Care at home for someone who has lost most mobility - any experiences of making this work?

[DinahCat]

Mum is 93 and very frail but until now she has had enough mobility to get herself into the loo, to the kettle to make a cuppa, and upstairs on the stairlift.

However she has been in hospital for a week now with an overwhelming infection and can barely support her own weight. She is also confused (delirium according to the staff here) though this is now easing. Memory however seems pretty shot.

She will soon be medically fit for discharge but obviously needs comprehensive nusring/social type support (only moveable with a sara stedy etc)

My guess (OT has not yet assessed but we expect it to happen next week) is that they might refer her to what is laughably known as "reablement" in the community hospital (around 40 mins away).

She was sent there last year on discharge from the acute hospital (broken shoulder and generally bashed about after nasty fall, and tbf stated out similarly weak) and the total of 6 weeks in hospital definitely left her with reduced mental and physical capacity (it was only then that she had to have care/use a stick indoors etc - and she stopped using her bed and moved to the riser recliner)

This time ideally I'd like to see her home sooner but I don't know how her personal care would be managed. Do they supply anything like a sara stedy for home use? Would regular "food prep washing and toileting" carers be able to use one or is that officially "nursing".

I'm not expecting answers to these questions specifically so much as hoping people might have their own different experiences to share, of fairly intensive care delivered at home, what was provided, what worked/didn't and (😭😭) what did it cost?

Thank you 🙏🙏

Sorry I’ve just read the full thread and seen that your DM is end of life care. I’m so sorry.

I would talk to the Consultant that’s she’s under at the Hospital and ask them how long they think your DM has and what can be put in place to make her end of life more comfortable.

If it’s under 3 months she should be entitled to a free place in a Nursing Home. Unfortunately, your DM may no longer recognise her own home if she has delirium and has been away from it for a while. People with delirium often ask to go home but they are craving that sense of security, comfort and belonging rather than an actual place you recognise as their home.

Thanks to everyone who posted this morning, I 'm so grateful. Other poa is much more sensible about protecting their own boundaries and energy (they have to owing to a disability).

I feel very lost, it's so helpful to hear about other people's experiences

Ice just reread your post again and if the Hospital discharge her with Carers then that “care” should be free for the first 6 weeks. There are some good ones but I really wouldn’t expect better care than your community hospital and at least there there will be staff 24/7 instead of 3 or 4 5 minute visits a day.

Its not unusual for them to be left for over 12 hours at night without a visit either.

Thanks @ExplodingSmittens - at this point I think we will be trying to find a place in a home. She just needs too much attention to be at home - it still takes two people to move her and she is constantly uncomfortable.

On reason for her being in hospital is apparently the pressure sore (she's on a matress that periodically tips her towards one side or the other).. @AddledPeacock was your df discharged with pressure sores that healed in the recliner, or was it just that they did not recur? I can't help.feeling she'd be so.much happier in "her" chair and I know some homes let you bring one in, and they are anyway very likely to have them

My DH has been completely bedbound for 4 years. In many ways it is easier to have that situation than someone 'kind of' mobile with a frame and falling all over the place (which happened for a few years before)

He's in his 80s, has some sort of genetic anomaly IMO that means he heals very well and I don't think without that it would be possible.

Basically though people who are bedbound or reliant on something like a Sara Steady to get them out of bed need 24 hour care, there is a bit of leeway if they can use eg an alarm, as long as their cognition and ability to use it is OK and they will not try to mobilise themselves.

You need to think very carefully @DinahCat if you can get support in place that will facilitate this, and if you can't, don't beat yourself up

Thank you @Uricon2 - things have become clearer to us since our last visit. We had an agonisingly inconclusive family meeting where they basically told us they didn't yet know how much care she would need - but the discharge manager talked around the 4 visits per day for a few weeks option, which would never be enough (we would arrange live-in if she was determined to be home, but her funds won't stretch to 24-hour waking and the hospital accepted that 'nights might be an issue'). Any mention of CHC or the hospital social worker was dismissed as 'we don't do this here any more, it has to be arranged direct with "CHC"'(?)' and 'not relevant' I was left feeling that there was no way we could give mum what she needed, but the hospital were not going to help in the slightest.

Then we talked to Mum and said she might be able to go home but she would be effectively on her own some of the time (when carer was asleep) and she said 'oh no, I don't think I'm well enough to go home. And confirmed she would rather be somewhere where there were people around all the time.

I repeated the conversation today and she said the same - 'I need too much looking after'. So that is the first of probably 100 questions now answered. I have visited now the grand total of one nursing home so far, but definitely progress.

And thanks to everyone who has supported this pre-emptively as it were. Now to go and delve into old threads about how to choose one (even confining the search to nursing homes only, there are SO many!!)

Not to scare you on price. We are looking at getting MIL (86) out of a care home (only there since July following a broken leg) and back home for full time care. She had carers 3 times a day prior to that. Current quote is over £12k a month for 1 live in carer with 4 hrs relief daily. This is self funded. London based.

Thanks @GCRyan - Mum herself I think
feels she would be better off in a care/nursing (tbc) home.. Although the prices we have seen for live in care (albeit without adding relief during breaks) aren't quite that high, it's still clear she hasn't the funds to stay at home for long, and we think all round the staffing and services available in a home will meet her needs for company and care better. We hope so anyway.