DF can't stand or walk, hospital want to send him home

[TheMerryAquaBird]

DF collapsed in the week as he suddenly lost the strength in his legs, he's been in hospital but they are keen to discharge home. He hasn't regained the strength in his legs so can't stand or walk, so I don't see how he can take care of himself, get to the toilet etc. DM has terminal cancer so can't be his carer, I'm scared it'll be left to me. I'll help where I can but can't do it full time.

Can we just refuse him coming home until he can walk? What help can I ask the hospital to provide, if any?

Thanks x

What have they offered in terms of discharge planning / reablement? If he's medically well enough to go home but has care issues they should have a plan in place such as carers etc.

I say this knowing it doesn't always pan out as my mother was in hospital for a month recently with a separate issue, lost her mobility while in there and yet they still let her go after minimal physio and she ended up in a reablement unit after a week as my dad couldn't cope.

Have you spoken to any OTs, and what does the doctor say?

Call social services.

He needs and assessment and a care plan

Hospitals tipping elderly people out into bad situations happens all the time. You need to tell them that it will be an unsafe discharge and that you are not able to help and don’t live there/work full time/whatever. Even if you do plan to help, you need to tell the hosptial that you are unable to.

You need to speak to his named nurse and ask if the physios and OT have seen him. You need to be clear that you don’t believe this is same discharge. You need to really push back and don’t be afraid to use PALS or formal complaints procedure if needed.

He will be sent home even if bed bound, as long as there is a care plan for him. Don’t agree to do any caring yourself

First find out if you are in a Discharge to Assess area as if you are then Social Services will not get involved until much further down the line as the NHS in those areas are responsible for making all the discharge arrangements and adult social care come and review it at 4-6 weeks.

Also have the hospital actually said they are discharging him home with no support or have they said he is now medically fit for discharge (MFFD)?

MFFD doesn't actually mean that discharge is imminent it means that whatever acute medical problem that they were treating has now been treated and that the other departments like physio and OT can now do their assessments as part of discharge planning.

Be clear with the ward about the home situation. It wouldn't be the first time that a patient has told the discharge coordinator some absolute whoppers about what level of support they have at home to try and spring themselves out of hospital quicker.

Make it absolutely crystal clear that you are not available to be a carer at all. It's up to you if you do decide to do a bit, but you don't want to give the impression of being available as they'll assume you can do a lot more and it'll all end up landing on you.

Also make it absolutely crystal clear your DM is terminally ill and also unable to be a carer at all. They'll assume anyone else around is able to be a carer unless it's spelt out. Would either of them be able to state this or would they talk about "managing" or just wanting him home?

Mention "unsafe discharge" a lot and ask about care packages. And do not let them discharge him until a care package is in place, otherwise you'll be left coping.

Good luck, it sounds like a really awful situation to be in. Are you able to take some time for yourself?

https://www.ageuk.org.uk/information-advice/health-wellbeing/health-services/leaving-hospital/

lots of info here OP. It’s a minefield but don’t get pushed into taking on his care

Thank you all so much, it is so useful to have the right phrases to use and questions to ask. I've not been able to visit the hospital yet as have been looking after DM, so I don't know exactly what they've said. He said they wanted to discharge him yesterday evening but he refused.

I'm going to the hospital today, so will see what's actually happening. I know in the past he told the nurses I would move in to look after them - but I can't! Personality and practical reasons.

Thanks again for all your advice x

Ask for an appointment with the hospital social worker assigned to his case. Generally speaking patients see a physio before discharge. They look him over and check that the home is safe. Does he have mental capacity. In his case he should go to rehab hospital usually 6 weeks.

If they want to discharge tell them that he is a vulnerable adult being released into an unsafe environment. This is where you need to start documenting everything and let them know you are doing so. Ask for the name, department of each person you speak with and the time and date.
Write down what they say and repeat it back to them so that they know you are keeping records.

From now on in you will be asked the same questions over and over again. At the front of the file write down all his info. DOB, address, tele no. DR details, NHS number and meds.

See my post above - hospital social workers are increasingly a thing of the past, both of the two hospital trusts I work alongside do discharge to assess which means the hospital make all the discharge plans and pay for the care for up to 4 weeks and adult social care review the plans before 4 weeks and decide if it's still needed. That's for both home care and residential care.

These days it's more likely you need to speak to the discharge Co-ordinator on the ward than a hospital social worker.

Have they determined what caused the inital problem? That's the first question. And can they fix it - that is, are you looking at a short period of care during recovery or will it be long term?

After that, as PP said you need to get the details of his discharge coordinator. As he has care needs they should have assigned a named one as soon as he was admitted.

And prepare your 'no'. Do it as a vocal exercise all the way to the hospital. You're likely to need to say it a lot.

Do nothing. Cruel to be kind. If the hospital can’t contact you, they’ll have to come up with a solution!

He should be functionally stable as well as medically fit for discharge
Ask about this

My dad was discharged on the 16th September He was so weak he could barely stand Died on 6th October after trying to get upstairs. He fell. Prostate cancer.

I’m an elderly nurse and this baffles me as we always ask family if there is any if they have any social concerns.

you need to speak to hospital and tell them in no uncertain terms that he isn’t safe to go home and if he does it will be a failed discharge. Hospitals don’t want failed discharge statistics. You need to ask what OT and physiotherapy assessments have been done and if they are now classing the immobility as his new baseline. If it isn’t his baseline and he could improve, they should be looking at either respite or rehab beds. You need to highlight that there’s no one to support and help him and that you need a social services care needs assessment.

I am so sorry. That is just shocking. My sympathy goes out to you.

Don't "refuse to have him home until he can walk" if there's no certainly he will walk. Be very practical about who can do what and what else will need to be done.
"DM can get drinks and make food for him, but she can't push him in a chair, support him to walk, or provide physical support when he's standing/walking/getting up and down."
"I can come in every few days, and help him shower, but I won't be there to dress and undress him at the beginning and end of each day and I won't be there for each toilet visit."

That way there are clear goals - he either has to dress himself or have a carer coming to do it. There won't be a live-in carer, so he either has to be able to mobilise independently enough to do bed, toilet, chair, moves himself, or he needs to go to a care home for now. If you "refuse to have him home until he can walk" you open yourself up to them finding ways round it that don't really work. Good luck

Hold firm on this, op.

If he went into a nursing home for a while, could your mother manage on her own?

This is what I was going to say. We had an unsafe discharge with my Dad and it was awful. We had to have him readmitted to hospital.

Be very clear to them that this will be an unsafe discharge, that you will NOT be there to care for him, and that your mother simply cannot.

They should only discharge him to an assessment place so that his needs can be fully evaluated and a care plan put in place. That's the theory anyway but it frequently doesn't happen that way. My Dad was just sent home in an ambulance and carried in through the front door by two paramedics with his weakened legs just trailing behind him!

Don't let that happen to your father. My mother ended up wishing she had declined to have him home because she realised very quickly that they wouldn't be able to cope, even with their carers several times a day.

I know the feeling of this only took well. Currently my dad is in hospital, turns out he was diagnosed with dementia on another admission last year, told his prostate cancer had returned and a shadow on his lung. He asked for us not to be told so nobody told us. On discharge he was sent for rehabilitation and collapsed in that hospital (we weren't told he'd collapsed and hurt himself!) and rushed back to the main hospital. Nightmare of an admission, we weren't told anything about his health and he was discharged and brought home by patient ambulance with absolutely no contact from the hospital discharge co-ordinator or hospital staff!! He arrived home filthy with the same clothes he'd been wearing for six days, ( I complained multiple times about this), double incontinent (this was denied when I called and gave the ward sister a piece of my mind. We got one carer am and pm. We noticed he's been starting to deteriorate and he took a turn and collapsed. I managed to catch him and fell on my knees to! Called an ambulance and he was readmitted. A junior doctor let slip about his prostate cancer and I explained we were never told about it and dad had complained for months about agonising pain in his back and legs. GP surgery also knew his cancer had returned and they didn't let on either, palmed me off with excuses! He's still in hospital but they're doing their best to get him out and we still don't know what all his problems are. According to them he can walk but doesn't want to. We witnessed a few days ago when he stands up his legs won't move and he nearly faints. I feel as though some of the staff think he's too much work them. It absolutely disgusts me how our elderly are treated in these places!

Also a friend of our family had a terrible experience with the same hospital. Her 34 year old daughter was admitted, very ill with cancer. She was in for weeks. One day her mum was doing shopping before going to visit her (a Friday evening) when her mobile rang. A neighbour in a panic saying her husband and son were helping a taxi driver carry her daughter into her house! She ran home and that poor girl couldn't walk or even sit up! Her mum called an ambulance, couldn't get through, tried doc on call, couldn't get through (GP surgery was closed for the weekend). She tried 999 again and just as she got through, her daughter slid from the sofa and passed away. So many of these terrible things happening to people and these hospitals are getting away with it.

My dad had prostate cancer (i posted upthread) he died on 6th October after a fall at the bottom of the stairs due to being so weak , three weeks after being discharged. He was sleeping while sat up on the side of the bed hunched over (this was the night before he died) i tried to get him to lie down but he said his back hurt . I was going to contact Adult Social Care on the Monday but he died in the early hours of Sunday morning.

When Starmer recently said they are going to tackle waiting lists and have targets what i heard was this "unsafe discharges are going to increase"

I'm so sorry to hear that Jennifer. That's absolutely shocking. That's exactly what I thought when I heard Starmer say that to! Not content with freezing pensioners to death, so they've decided to keep kicking them out of hospitals when they're seriously ill. I honestly don't know how they can sleep at night. I've had more information out of other patients than hospital staff. Disgusting how they treat the elderly who are the ones who've paid the most into the public purse for the NHS, social care etc., and those are the very organisations who are letting them down!

@TheWorthyNewt Thank You And im so sorry to hear that your dad is ill and they are totally gaslighting him.