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!

She may be medically fit for discharge - ie: no longer needs to be in a hospital bed, but that doesn't mean you can cope at home with her level of care needs.

Put your foot down. Don't let SS browbeat you into discharging her into your care. All they want to do is save money by foisting her onto you. Say a point blank no, and that it would be an unsafe discharge.

The hospital and/or SS should arrange for the discharge team to do a care needs assessment. Do not under any circumstances say that you can cope in any way. They will have to find an interim rehab care place for her (late MIL was in one for two weeks), whilst they find a care home place. Again, it is not your responsibility to find a care home for her, it is theirs. You and your DH will have to refuse to co-operate in any way, even if they offer carers coming round to your home several times a day.

Just say no.

You should have told them it is irrelevant because you can't have her home again as you simply can't cope. And refuse to engage more with them. No - of course you shouldn't have said everything was fine - and she can't be made 'fine' ever again, sadly.

Do NOT accept her coming back to your home - tell them it will be an unsafe discharge, because you cannot cope any longer

It's is hard to say 'no' because our instincts tell us we are being selfish and we don't want others thinking we are!! But you need to do it and stand firm

You need nerves of steel for this bit OP. Tell them she can't come back no matter what kind of manipulation they try. Just keep repeating yourself throughout the guilt trip.

Not sure why you're dealing with this though.

Hospital acquired delirium is a thing. It can improve once the person is out of hospital. So they’re right to want her out of there. Just not back home to you

Just say no. My stepfather lived with us until he lost a leg due to diabetes. SS wanted to send him back here but we said no. He wouldn't be able to get around from room to room in a wheelchair and I wouldn't have been able to deal with the physical needs of a 90 year old man. He stayed in hospital until they put him in a care home, and died 6 weeks later.

Thanks for the further reassurance and info about delirium, makes sense as I do know hospital is making this worse.

I’ll ask about continuing care, worth a try. There is a care home close to us that takes council funding so I’m going to give them a call.

I know logically I’ve already done more than most but do still feel guilty, she’s so distressed and is crying to come home when we visit.

If I knew she just had her last few weeks I might relent but she’s weirdly medically fit, perfect blood pressure etc. she could lay there for years and I can’t give up any more of my own (and my aging DHs) life.

will keep you posted

I agree the best thing is to say you were struggling before and with her reduced mobility there is no way you can care for her now. How did the fall occur? If she has dementia, advanced cancer and is incontinent that is a lot of care needed. How old are you and your DH?

Op, I had a family go through a bear identical situation. You have to tell these people your MIL absolutely cannot return to your home and you must stop talking to them about it. They have no right to grill you or coerce you into providing more care. Stop talking to them and let your husband discuss with them where they will place her.

"Thanks ever so for locking down for us. Now we want to drive you into an early grave so we can free up our beds"

@Weaktea watch out for the 3am discharge. Ive seen other Mners get caught out by this one. They discharge in the middle of the night to try and force you.

Or the ambulance transport just turning up at your home with no notice

@Weaktea - don’t ring around looking for care homes. It’s harsh but you must wash your hands of any responsibility for your MIL - the hospital and SS will sense a weakness in your resolve and exploit it.

Refuse , we had the same situation with my dad , he had literally spent the night delirious and fighting with staff due to water infections to the point he had to be restrained yet a few hours later he was deemed fit for discharge back home where my mum would have been unable to cope

OP it must be really tough. But honestly, your best way to fight for MIL to have the best care from here on in is to resist this.

It probably would make you and your DH feel better to research options yourself? Do this and you can start presenting them with what you think would be best for her - rehab, local care, whatever. Find out what’s on offer. She does need out asap as it sounds as if hospital isn’t helping. But NOT to your home.

Folk are right that they will try and spring a discharge on you. A neighbour was coerced that way as the ambulance just turned up. No warning.

Tell them you will not discuss it, you cannot provide care and consider it a safeguarding issue. Tell them that if they discharge without warning you will absolutely not accept her and will make an immediate complaint. Make it clear they won’t get anywhere bullying you - not because you don’t care but because you DO and you are fully prepared to fight to get her proper care, even if that means literally refusing to open the door.

It sounds insane I know but seriously, they are so cash strapped that they absolutely will fight dirty. It’s really sad but it’s reality.

Been there.

All the advice on here is exactly right. Put simply, the hospital and SS just want poor MIL ‘off their books’ As long as you’re ‘coping’ it isn’t their problem. We had to be extremely assertive in exactly the same situation. Whilst MIL wasn’t in advanced dementia, she was very incontinent and our house was totally inappropriate for her physical needs. They had everything planned about how we were going to adapt our home without even getting our agreement!

I would also strongly urge you to record or write down everything that you are told/asked plus the date/time and the name of who spoke to you. We had a lot of double crossing by different team members who tried to suggest we had agreed to take care of MIL and then changed our minds. I was able to quote back on quite a few occasions the actual conversations and it surprised them that we were being so meticulous in our record keeping so they eventually gave up trying to obfuscate any arrangements.

Sadly, a lot of elderly and/or confused patients talk about ‘going home’ Quite often they are talking about somewhere in the past and not literally their current house. If you get the chance, gently ask MIL where ‘home’ is. I suspect she’ll refer to a place from decades ago.

It’s truly horrible - I feel for you as you are made to feel like you are abandoning your MIL, but have faith that this will ultimately get her the best possible care without you sacrificing your physical and mental health. X

Folk are right that they will try and spring a discharge on you. A neighbour was coerced that way as the ambulance just turned up. No warning

Yep Not the first time ive heard of it which is why i mentioned it
Despicable

At 92, with dementia, delirium, falls and advanced cancer I'd be expecting this to go through NHS Continuing Care Fast Track funding.

If they aren't doing that I'd be very pushy asking why not.

With the tech we have today i would be secretly recording any meetings to pre empt lies and gaslighting.

The emotional blackmail we were put through during Covid has backfired in a way because more people recognise emotional blackmail and guilt tripping for what it is now.

You're doing the right thing op x

Gosh some of these warnings! Thanks for the heads up, I can be quite the push over so appreciate being forewarned very much.

its the OT team pushing. I’ve only spoken to one Dr, she was lovely and very reassuring that MIL would be with them a while as a break takes weeks to fix so I really thought I had some breathing space.

I also have a long awaited holiday in 4 weeks and I will not jeopardise that, the normal respite place would not entertain her now.

thanks for the suggestion to take notes, good idea. I’m starting a diary now x

Is that legal?

Use the phrase 'unsafe discharge '. Contact SS yourself, hospital communication with them not always good, and as an ex SW I know hospital consultants have discharged patients without letting SS know, to free beds. And sending people hone doesn't necessarily save SS money as care packages at home can cost more.

It is legal. However it's much easier to just say you want to record and put your phone on the table at the beginning.

Has happened to me a few times in family meetings, doesn't bother me and I'd rather everyone be open.

This.

I did the honourable thing and asked if I could record a meeting with the agencies. I was told absolutely not, but when I asked for minutes afterwards, there clearly weren’t any and when I upped the pressure, it was obvious that someone had tried to cobble together (and fictionalise!) what was actually discussed.

To this day, I regret not just putting my phone on record in my handbag as some of the things that we had allegedly said or agreed to were so way off the mark, it was clear DH and myself were being gaslit by TEN supposed professionals! It was genuinely quite alarming that they were prepared to close ranks like they did.

That’s shocking!