Urgent advice for elderly mum in hospital

[HarryBlackberry1]

I'd be so grateful if anyone could possibly offer me any advice. My elderly mum (79) is currently in hospital, and is very ill with a kidney infection. This is the fourth time this year she has been admitted to hospital urgently with these types of issues.
The problem is that nobody ever gets to the root of the problem, and she is discharged from hospital when she is still clearly very unwell. There is no aftercare at all, so my mum, who has been sent home poorly, quickly declines, and ends up back in A and E.
She had stents fitted in her kidneys back in February, and they haven't been changed/checked.
This is forming a pattern now. I emailed PALS last night, but is there anything else we can do? Any agencies who would help us to advocate for her?
My dad is 80 and is exhausted with being back and forth, waiting in A and E for hours before admission. Rinse and repeat. It's just heartbreaking and my dad is struggling. Nobody in the family knows of official routes we can follow.
Please can anyone advise?

I would make sure you are there when the consultant does their ward round and discuss. Ask what the plan is long term, maybe don't agree for discharge unless she has a follow up appointment?

Thank you. It's very difficult, because my sister and I both work full time, and it's my dad who is always there when she is discharged. He just seems to accept whatever they say and takes her home.

I’d ask them why your mums stents have been left in for over 6 months….they should have been changed by now.
im sorry she’s going through this terrible time…it’s really important to drink plenty fluids but I know from personal experiences that it is easier said than done.
wishing you all the best.

Ask for the consultant to phone you at your mum's bedside. Prime your dad that this is what he needs to ask for before discharge.
You need to advocate for your mum

Have a list of questions ready for the consultant
Your mum clearly needs ongoing outpatient care to avoid these acute admissions. What is her care plan? Ask that question directly

What community services do you have locally? Virtual Ward? Rapid Response? Has she been referred to any of these?

I think you need to be on top of the symptoms of the early signs of her deteriorating and escalating it asap. What are her usual symptoms of deterioration? Usually increased confusion, falls, going off their feet, temperature. Is she on a long term anti-biotic?

Hospitals won't just keep people in if they are clinically stable because a relative doesn't agree to discharge. Presumably she is under the Urology team - I would be asking for a discussion with them and ask what there plan is going forward.

Thank you all for your advice. The problem is compounded by that fact that my mum hates GPs and hospitals, so even though we can spot the early signs and symptoms, she point blank refuses to be seen by anyone before it's very serious.

She probably also insists on being discharged as soon as she feels well enough to argue and her DH probably has little choice but agree with her. That is really going to make any intervention difficult.

Yes. If she is refusing to cooperate then really the medics hands are tied. But this is not uncommon in elderly patients.,

I’m afraid I would take a couple of days off work to lurk at the bedside and get more information. It may not get you very far but there’s at least a fighting chance of understanding what’s going on.

If she hates medical intervention, would she write to her Gp giving you permission for them to talk to you? It makes a huge difference and might mean less hospital visits etc. Having power of attorney would be even better but will take a while.

The stent really needs changing. This is most likely the cause of the repeated infection (foreign body in her ureter) Is she under the urologists or the care of the elderly team? Whichever they should chase this up.

my mum hates GPs and hospitals
He just seems to accept whatever they say and takes her home.

So the above is the problem. As long as your mum wants to go home, and your dad accepts this, she will be discharged home. That is the official route for people who have the capacity to decide.

The first people that you need to speak to are your parents. Your mum has to accept that she is not well enough to go home, and that rushed, repeated discharges are not in her interest. Your dad has to insist on speaking to her consultant and to staff on the ward, and to the discharge team, and making a big fuss about the repeat infections and lack of aftercare. If he can't do this, you and your sister will have to. I'm afraid that no one else will do it for you.

It's tough when you're working FT. Unfortunately my experience was as @PermanentTemporary said. The most effective I have been is when I managed to speak to the doctors myself (armed with notebook, pen, patience and persistence) and that mainly meant time off work :/

With your parents, only you know what works best with them. The carefully constructed shit sandwich? (Nice words, hard truths, nice words). Shouting? Weeping? Coaxing someone she DOES listen to, to deliver the message?

Ultimately if she does have capacity then you can only persuade, and it's a frustration you are not alone with on this board!