritise as you will be picking up the slack.
I would be very firm about her staying put and ask every day when will the appropriate care package be ready. It is absolutely who shouts the loudest.

I'm an OT in an acute hospital with some input into a frailty ward and I would recommend not doing this. What happens if she doesn't settle, what's the backup plan? If carers are going in 4 times daily and something goes wrong they will send her back to hospital, if your there you will either be stuck there or you will be the 'bad guy' if you say you can't cope and she has to go back into hospital. I'd suggest that your dad being there should be enough to reorientate her and the carers there for practical things. It's not normal for you to be living with them so that isn't going to reorientate her🤷 I'd say that and that you have other commitments making this not practicable.

I have worked in this field OP. Have been in many multidisciplinary discharge meetings. I have never known this to be asked of a relative, though some do offer. Am in Scotland too.

For the reasons PP have said, I would not agree to this. Doesn't sound like a safe, sustainable discharge.

How likely is it that refusing would really destroy your relationship with them? They need you.

Refusing isn't being neglectful, it is holding out for a better solution ( one that can be sustained and won't lead to disaster).

we are told Dad doesn't need a carer because although he has significant health needs there is no dementia and therefore no requirements for a carer.

Well that's nonsense for starters. It's very common for people to need carers for mobility issues with no cognitive impairment.

And a 10-minute visit is no practical use whatsoever. It may be enough time to check someone is alive and hasn't fallen over or gone walkabout, but not to do anything else. I don't know what SIGN has to say on the matter, but NICE guidance specifies care vists must be longer than that.

What constitutes a ‘full’ care package? I thought, from reading on here, that it was 4 carer visits a day - which is what is being offered here. Should it be 4 x 45 minute visits - to actually allow some care to be delivered at each visit?

i totally agree with the pps. Scotland here also. The hospital wanted to discharge my immobile, doubly incontinent, demented MIL into the care of my FIL who was totally unable to cope. We had to coach him to state that he couldn’t keep her safe, no matter how much he wanted to. And SiL had to say over and over that she was unable to provide the level of care that MIL needed.

can you get your dad to see how this is not going to work, no matter him much he wants it to? That his wife is not going to be safe at home in this situation?

They did this to us. Sent mum home post stroke and bed ridden and unable to do anything for herself. Dad just wanted her home.
There was follow up care, a short time four times per day for a week or two, then it went to two per day. Then at five weeks we found out that to keep the package in place we would have to pay.
You won't be doing your parents any favours agreeing to this,you really won't. She was classed as having help at home when in reality it was me and I didn't know. I live a couple of hours away, work full time and have a family.
Two years on she still hasn't seen a doctor and there's no physiotherapists either.
The system is a joke. Don't get sucked in.

I've seen physios and doctors asking single women with broken hips and no family to ask their neighbours to care for them! When they say no they kick them out anyway. This was an ortho ward. A rehab should keep her until she can be home safely. There shouldn't be such an urgency for beds. But I guess there is everywhere.
Tell them straight you can't do it. Dad can't physically care for her so if that's what they say she needs you need a carer. If her dementia will make her need this regardless of when she leaves the rehab then there must be funding with adult social care.
I guess they could try and claim you must fund this yourself? What's mum's financial situation like? Is she on pip or attendance allowance?

Please, please , please DO NOT agree to this ............
I speak from experience - it's a way of social services passing the responsibility onto you and once you agree it's awful xxxx

Echoing everything everyone has said on here. I can’t stress enough the pressure that is put on a competent (almost always) daughter to provide full time care for elderly parents. Stand firm. Explain to your parents you love them and want to get the best care package. Keep using the words unsafe discharge to the professionals.