DF now refusing discharge from hospice and wants to stay!

[Totallybannanas]

He has been there for 2 weeks now and they have managed to stabilise his symptoms so the plan was to discharge him to a nursing home. Long story short there was a mix up with the funding, and I've been struggling to find ones with nursing care and with a bed. I think the more expensive ones have been declined and the others have filled already the bed due to funding mix up. Anyway they have offered another home which wasn't the best, cramped and smelt of wee. Dad doesn't want to go there but we have no alternative and he doesn't want to go home. I do not want to be his carer again ☺️ I know what he is thinking and he is hoping to stay as long as he can and is now wishing himself to die. The nurses keep pestering me about nursing homes and about me finding somewhere, but I already feel I've wasted time looking. Obviously I didn't realise there was a restricted budget and you can't top up anymore, so any home we get isn't going to be great. I also don't want to make that decision. He has capacity and I don't have POA so surely he has to decide or they have to just move him. I just totally tired and bogged down with it all.

Equipment can be provided but the care a person needs at end of life is sometimes unpredictable and doesn’t work well with a typical package of care which will be timed visits by carers, not qualified nurses who can administer (injectables if needed) medicine as required. So a Nursing Home is sometimes the best option. And if he is CHC fasttrack funded then it’s nothing to do with social services. It’s health funding. And CHC will have a brokerage team who look for placements and care packages. This doesn’t have to be the OP’s problem. If she wants, she can try and chase up CHC brokerage. But frankly she sounds burnt out with caring for her father and no judgement here, caring is hard, hard work.

Is he on a ward or in a hospice? You’ve said both in your posts.

He is on a ward within a hospice. Our local hospice take patients in to manage symptoms if they cannot manage it at home. They normally stabilise them and send them home within 2 weeks.

I’m a nurse and if someone refuses to leave they’re within their rights to get them admitted to hospital with ‘social concerns’ and then they’d be stuck in hospital instead awaiting a social assessment for a palliative preferred place of care so I’d really try to work with them. Hospices often have their own social workers

Dad, the hospice say you can’t stay here, it’s not an option. You can go back home, or into care home - you choose. I can’t look after you … I have a job and my own life to lead. Then step back. Very hard to do, I know, but it may be the only way to get him to accept a change.

Just tell the hospice that they need to get a care manager or social worker to discuss with your dad what his options are as you do not have POA and are frankly at the end of your tether trying to cope and then step back . Stop visiting everyday and take back control of your life a bit . It may sound harsh but if he’s got capacity there is very little that you can do .

Of all the hospices I've worked at, having a social worker was rare.
Possibly there might be a discharge planning nurse but probably not.

There just isn't funding for these roles.

OP I would suggest that on your next visit you ask to speak to the doctors and say that you know he wants to stay but you also find him very difficult and you just aren't in a position to do more than visit. Finding a care home has been very difficult, and as his daughter he won't accept from you that he needs to go to one.

@AnnaMagnani They don’t but the OP should be contacted by LA social worker and the hospice should facilitate this. It’s an issue because SS must be involved with future care decisions. As op knows there’s not enough money for a nursing home, SS need to be involved regarding what might be possible. They like cheap home care and will expect op to do it though as 4 short visits is never enough. Depending on mobility, a regular care home might well be ok.