Hospital discharge

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The hospital are trying to send my uncle home. He is 92, partially sighted, double incontinence and frail. The hospital want to put him in a hospital bed in the living room ! My auntie has late stage Parkinson's and cannot look after him. The hospital think 4 care visits a day is enough. It's ridiculous.
My auntie cannot have him back home in a bed in the living room. The house is tiny and she wouldn't be able to get past on her walker. She also has freeze episodes with her Parkinson's. She is incredibly upset that the hospital are trying to send him home tomorrow! Her brother has stepped in to deal with the situation.
I'm praying my uncle will be moved to a care home. Please offer wisdom for Thai situation.
I'm appalled

You need the phrases 'unsafe discharge', 'not possible' and 'no'. Repeat as often as necessary.

It's such an awkward situation. I was so angry today but unable to go to speak to hospital staff as I am not classed as a close relative

Does anyone have LPOA for health?

LPOA could be key here if your Uncle lacks capacity about where he wants to live and be cared for.

Otherwise tell your Auntie to not open the door if they try to deliver any equipment before discharging your Uncle.

Bloody outrageous! Do you know if your Aunt was also interviewed about the discharge plans? Trouble is sometimes people are so desperate to get home they aren't honest about how bad it will be, or are scared of possible care costs so want to go home instead of a care home, or they present their best case abilities which can give a less than suitable outcome.

I'd be pushing at least for the 6 week reablement period in a care home because carers there are more able to really assess what's needed. Would also be checking he has definitely recovered from whatever he was in there for, they tried to send my dad home when he still had a infections in his bladder and lungs, totally not appropriate.

Hope your Aunt's brother can get a better outcome for them.

What does your Uncle want? Does he want to go home to be with his wife? Does he want to stay in hospital? Does he want to go into a care home?
His wishes must be considered.
My wife has a hospital bed at home and four visits every day from carers. I still do a lot for her. Neither of us ever want to go into a home, our choice is to be together.

Well, it's great that you and your wife are able to manage at home, but it is very clear from the OP that this will simply be impossible for her uncle and aunt. Even if the uncle does want to go home, that will not be possible as his wife has advanced Parkinson's and is unable to care for him.

I'm pretty sure most people don't want to go into a home, or have their spouse go into a home, but it can become impossible for someone to stay in their own home as it would actually be unsafe and dangerous for both spouses.

I agree with you but in the original post there was no mention of what he wants. His wishes should be considered along with all the other factors.

Yes, there should be a conversation with him and he should be involved in decisions about his future, but to be honest, his choices are pretty limited. He can't stay in hospital indefinitely, he can't go home as his wife can't care for him, so really his only option is a nursing home with possibly a spell in a re-ablement ward or hospital beforehand.

One key bit to get your head around as it’ll impact the next steps.

Hospitals are not there for care. They’re for medical treatment. He can’t stay there indefinitely. So fighting the plan to discharge in itself is unlikely to get anywhere.

So the focus needs to be on appropriate care arrangements on discharge.

Your aunt may need to make very clear what she is / isn’t capable of doing. Making it clear that she’s not going to be at home for the first couple of weeks may help with that (eg. Is staying with friends who vet the Christmas period). That helps avoid any unrealistic assumptions being made about care she can provide.

It also needs the family to be realistic. Care homes are expensive, and don’t necessarily provide any more input than 4 daily visits and a hospital bed do, unless there’s a safety concern on wandering. If the person is very frail then they may be as well off at home, as long as your aunts access needs aren’t hampered excessively.

It might help for you or someone else sensible and realistic to offer to be with your aunt when the relevant team visit their home to plan the equipment needs.

It may also be a good idea to request a needs assessment for your aunt. That gets her limitations formally recognised.

Care homes are expensive, and don’t necessarily provide any more input than 4 daily visits and a hospital bed do,

Expensive, yes. But they offer far more than carer visits at home can: more regular schedule and continuity; all meals prepped and cleared, and cleaning done; accessible bathing facilities and hoists; cupboards of spare equipment if something like a pressure mattress or cushion is needed, rather than having to wait days or weeks for assessment and delivery; checks every hour or so through the day and night; entertainment, if the person is up to it; and someone - or multiple people if needed - instantly available to help in an emergency and fairly quickly available for non-emergency assistance.

An individual carer popping in for half an hour a few times a day is nowhere close to comparable.

Why is he in hospital, has he had a care needs and home assessment, what was their situation like before he went into hospital. I would tell auntie to say it's unsafe, he needs a home assessment. Does anyone has power of attorney for either of them. What does uncle want to do.

Sorry, this

Care homes are expensive, and don’t necessarily provide any more input than 4 daily visits and a hospital bed do

In my previous post is a quote and should have been bold.

I've noticed the hospital my MIL frequently gets admitted to has started using the phrases 'there is no medical need for you to stay' or 'there is nothing more medically that we can do for you'. It's only during her last couple of hospital stays that I have noticed this - saying that she actually likes being in hospital!

What are your uncles wishes and does he have capacity?
If he doesn't have capacity does anyone have LPA?

The plan for someone to be discharged home with four care calls a day and with a hospital bed in the lounge would be a suitable plan for many frail older people and it is indeed how many people live. If your uncle has capacity and his wish is to return home the hospital and social care have to try and facilitate this.
One of the main issues here seems to be your aunt and her needs which absolutely need to be taken into account. If the hospital bed and change of layout makes the ground floor of the home unsafe for her then it's not suitable. With four calls a day it wouldn't be expected that she would provide any care needs (yes I know).
I hope your brother is able to help advocate for your uncle and aunt and that a suitable resolution is reached. Good luck

The social worker responsible for your uncle’s discharge should be discussing your aunt’s needs/concerns with her too. It’s difficult because she will likely put a brave face on things to get your uncle home. She needs to explain what it will be like on her/his worst day. The social worker should ensure they are both safe on discharge. Good luck, it’s a horrible situation.

Update. GP visited my auntie at home and agrees unsafe to send uncle home.
Now looking at a private care home

Great update. I hope your Uncle settles well wherever he moves too.

Who is caring for your aunt?

Her 2 sons and myself. I also care for my own elderly mum and my son with SEN . It's not sustainable

I'm glad to hear that a sensible decision has been made about your uncle. Would it be possible for your aunt also to go into the care home?

Has the aunt been assessed for carers herself? Sounds like she would be able to get carers and support too.

Kindly, I don’t think they are saying she enjoys being in hospital. They are saying the same thing that @ScaryM0nster is saying. The hospital is there to treat an illness. If it can no longer be actively treated they have no reason to keep the patient.

My MIL had the same - told on multiple occasions that there was nothing more they could do.
She definitely felt safer in hospital after an incident ( heart related) , but all avenues of intervention had been exhausted. Them saying this was the catalyst to move her to a home.

I think perhaps I wasn't clear - MIL enjoys being in hospital. After her last stay, she told the doctors she wanted to stay an extra night when they tried to discharge her. It was then we heard that phase 'there is no medical need for you to stay'.

@Fluffyholeysocks Got it! Thanks for that.

Yes my MIL loved the fuss of a hospital stay - more about the family flocking to her side etc. and she did feel safer.