What next? Not safe at home.

[DaysofHoney]

I will try to keep this short but it’s quite a long and sorry story…

Dad lives alone in social housing, has done for the last ten years or so. Until then he worked.

He was diagnosed with stage 4 cancer of the jaw (sort of sinus area). Life changing surgery and radiotherapy have left him unable to speak or eat (he is tube fed). His quality of life is utterly miserable. He has lost so much weight and is extremely frail, and incontinent. Apprarently there’s no sign of cancer anymore.

He is now dependent on one family member going in twice a day to ensure his feeds are prepared and that he has his meds. I live overseas and my other sibling is in a city three hours away. He cannot use the stairs anymore for fear of falling. Indeed, today he has fallen again and is yet again waiting in A&E, waiting to be assessed.

I do not know what to do with him. He is a stubborn man and refuses to move his bed downstairs (there’s not really space to be honest). He refuses additional support/care. We are slowly trying to get him to accept that he needs much more help, probably 24/7 as he’s simply not safe. His fall today wasn’t on the stairs, his legs just gave way. He has an alarm but didn’t use it.

I feel overwhelmed by it all and don’t know what’s best for him. He doesn’t want live in care but seems relatively accepting of an assisted living set up or possibly a care home (the type where he can be a bit independent). He has a small pension he was made aware of last year. It wouldn’t last long given the cost of care though, perhaps a year or so.

Has anyone been through similar? What would you do for the best? Any suggestions would be welcome. I feel lost.

They never want “strangers in the house”. But the reality is that they need them. If the person who goes in could arrange to be there when the carers come the first few times it might make it easier. Once they get used to twice a day it makes it easier to ramp it up to three or four in future.

Are there hand rails? If not they need fitted to help him manage the stairs. Possibly physio to strengthen his muscles. We got all that from the council and hospital. Not sure what happens in England as Scottish system is different.

If the bed needs moved I’d just do it and explain it’s temporary

Thwy want what they want but sometimes it’s what they actually need that trumps everything.

I know you are right - he doesn’t really get to choose what he wants at this point, sadly.

I should have said, he had carers before my relative. Twice a day, it was going okay but he didn’t want to carry on. He now pays the relative instead.

If he’s admitted, the hospital should do an OT assessment to see if he’s safe to go home, so make sure they’re aware that he lives alone,
Unless he has a lot of capital (more than £14k) he should be able to have care at home, he may have to contribute some of his income but will be left with enough to live on.

If you haven't already, I would suggest you work your way through the AgeUK guides. They should help you wirk out next steps. https://www.ageuk.org.uk/information-advice/care/

Has he been admitted to Hospital @DaysofHoney?

Yes he was admitted yesterday. He was also due to have a small surgery on Tuesday.

Ok so my usual line in these sorts of situations is to go on the charm offensive with the Discharge Clerk on the ward.

You want him to have had an OT assessment at home and point out how he’s falling and not using his panic button. The phrase you usually need is “I want to avoid an unsafe discharge”.

If your DF has a SW I would talk to them too about your concerns. It’s going to be difficult because the SW will want things to continue as they are as using the relative is the cheapest option.

If your DF hasn’t got a SW ask the Discharge Clerk id obe can be appointed.

Thanks, he doesn’t have a SW but has had a previous OT assessment although things have deteriorated wry quickly since then.

and he hasn’t been admitted yet, still waiting in A&E - they won’t do his feeds either 😫