Advice to resist pressure for discharge of MIL to my home

[Weaktea]

I’ll try to be brief. I’ve cared for Mil at my home for 5 years. Now severe advanced dementia and stage 4 cancer, incontinence she’s 92. A recent fall has left her with a broken foot and she’s on day 9 in hospital.
she is now completely delirious but they have said medically fit and need to have a discharge plan. Would I have at her my house? I’ve said no. They Mentioned hospital bed downstairs, hoists and visits from carers.
she used to have a little
mobility so I could just about shower her but they don’t think she’ll regain mobility.

i was at the end of my tether anyway, they have said they will refer to social services which I welcomed.

what can I expect or push for?

thanks!

Under these circumstances I would have thought MIL should be discharged to a nursing home tbh.

Simply say no, she cannot return to the house. Say it is an unsafe environment not fit for her medical or physical needs.

Discharge to nursing home. It's a heavy mental and physical burden for you to care for frail MIL with those health conditions on your own, even with carers coming in.

I’d just continue to say no. There is no way you can manage. I’m sure they can discharge to a care/ nursing home. It all comes down to money/ budgets and you are the cheap option

It’s a sad fact that at some point caring for someone in your/their home becomes impossible. Keep saying no to the hospital. You are no longer in a position to help. SS will try and guilt you into continuing the care. Say no every time.

If you are not able to cope with her at home then yes you are within your rights to say no. It sounds like social care involvement before now would have been a good thing too.

Have they spoken about applying for Continuing Health Care funding for her to have residential care? It sounds like she may be eligible. The hospital can start the assessment - https://www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/

I’m sorry to hear you’re in this situation OP. You need to ask that she is properly assessed. This will determine her care needs and, if advanced dementia, she may need a specialist care home.

You’re entitled to the formal assessment and it’s essential to keep your MIL safe and find the right provision. Refuse any other pathway as they will find any excuse to discharge back to you due to pressure on services unfortunately.

I agree, discharge to nursing home will provide the level of care needed.

Being nice, you were already at the end of your tether when she had a little mobility. Changing beds for someone who has no mobility and is incontinent is going to be very hard work.

Unfortunately, the NHS is under stress and they will try to bully you into a situation even they know is unsustainable. Years ago my mum was having falls, needed to be lifted. Hospital wanted to send her home to my elderly dad who couldn’t lift her. I wasn’t driving due to C-section, two siblings away and third lived 30 miles away and didn’t drive. When we refused to accept her home we were threatened with social services, we told them to do it! Once siblings were home from holiday and available to lift mum, we were happy for her to come home.

Why are you having to deal with this, are her children / next of kin not around?

Stand firm and prepare for pressure. Consider what you want to say and repeat it like a robot. You also need to make sure that DH/other family in the house do the same.

Be prepared for random calls in the morning to say "as agreed MiL is coming home today" and tell them that she cannot be discharged to your home, there is no such agreement, they need to correct their records and you will be out.

You cannot cope with providing this level of 24&7 care with a couple of brief minute drop ins from carers. She needs professional care at this stage for both your benefits.

Just keep saying no, you cannot manage this level of need at home, and you will not as you were already unable to manage and at the end of your tether.

Say yes, refer to social services.

Say the same to SS, and emphasise your MH to them as well as the level of need. Say that quite simply you are unable to house her any further.

They need to find her a nursing home place.

Really sorry you are in this position, OP, you have done so well to get this far with her at home.

@Weaktea nope, nope, nope!!! impossible for you to carry all that!! she needs nursing care not home care!!

I was about to ask why was her previous care down to the OP - where is the MIL's blood family in all this? Why should it have been down to the OP?

Nursing home as above.

Does she have any savings and is she likely to be self funding? If so and if you have poa then you can just go ahead and start arranging it. If she has no savings then just push back on social services as above.

I'm presuming OP is married to and living with mil's son, who is her blood relative. But we'll know care often falls to women and tbh most sons aren't (and shouldn't be) doing personal care for their mums. Most women would prefer another female to be helping them bath etc.

Agree, you have to refuse. Say you do not have space for a hospital bed downstairs or hoists. They haven't seen your house so they don't know. Say that you have back problems so are unable to lift or assist her in any way.

She sounds unfortunately in a bad way and honestly she needs a more professional set up. So you are honestly doing the right thing by refusing

A long term care home would be better for you both. If there is a good one near you that could be the solution. You could visit as often as you wanted to and less chaos for everybody. You've done as much as you can, but this is the time for her to be in a place. You were right to say no. Good luck.

Thanks for the reassurances. I will just keep refusing then. They have mentioned the possibility of an NHS rehab hub which might be a good option.

yes I am married to her son but do all personal care myself.

i don’t think we’d get continued nhs care, given that she’s ’medically fit’. From what I’ve read you have to be all but dead.

Perhaps but you'd think blood children would be in charge of responsibilities regarding their parents finance and care, power of attorney?

Ok.. your mil is absolutely not fit for discharge if she has a hospital acquired delirium. If its her dementia that is a different story. It sounds tbh like she needs a care home to meet her needs, no way should you accept taking her home with a hoist etc. she needs a social work referal now. Im presuming you or your husband have POA. She likely wont qualify for a rehab bed as to put it bluntly she has no potential to get much better.

It will fall to you as a family to find her a nursing home, the hospital absolutely will not do this. You should start looking at ones local to where you need

@Nap1983 her dementia is bad but she definitely is now very much worse and nurses agree, delirious. Should this keep her there? Can it be treated?

My DH is in charge. he just doesn’t mumsnet

Steel yourself for possibly having to chase social services and play hardball with the hospital, but don't budge. (I went through something similar with my dad).

Also, she might well be eligible for continuing health care, but brace yourself for a long and arduous process. It would be likely you'd be refused the first time at least. Also they will try and talk you out of applying for it, telling you you won't get it etc. There are some lawyers who specialise in sorting it out, which might be worthwhile if you have the budget.

The hospital just called to grill me about our house and what adaptations I have, how I was coping and how she was before the fall. I was truthful but I’m not sure I’m playing this right. Woild I better saying everything was fine and I’ll only have her back if she’s made fine again? I feel like I might have made it seem like I’m well equipped to deal with this…. Already feeling the pressure!