Mum needs a nursing home after car accident

[GlassLampshades]

Hello,

Can anyone point me in the direction of amazing resources, podcasts, websites etc where I can start to understand this whole new world that I've just arrived into?

My mum is late sixties and was in a car accident at the beginning of the year. She has a brain injury as a result, is currently in a specialist unit, and has been told she needs to leave as they can't do any more for her.

They advise a nursing home at mum's cost. My mum is bed bound due to the brain injury which has caused paralysis. She can use her hands and arms and can sometimes pull herself up to sit, but requires 2 / 3 people to move her. She does not use the toilet and only moves out of bed with a hoist to a chair where she sits for a few hours a day. She can hold a simple conversation but has clear cognitive issues, doesn't seem to grasp her situation, no short term memory.

I need to quickly understand how we go about financing this. My dad is also late sixties and in the family home in good health. The house is wholly unsuitable (a crumbling victorian terrace) for him and he would like to sell in the near future. The social worker says a decision needs to be made on Monday.

I’m no expert, but surely she needs nursing care with that level of issues. In which case it would be at least partially funded wouldn’t it?

I think the nursing element might be.

I should have said as well there is a DOL in place. I don't really know if that is relevant.

What country in the UK are you in?

NI

Im so sorry about your mum. What an awful thing to happen.

I'm suprised that the hospital doesn't have someone liaising with you to help with next steps. If they are leaving it entirely up to you, I would start by contacting your local adult services team. They will be able to advise amd you'll soon become an expert. I hope you find somewhere that is a good fit for you all.

That is really helpful. Be careful what advice you get as care provision and financial support is really different across the UK.

https://www.ageuk.org.uk/northern-ireland/information-advice/care/find-care-support/ I would call a NI advice line on Monday - Age UK has one for example. Even if they can't help they should be able to signpost to others.

A quick Google has this - your mum may meet this...

https://www.ageuk.org.uk/northern-ireland/information-advice/health-wellbeing/health-services/nhs-continuing-healthcare/

Your social worker is unreasonable giving you a Monday deadline and no information about the support that is available.

Care is complex and you've got to know the system and also what to know what to ask about.

Does she have savings, capital or assets outside of her and your dad's home?

I guess she has had a Continuing Health care Assessment, as you mentioned she has nursing needs.

I would say the most important thing is to ask for a Continuing Healthcare Assessment. This is NHS funding. Don't allow people to rush you! You need time to research your options - as you say -it's all new territory.

I don't live in NI but worked fora short period of time in Neuro Rehab working with people who had brain and spinal injuries. Many of the patients had life changing injuries. As part of discharge planning, Occupational Therapists would visit the patient's home and assess if any adaptations or equipment were needed for a safe dicharge. Sometimes equipment could facilitate safe discharge sometimes not and alternative accommodation would be needed to be arranged with a social worker. Remember it is not yours or even your Dad's financial responsibility to provide ongoing care for your Mum. The Social worker would need to do a financial assessment to ascertain your Mums (NOT your Dads as well) financial position. I have a questionmark whether your Mum may be able to access NHS Continuing healthcare due to the accident? No expert though.

The thing that jumps out at me is the social worker telling you she needs an answer by Monday? My response would be that she may want one, but she won't be getting one.

Where are the health professionals involved? There would be an MDT involved with your mum in hospital made up of Doctors, OT, Physios etc who would be involved in discharge planning.
For example, the OT would assess your Mum's cognitive and physical function and outline her difficulties (and strengths). Only from a thorough OT assessment would they be able to say what your mums living environment needs to look like and what support/care she needs. Your Dad needs a home and they cannot force him to sell his home to pay for your mums care.

"They advise a nursing home at Mum's cost". Who is they? The social worker?
Have they financially assessed your Mum and her assets?

Your poor mum, and your family what a horrible situation.

You have some difficult weeks ahead of you.
I would not allow her to come home. That is the optimum situation as far as the social worker is concerned. They'll install a few bits and pieces, give the minimum of external care and your family including your aged father will be expected to do everything else. The reality of this is so so difficult.

If she stays put in hospital they will HAVE to find a suitable solution in order to release the bed. It's a perennial problem and I sympathise with hospital staff but they also know that this is true.

What I don't know is the standard of care /quality of the home that will be found. I think that will be your hardest battle particularly as it may not be geographically easy to visit. It may be worth seeing if there are any reciprocal arrangements with ROI if you are near the border.

But even if you wanted to, you couldn't sell your parents house and release enough equity to fix this quickly. Your father may live for a very long time yet and may have his own care needs.

@GlassLampshades

Tell the social worker that they will need to either help or wait until you can sort this out.

They can not discharge your Mum without something in place.

Does insurance from the time of the accident cover anything - either hers if she was driving or anyone else involved as her life has been changed so completely.

Wishing you and your family best wishes 💐

She should be getting PIP full rate, as she qualifies, or the equivalent, don’t be rushed into nursing homes.
is it possible for negative equity?
Also if the accident was not her fault, is their compensation from other party?Please discuss with care plan, and social worker

The social worker will just be looking for a general idea of whether you’re open to nursing care or wanting mum home somehow. This is going to be a longish process and their role is to help and guide you through it. If you don’t feel that is happening , then say so.
Age UK are a good starting point, they do some downloadable booklets and guides on looking for care homes, what to ask, and how the funding works.
your dad’s home will be discounted from the financial assessment but any savings in her name only, or half of any joint savings, will be counted in.

Thank you very much. It is complex and intimidating. I am hearing everything via my dad and he is understandably traumatised and scared and I'm not sure he is able to focus on the practicalities. I will try to be there on Monday when he meets the social worker. He wants to bring her home and feels duty bound to do so, so it's not easy having to be the "evil child" insisting on a nursing home. I'm doing it for my mum though as there is no way he could provide the appropriate levels of care outside of the care package, and he'd run himself into the ground trying.

I did ask him to raise the NHS continuing care assessment with the social worker but he forgot.

The specialist unit advises the nursing home. The social worker has said mum would have to fund it.

Are you not claiming from the car insurance? She should be covered for long term care. There’s a separate claim - for injuries.

My sisters employer won 3 million 20 years ago.

What have the insurers said?

@TreadSoftlyOnMyDreams is correct OP. The hospital staff will be under pressure to free up the bed. It is not down to you to you to find a solution to this, they need to assess your mums needs and do a financial assessment of your mum. Its not clear from your original post if this has been done.

Have a look at this guide - this is a link to an org called Beacon who can offer independent advice on whether you mum can access continuing healthcare which is funded by the NHS.

www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/#:~:text=To%20be%20eligible%20for%20NHS,how%20complex%20your%20needs%20are

If this cannot be obtained for your Mum, then in Northern Island if your Mum has more than £23,250 she would have to pay for carers. Once her assets go below this threshold, she would be required to pay part of the care fees. Once below £14,250 then she will no longer be required to pay. Important to note this means test is purely on your Mums assets. Say you Mum and Dad have a joint bank account of £50k, £25k of that would be assumed to be hers in the assessment.

The home that your Dad is living in will not be included in the means test/financial assessment as he needs somewhere to live.

If your Mum and Dad had a joint by-to-let Property for example, this would be included in the means assessment.

I thought about the insurance too if it was a car accident. The Social worker is being totally unreasonable forcing you to an answer by Monday. The rules about who is entitled to funded nursing care are very complicated.

Thank you very much. Nursing home is the only viable option in my eyes. But my dad is feeling guilty and like he should bring her home. I'm against that, for my mum's sake as well as my dad's.

just realised you are getting all the info 2 nd through dad. Do talk to them yourself or be there when dad meets them.
maybe they are talking about an assessment unit? Where I am, that’s a short term nursing placement which allows for a fuller assessment and care planning for home or long term care. They would be looking for a quicker decision on that, as it’s then that you’ll have time and space to plan what’s next. Usually 4 weeks.

No assessments have been done AFAIK.

I realise now it's very important for me to try and accompany my dad to the meeting with the social worker on Monday as I'm hearing everything second hand from him.

They have a small joint savings account which would put her under the threshold. No other assets apart from the house and their pensions.

It might be that when your dad sees mum in a more homely setting, in a care home unit for assessment, - he’s more able to make a decision as at least he can see the benefit of it for her then. And there should be input from different professionals to talk through her needs and risks, and how these could be met or not met at home. So it’s not all coming from you??

Thank you, this is very helpful.

@GlassLampshades I can say from personal experience - please advise your Dad not to feel duty bound to bring her home. Your Mum has complex needs. Once she is discharged home, he will be left to get on with it. When he can't cope with the stresses of it and reaches out for help he will be placed on a waiting list to be seen by community therapy/OT's which can take weeks or months to be seen. I have seen this first hand. It is not in your Mum's best interests for her to be discharged home and for your Dad to attempt to do the bulk of the care. Please remind him of this. Take your time and don't allow social workers or anyone else to pressurise your Dad into letting her come home.

Small joint savings account