DF in hospital after fall- meeting Integrated Discharge Team

[mullingitallover43]

DF (72 - Lewy Body dementia & Parkinson’s) fell down the stairs at home and fractured his spine. It’s a stable fracture.

He was taking by ambulance to local hospital and is now in acute medical unit. He has complex cognitive and physical needs and has a 121 nurse as he is high falls risk. He is very confused, delirious and hallucinating, but in his lucid moments is asking to go home.

The council recently delivered a hospital bed to his home which is not on the ground floor - this was prearranged by social care before the fall.

His wife (my SM, 62)would prefer my dad to go to a nursing home as is very worried she can’t manage his care anymore. I tend to agree he would be safer at a nursing home and needs around the clock supervision.

a scan of my dad’s spine has shown up lesions on the spine which they are testing in case cancerous.
the suggestion from the dr seemed to be that treatment would be difficult for my dad.
The hospital is arranged a meeting with the IDT today which I will attend with SM.

any experience on what to expect at this meeting would be great please.

My DF has a POA in place for finance but not for health. He has not yet signed a Respect form and I believe in his current condition will be deemed not have the mental capacity to make decisions.

Something very similar happened to my MIL this year. She ended up in hospital after falls (also one downstairs with spinal fractures and other severe injuries) also had advanced Alzheimer’s.
She was in hospital for 6 weeks. Doctors said she wouldn’t be able to go home. Her partner couldn’t manage her any longer.

Several staff kept saying she’d be “ home in a few days” and she was moved several times. Communication was poor and after a move often they hadn’t read her notes.

I’d be checking that people at the meeting have actually met or assessed your DF. We had a phone call from a social worker to arrange transfer home. He hadn’t met or assessed her. Once he did he apologised.

The discharge nurse was actually very good and the social worker apologised after meeting MIL.
Have you researched CHC funding? Might be worth exploring. MIL qualified and was moved to a nursing home for end of life care.

They could offer carers at home which is free for 6 weeks in some cases or might offer a rehab/ assessment home.
We were given a choice of 2 homes under CHC.
Hope the meeting goes OK.

Thanks so much this sounds like a similar scenario.

The meeting didn’t materialise today and we were met with confusion when we mentioned that it had been booked for 2pm. We were given a “This is me” form to fill out for my dad and told it would be added to the system.

The Dr finally came and seemed annoyed us when we enquired about results of his blood tests for cancer - asking where we got that idea from. We had been told by another Dr that a scan found lesions on his spine and we should prepare for the eventuality it could be cancer.

meanwhile, they are telling us that it could be quite some time until discharge to pathway as Leicestershire is particularly slow to assess.

We have requested CHC funding, and I think the next step will be a nursing home - though dad still believes he’s been kidnapped and is going back home tomorrow.

any tips for how to manage this with a parent with dementia would be great. I’m just trying to stay in the moment with him and keep raising him that he’s safe and nobody is trying to harm him. He’s very angry with his wife did not taking him home, I imagine this is a sadly common scenario

Sounds like poor communication again. My MIL kept asking to go home. When she was first in hospital it was one of the only words you could make out. DH just kept saying you need to get better.
So sorry you are going through this.

This sounds very tough. I hope you got some sleep.

I think you’re right to keep saying, you’re safe. Look for very simple sentences, not questions. Saying ‘nobody is going to harm you’ could be interpreted as somebody called Nobody definitely is going to harm you! I used to say to my mum, ‘you need a bit more help at the moment’.

It is so painful to talk with a person, especially a parent, with dementia and not take what they say and the emotions they express at face value. It feels disrespectful. But we have to do it. It’s a huge part of the stress. So it helps to be as truthful as you can be. With my mum, she definitely did need a bit more help at the moment. She did need to stay at a convalescent home.

Thank you so much for understanding and sharing your experiences.

Put everything in writing. Follow up every conversation with a note of your understanding of what has been communicated. Dates, times, those present and keep audotable proof of sending it.

It avoids obfuscation.