Adviced needed

[Sadless]

Hi all my mil is in rehab at the moment after breaking her hip . She currently lives in a flat with stairs and before the accident we have been trying to get her a ground floor flat .
anyway drs said she couldn’t go back to that flat so her older son has been looking for property some where else social housing . He’s accepted one this morning for a flat in a block says assisted living but only part time and it’s on the second floor . He told me last week that the drs said might as well go into assisted living now instead of a few months down the line .
we have proper assisted living in the area with full 24 onsite people still self contained flats which I would have thought that’s what he meant by assisted living . My husband is stressed because he doesn’t think she should go to an upstairs flat again but seems like his family are abit stupid . The hospital told my husband last week that family were pushing for her to not go rehab and straight back to the flat. She can’t even stand up yet and she’s 87.
do I tell my husband to just leave them to it because even time he saying anything it’s just ignored.

thanks
sal

Your DH needs to speak with MIL and find out what she wants and what she has said to the hospital.

What is the family dynamic? Will she make up her own mind or will she opt to go with who ever "shouts the loudest" or guilt trip everyone into a compromise?

How many family members are involved and who was doing the bulk of the "housekeeping" chores that DMIL cant do any more?

Is the funding all social care or can she or the family fund some of the changes?

Has DH been in contact with the hospital social worker etc or who is the "lead" contact?

Has brothers found new house a working lift?

The children need to discuss how each see the future and say who is willing and/or able to do what. Moving can be very hard at the best of times but moving to adjust for a "end of life" pathway is always going to be so much harder. So if brother is willing to put in the work twice should she need to move I would say let DMIL decide. If he is going to expect DH to share the work involved he needs to have a discussion with his brother on how involved he will become if it all falls apart.

ahe hasn’t got a social worker just yet the rehab place she would next week . My husband has mobility problems but he’s the one who sees her the most and she rings him first before any of her other children. She has two older daughters that don’t have any involvement at all other than a phone call once a week . His brother goes once a week and takes her shopping that where she broke her hip .
she told my husband to let brother sort it out but if it’s not suitable and she’s going to struggle then what do you say?
I feel that my husband is pushed out by his siblings like he’s stupid and just has to do as he’s told . He’s the youngest but nearly 50

thanks
sal

Then your DH and brother need to work out what works for them together. And DH needs to set limits on what he can take on.

The hospital SW should be involved if she needs care in the community. She wiĺl need an updated assessment. The OH, physio, doctors, nurses and any other department can all feed into the hospital assessment of needs for a safe discharge.

DH should point out to his brother that the best time to get Social services and housing sorted out is when DMIL is bed blocking.

And if the full service home is acceptable that one move "shock" is better for her MH than two or more moves

That her dependency will only get higher and its best long term if the services are future proofed as much as possible.

DH and brother need to work that out and if in the end DMIL is going to go with his brother he needs to accept that she has a right to choose and if needed he has a right to say no.

What was her mobility like before hand? Have physio tried to get her to stand yet?

You may need to be realistic about how much mobility she is going to regain. At the moment you just don’t know how much that will be. There is a rule of thumb that if she walked without a stick she would need one, if she used two sticks now she will need 2 or if she used a zimmer she may not walk again. Many old people don’t recover well from a serious fall and there is a high mortality rate within the first year of a fall. You’re MIL may have significant care needs when she leaves rehab.

Social Housing assisted living is vastly different to private assisted living. 24/7 care in assisted living is becoming more unusual as the managers/wardens are not carers and normally if someone needs overnight care then it would be suggested that a move to residential care would be more appropriate. If assisted living then there would be a lift between floors.
If she fractured her hip and isn't standing then your DH needs to contact the discharge coordinator at her rehab placement and find out what the discharge plan is. It sounds like she isn't 'clinically ready' for discharge. My dad is currently in hospital having fractured his hip 5 weeks ago, discharge isn't currently an option due to other problems, but when the discharge coordinator thought last week that it might be, she rang me and had a lengthy discussion on what it would most likely look like. Has brother got power of attorney? Your DH needs to ask for a phone call with the discharge team rather than relying on conversation from family

He spoke to his mum last night and she said it’s fine it has a lift. But she struggled before getting from her flat to the car park which wasn’t far and it will be a longer distance now. She was given a walker last year after falling down stairs while she was living with her daughter. They fell out and she got her son to apply for property and he got the upstairs flat. It wasn’t suitable to start off with we apply to have a walk in shower put in and a stair lift but was told it would take about 6 months . My husband said it’s up to her if she thinks she can manage but his brother can take the extra work load . She has a dog which goes out 4 times a day and she used to go to the front door most times with her walker. It will be a pain in this new place . I think his family just think he’s being a problem and it doesn’t really matter what he’s says . But they expect him to be the one there all the time .
i even think his mum doesn’t think he knows anything he’s just wants her life to be easier not worse then it was.

thanks
Sal

When my Mum who used a zimmer broke her hip we were told it was very unlikely she would walk again. I think it’s time for your DH to have an honest conversation with his Mum’s doctor about the probable out come for his Mum. I think everyone involved needs to have realistic expectations to understand what extra care she is going to need in the future.

They are keeping stuff from him after the drs said she wouldn’t be able to got back to an upstairs flat . We said we would go pack her flat away ready for a move. When he told his brother he said hang fire she might be able to go back. So day after my husband went to the hospital spoke to the dr and he said family don’t want rehab and pushing for her to go straight home. They didn’t agree with it and said they would have to do a fire risk assessment but still wouldn’t be a good idea.
anyway the paperwork got done while his was there and his mum agreed. She most know she can’t even stand up .
but he was never told that off family that was there plan drs had to tell him .
i think they think she will be back to normal soon her friend broke her hip last year and she owes her house and it’s took 9 months for her to start using the stairs again and even now she keeps falling.
we are going to the rehab place tomorrow and will go speak to them in the office .
his brothers down as next of kin because he went into hospital when she had the accident.
but he thinks he’s the boss

thanks
Sal

If your mum is in rehab, she will be accessed by physio therapist and also occupational therapist. This can take time due to how your MIL is progressing with her mental and physical well being.
Your MIL home will be assessed,
by OT. They will or should discuss you MIL they best way forward as to her discharge. All this takes time.
I have worked with the elderly in NHS rehabilitation. The NHS and have a duty of care to your MIL and therefore will not allow risk to her. Once she is more stable and up and about PT, OT and the nurses and doctors will discuss what is the best way forward and liaise with the local social services. Sometimes if a places cannot be found that is suitable for your MIL needs, she maybe put in to a care home until a suitable place is available.
Try not to panic, sounds as though family members are rushing around trying to find her a place, which is understand .
However as your MIL in an inpatient she will be assessed on a daily basis.
So wait until she has had PT & OT and then try to speak to OT and they will
give you information on her progression. MIL safety is paramount and the NHS has to make sure she willl be safe when she is discharged . These situations take time and be asssured your MIL is safe while she is in rehab . Deep breaths and speak to OT. Try not to jump the gun , as you should find the local authority will work with this with you and DH and other family members . Early days at the moment.

Hi all he spoke to his mum yesterday and she seems happy enough with going to the new place. She said she will have carers in and they will be able to take her dog out .
I think she will be there for the full time of 4 weeks . Don’t know if the carers will be permanent after she leaves or a set time .

thanks
sal

Quick update she had a visit from a social worker last week and she just suggested going into a care home which mil declined. On the same day her other son had the therapist at her flat seeing if it’s suitable and they have agreed so she’s going back early next week. The social worker said funding wasn’t available to have carers in And if she was to go back to that flat would need stair training which hasn’t been done . See how this works now

sal

If the funding isn't available then your mil must have more that £23,250 in savings? Either in savings or in a property? Unfortunately this means that she'll have to pay carers herself. The stair training will be on her discharge plan.

She’s no money at all other than pensions and attendance allowance. Do you think the meeting on Friday was a discharge meeting the social worker left a phone number to contact if she changed her mind about a care home . But no other appointments to see her have been made ?

sal

It sounds like it. Your DH needs to speak to his siblings urgently or the discharge Co ordinator because it sounds like different things are being said to different people.

He going to the rehab place shorter and will try find out what’s going on. See if he can get some luck his own brother is not telling him anything.
sal