Home 'assessment' help/questions/feasibility

[SickFIL]

NC due to family dynamics. Step FIL, 82, had a stroke 4mths ago. Rehab staff are requesting MIL has a home assessment. They obviously want to get him out ASAP. My concern is that he cannot stand, walk, toilet, wash nor move one side of his body at all. He can talk and just feed himself with 1 arm- but do little else.
MIL believes the assessment will provide a free adapted bathroom and some sort of home help, but I doubt this is the case. They aren't rolling in it, but I doubt they'd quality for any free help.

My question is- How long can someone stay in rehab? Is there a set timeline? This is at an NHS hospital, but I think its a 'rehab' ward

• Am I correct that any home help would only be for 6 weeks?
• What findings in a home would make it unsuitable? There is a downstairs toilet, but it would need significant modifications to make it a wet room with a shower to fit a wheelchair/hoist.
• If he moved to a care home and MIL stayed in her own home, how would funding work? Would she need to sell her home and downsize?

What savings do they have?

Once there is little to no likelihood of further recovery the hospital will need him to be discharged. Given his needs it sounds like a choice between residential care or home with maximum package of care visits, but a lot will depend on their financial situation and therefore whether they will be paying for their own care or be funded by the council.

While MiL is living there, the home will not be counted towards the funding calculation.

Here it's 6 weeks free for carers then you need to pay, but that is capped. How is he transferring at the moment? Stedy, hoist? They'll be looking at the size of rooms, turning circles, doorway widths etc. most likely they will be looking into where a bed can go downstairs. Intially he will be expected to 'strip wash' with carers helping. Longer term social services may be able to help arrange a wet room, funding for this depends on their savings.

It may vary in different parts of the country, but IME the home assessments are a precursor to sending someone home. There will be a separate package of carers. (20-30 mins, up to 4 visits a day, depending on his level of needs). They are usually free for the first 6 weeks then charged if you have more than £23,000 in savings.

The home visit assesses the house so that appropriate equipment can be provided - a hospital bed, a commode, an electric bath seat to lower him in the bath, ramps to get in/out of the house . . . . All free. One of our neighbours did get a wet room installed, but that had to be paid for, though it didn't have to be paid all in one go. Monthly instalments were set up.

The most important advice is for your mum to be really realistic about the help your dad needs. She should make it clear that she cannot do X or Y - she will need help with that.
HTH

And yy the house does not count, just savings . . .

Thank you everyone. Some great tips and help. I sure they have more than £23,000 in savings so would be paying for care after the 6 weeks.

The most important advice is for your MIL to be really realistic about the help your step dad needs This is the issue- I really don't think she is has any clue of how draining and difficult this will be. Not only modifying the house, if that is even possible, but MIL isn't well herself. I'm also unsure is he will ever be able to stand/walk- when 4mths of physio has done nothing so far. 😔

@Hairyfairy01 He is being hoisted from bed to chair/commode.

Does he have capacity to make discharge decisions? How large are the rooms in the house? Are you able to be there when this assessment happens? How will he be cared for between care calls? For example what if he soils? Does he need turning at night? Is his skin at risk of breakdown? What chair will he sit in? Is this suitable? How is he eating? Does he need feeding / soft diet, any choking on food? Can his feeding be safety supported at home. To be blunt if after 4 months he's being hoisted it is highly unlikely he will walk again. Have they explained what (if any) physio he will get on discharge? Have you spoken to the OT about your concerns?

I agree that talking to the hospital OT would be a very good idea ASAP.

The home visit will be done by an Occupational Therapist to see if there is space to have a hospital bed and hoist somewhere downstairs. The carers might plan to wash him on the bed or hoist to a commode and wash some of him in a sitting position.
If he is voicing a desire to be at home,( and is deemed to have capacity) and his needs can be met at home, they will do all they can to make that possible. Even if your mum turned round and said she cannot provide any support, if they could meet his needs with 4 calls a day they would want to try that before looking at other options.
A disabled facilities grant to fund bathroom adaptations can take months and months and will not be done prior to discharge home unless deemed essential for discharge.

We got a grant for parents bathroom to be done and it took 18 months from application to install. SS will also fund 12 weeks of care in some areas after hospital discharge, either at home or a care home.

Thanks again for all the info.

Does he have capacity to make discharge decisions? This is the question! Before the stroke, there were concerns about early dementia, but that was blamed on needing hearing aids- which he never wears! I hope that have been doing neurological testing, but dementia has been a concern of mine for sometime.
Since the stroke, he has had good and bad days. Some nights he is awake and trying to climb out of bed, then he is sleepy all day. I assumed some sort of delirium/sun downers, but he claims to remember trying to climb out!
Due to distance, I don't see him often, but will try speaking to the OT involved.