Ensuring safe discharge

[Dibble135]

Mum in hospital for 2nd time in 2 months, this last time because she couldn’t eat and drink sufficiently at home where she lives alone despite me and dsis doing our best to support.

Hospital called tonight with no notice to say come to pick her up. I’ve refused as no care package put in place. She cannot walk independently or wash and dress.

Now told tomorrow OT and physio will take her home to do assessment and arrange package based on need.

My question is this. Is this essentially just a way to get her discharged and she will be left there no matter what?

Does anyone have any experience please?

Ring the ward and speak to the most senior person in charge and say the words unsafe discharge over and over. If she hurts herself after discharge you will make a complaint, stuff like that.
Go in at 9 and ask to speak to the discharge coordinator and say unsafe discharge over and over again.
I think you need to put forward some ideas though- what do you want to happen?
Carers 4x a day would probably be forthcoming but don’t sound sufficient.
Nursing/ care home sounds ideal- can she afford to self fund this? If not say they need to fund this for 6 weeks as an interim continuing healthcare measure to allow means testing etc.
My experience is a little different but from arguing (discussion) with discharge coordinators you need to be extremely polite, extremely articulate and extremely assertive.
Do not let them tell you to do all the care- keep saying you are unable to facilitate that. Your role is to advocate for your mum, but not necessarily to carry out the care yourself.

I agree with this. Get them to note in your Mum’s hospital notes that you believe it’s an unsafe discharge and show you were they’ve writren them.

My Mum was given an unable discharge. She fell and broke her hip within 6 hours of being home and then died after 6 weeks in hospital.

Thank you. It was the words unsafe which I think stopped them sending her home tonight!

I cannot go in as I don’t live locally but can telephone as I have been doing.

Temporary care home sounds ideal. She was pretty independent up until her gallbladder burst which is what started this. She needs to get fit for surgery but no chance of that without a lot of help. I don’t know the costs. She owns her home and has about £10k in savings.

I can be very polite and articulate so no worries there!

I’m so sorry to hear that. My mum fell the day she was readmitted hence my worries.

@Dibble135 I had this 3 times with my DM. It’s a total shocker and my LA (Buckinghamshire) never did an assessment at all. Ever. I just had to take her home and we had to cope. It’s atrocious when you are old. I’ve heard exactly the same has happened to others. I arranged private carers as nothing forthcoming from LA at all.

This worked well as Dm did improve. Eventually DM at 99 had a back condition (never did get told what?) and could not move . After 6.5 weeks in hospital I got the discharge call but they had assessed she could not go home. Assessment seemed to be done by OT. So get hold of OT.

I then got the social worker phoning up. Said DM could go home with 4 visits from carers a day. I could not believe what I was hearing. These people are just useless. Eventually I managed to get across that the hospital said no to going home and that DM would pay for a care home. She never asked about DM’s finances! In an hour of telling me she had assessed DM as suitable for going home.

To cut a long story short - get a care home sorted. 4 visits a day will mean she’s confined to bed. So is the bed suitable? You won’t get nursing help so there will be more and more problems. Can DM pay? If not talk to discharge and get them to contact LA.

Just one other thing - I barely spoke to a nurse or doctor in 7 weeks. They didn’t answer the phone - ever. So even going into the ward produced nothing. They didn’t even write the name of a Dr above mums bed. However the care home was amazing! Just so pleased we found it. DM had her 100 th birthday there. The hospital and help we received was atrocious..

@Dibble135 They will offer 4 visits a day because they won’t pay for a care home. Can your DM pay? There has to be a better end to life than this by the way.

I’m so sorry this happened to you. It is shocking. DM is deaf so cannot understand what doctors are saying. Just nods along. I’ve trained her to call me when they come and give them phone but it doesn’t always work.

How do you know if they can pay?

@Dibble135 If your DM has savings over a certain amount (I think £23,000) the LA will not pay 1p. Could be less the man that. If she’s next to no savings, but has a property, you need to negotiate. The LA will offer what’s cheapest for them. Not what’s best for DM.

Unsafe discharge. Over and over.

Ours get the physio to watch while the elderly person dies chores in a room made up like a house. Making a cup of tea, going upstairs etc. using toilet.

They then recommend what needs to be done. Then I liaised with our councils team to get carers in and modifications done (handrails mostly and a bathing contraption) before she was allowed home as it would be an unsafe discharge without all those measures being in place.

Hospital physio in the same hospital as mum I mean just collected her in a wheelchair and returned to her ward after.

Just say its an unsafe discharge and there is noone to take care of her. Hospital's are notorious for sending people home without a care plan or equipment in place. Sorry your mum is ill. Ask for a meeting with the ward manager or senior nurse and explain why its an unsafe discharge. Good luck x

Thank you so much everyone, I’m so grateful for your support 🤗

The hospital tried to discharge my mother in law after brain surgery with no care plan in place. She was desperate to get home. They rang everyone in the family but we all refused to be responsible for her. Definitely not safe x

Reading this makes me realise how lucky I (or rather my mother) have been. She was only discharged from hospital earlier this year having broken her hip after a full 're-enablement' package lasting six weeks was put in place - carers coming in four times a day. Also physios and occupational therapists on a regular basis to assess what she could and couldn't do in the way of washing, dressing,cooking, giving herself her medication etc. Items such as a commode for downstairs and a frame for over the upstairs toilet were delivered quickly and free of charge. After six weeks they agreed that she still needed some care, and although she now pays for it, it was arranged and managed by the local council.

yep do not even five any kind of hint you can manage her at home or they will latch onto that basically she needs to stay where she is unless she can be looked after in a care home or with carers do not allow them to discharge her keep repeating its not safe as there is no one to look after it is up to the hospital to ensure safe duscage and that care is in place before discharging and not necessarily from the family

I’m so glad that was put in place for you. It’s the way it should be after in my DM case 80 years on planet, working most of them and paying taxes…

My DM got to 99 with fuck all. It’s definitely a post code lottery. I tried over and over when DM was 97/98 after hospital stays to get her assessed. Just told no. They had no staff. It’s actually a very upsetting. You don’t get to speak to anyone. They don’t put you through to senior people at SS.

The doctors don’t speak to you.The GP won’t speak to you. No conference about how needs can be met. After 5 weeks of no contact with doctors I made a huge fuss as DM wasn’t improving. I got a surly doctor phone me up. She said “I’ve got 5 minutes before I go off duty - what do you want to know?” She confessed she had failed to get the pain team to visit DM. She had no idea about anything really. I guess the pain team was busy with younger folk. They never did visit my distressed mum. Weeks go by and you know nothing about anything. The elderly are just left at the bottom of the heap. DM was transferred to the care home in immense pain. Don’t get old. There is little care that’s suitable or even caring.

I’m so sorry. You sound like an amazing daughter who did all you could for your mum 🤗

A few years ago (when my DM was alive) she was getting ready for discharge from hospital. The hospital arranged a home visit by an OT to assess how DM would manage. The OT brought DM to the house and I met then there. After the assessment the OT took DM back to the hospital and they were then able to work on a couple of things in prep for her discharge. So in theory, all would have been well. Except, whoever discharged her forgot to tell the Social worker that she'd been sent home, which meant that the care package wasn't activated and so no carers turned up to help her get dinner or to get ready for bed. I had a few choice words with the ward sister that night but the words "unsafe discharge" were the magic words that got everyone moving.

I was 75 miles away caring for a disabled family member at the time so DM was totally alone.

I did but it wears you out! It never feels good enough and it’s a constant worry. One issue with just a phone call telling you to pick up DM is that you will disappoint DM if you don’t. They want to be home and say they will manage. The hospital never talked to me about how I would manage. I’m an OAP too! If you get lucky and actually talk to someone and DM doesn’t want to go home, you might get a care home instead. When I got discharge calls DM was packed and ready to go! Just not in the end.

DM repeatedly lied about what she could do too. One OP did speak to me on one occasion and listed what DM was cooking and how marvellous she was. It was what I cooked! She turned her heating off and the hot water too. So they don’t get an accurate picture at all. Anyway - I’ve said enough. Stand your ground and do your best.

An OT at her house! WOW!

Mum was in a similar position in Hospital this year. She was assessed in hospital and they decided she could go home and would arrange carers 4 times a day. I absolutely refused to allow that as it would have left her bedbound and just moved/toileted 4 times a day. We decided that she would get much better care and company in a care home which we could choose as mum has the money to pay for it. She has now been in a local care home for two months. Enjoys the company and the activities and looks better than she has in years.

The visit home with OT is what I understand is planned tomorrow so it’s reassuring to know they can take her back when they see she can’t manage. That is the point, see not just ask. DM doesn’t lie so must as not realise what she thinks is managing is nowhere near!