Hospice want to discharge to nursing hope advice needed.

[Totallybannanas]

Dad is 80 and has terminal oesophagus stage 4 cancer. He was diagnosed 8 weeks ago and has been hospital to have a stent fitted. He hasn't been coping well psychologically and suffered a UTI and incontinence. He was admitted to manage his symptoms. Anyway long story short, they want to discharge him after stabilising following a 2 week stay. They were were discussing a care package home or nursing home. They initially couldn't decide if he would be nursing or residential. I put forward some homes either nursing or residential and they have fast tracked CHC. It has come back with a home (not open I have chosen) that accepts fast track funding and has a bed. I don't know what to do, I have struggled to find any nursing homes that are not dementia specialist. I found a lovely residential, but now wondering if that will even work as he needs alot of medication to manage his pain and state of mind. I'm not sure on the home they have suggested and I'm feeling under alot of pressure. If he goes home, I don't know how he will manage. His mobility isn't great, he has had a call since hospice and can't manage his medication. I can't be with him 24/7. I have gone sick from work but I can't do this indefinitely.

What do you think of the home?

I would take a breath and go and see it. Tbh it sounds to me as if he is very likely to need nursing care in some form. Does he have capacity to choose this home or are you having to do it for him? See what you think of it first. Is it near you?

Basically, I can find an alternative nursing home anyway. The ones I put forward I wasn't sure of if I'm honest but this one wasn't one of my choices. It seemed very cramp and cluttered. But then I have spoke to people who said it is nice. The nurse and staff seemed nice. I don't have POA. I just don't want this responsibility. He has capacity, and yet they seem to be talking to me and not dad.

I’m so sorry to hear about your dad.
Bluntly, a care home will not be appropriate in the coming months as he will need registered nursing care to keep him comfortable. Go and visit the one suggested, it may surprise you. It’s always about the care and atmosphere, not the decor or setting.

I'm sorry for your situation. It depends on a few factors I think.
What's his prognosis? Qualifying for Fast track CHC would suggest just a few weeks or months (and I apologise if that's not been conveyed to you already)
Where does he want to be?
Where do you think he should be?
Is he now or likely to soon be mobile?

From what you say it seems that he can't go home safely so he needs residential. The hospital discharge team should have a social work team to advise on the type of home required. It's my experience that the feel of a home is so important and that having a smart foyer like a hotel is not indicative of quality of care. If you see staff sitting with residents, holding their hands or with arms around shoulders then it really doesn't matter that there are a couple of sandwiches left under the table from lunch!

I wish you and your father the best outcome.

If the staff were nice, then go for it. I’d say have him out of hospital.

The ICB nurse and social worker I spoke to said that the staff and how they are to the residents is way more important than how recently the home was decorated. They advise visiting over a meal time so that you get a picture of how the staff are at what can be a tricky time (managing quite a few people with different needs all at the same time). Good luck!

Thank you, I just feel the responsibility and decision is on me. I'm so worn down with is all. He has been in the hospice for over 2 weeks and the care and the staff have been amazing and I almost hoped he would have passed there. I'm fearful of him going home but also I think he will hate this home.

But I can't really find an alternative.

I have been following your story @Totallybannanasand I can’t even begin to imagine how hard it is for you.
You are doing an amazing job of advocating for your DF.
He needs to be in a home, you can’t look after him. Is this home perfect? Who knows. Is he likely to be happy there - well maybe not but will he be happy anywhere? He is in pain and has a terminal diagnosis, even if it was the best care home in the world, he wouldn’t like it.There is no better option available and for your own sake as well as his, he should go to the care home.

I work as RN in a care home and my advice is not to be taken in by all bells and whistles decor ! Very misleading and quite often sterile and soulless! The home that I work in is actually quite scruffy in some areas but the happy, caring atmosphere is why it is considered to be a lovely home!
We have many residents who come to us for EOL care and all the trained staff are very experienced with medication administration and use of syringe drivers.
I wish you and your Dad all the best X

Personally I feel he would be better off going straight into a nursing home where the staff will be on hand to cope with whatever the future holds, unfortunately life won’t get any easier for him and it will save him having to move again.
As others have said it definitely isn’t about how a home looks, it’s about how the staff look after their residents and the care they receive, go and have a look and chat to the current residents.
Also your Dad may not be happy initially going into one but he probably won’t be happy at home waiting for carers to turn up either! If he settled reasonably well in the hospice he can settle again in a new home.

Did you have a look at the CQC website? https://www.cqc.org.uk/ You can check inspection reports for the homes there. It does seem he needs nursing rather than care home if he's been awarded CHC funding.

If you need support, Macmillan have help available to you. https://www.macmillan.org.uk/