i need fast advice for my dear sister

[mydearsister]

my ds is 75.
She has been in itu for the last week.

*she has endured bowel cancer for a number of years.
*her remaining kidney isn't functioning well, but has been stabilised now.
*she can't walk, the result of kidney infection , black feet and swollen legs. completely bedridden.
*she lives on a 11 floor flat in London.( her dh refuses to allow her even a tv to watch even though she is a virtual prisoner in her ...squalid home)
*her dh is 85, , sometimes he isn't aware of his surroundings.

last time this happened 3 months ago, my dsis admitted that she couldn't cook...couldn't stand...couldn't shop, couldn't walk...when she was discharged that time, she was offered palliative care, but it was turned down.
no family/friends nearby, I am the closest but 3 hours away.
they are totally alone.
each time dsis reaches A&E, it is because of her non existent care at home.
each time this happens I have told the nursing staff re her home conditions, but nothing has been acted upon.
they say, which I understand, they can't force anyone to accept help.
I am 71, and can't bear to hear how my dsis is living a hell like existence.
each time she is admitted to hospital, she begins to eat again and is stabilised, but then returns to her living hell.
she may be released this week again, but released to what????

I would try putting it in writing/emailing the relevant department setting out the background, how urgent it is and what has happened to date.

There's something about the formality of some sort of written record that seems to galvanise people over telephone calls/speaking to people.

It maybe because the contents of a phone call can be disputed or talked down ("she never said it was that bad") after the event, but if you have a written record then (if god forbid) something bad happens, the written record is indisputable.

Provided you target the correct people (most senior in relevant plac) written tends to do better than a phone call/speaking to people.

Sounds like you need to speak to his GP/medical practice about getting him sectioned if he's not eating and refuses all offers of help/contact.

Presumably your sister can tell you which GP practice you are with and you can speak to them and insist they tell you what to do when they have a patient with dementia who is not taking care of themselves and therefore a danger to themselves?

I feel so sorry for your sister, at least she will be looked after in hospital.
bil may be getting his commuppance red flags of abuse

It sounds like he needs to be assessed by adult social care. The local council will have a duty officer you can ask to speak to. Tell them all you know and stress that he is a vulnerable adult who possibly lacks mental capacity to make appropriate decisions. The new care act means they have a duty of care to him that should be at least investigated.

Self-neglect is recognised by the Care Act 2014.

yes, on one hand knowing my sister is receiving the most amazing care, even though she is very poorly, it is so painful for us, when he keeps asking why isn't she coming home.

he refuses to have contact with any agencies, but ringing me in despair, also to my poor sister in her hospital bed (tubes everywhere, just out of itu).
we have just discussed him coming to stay with me for a week/month or however long it take for her to be strong enough to come home.
he refuses any suggestion of help.
maybe eventually he will become hospitalised himself, but no peace of mind for my dear sister.
I have repeatedly spoken directly to nursing staff, but due to his infrequent visits, they haven't put two and two together.
I shall ask my sister if I can write to the social worker to explain the situation.
I asked her today if I could talk to them but she said he wouldn't agree to talk anyway.

Have you spoken to the hospital's social work department?

Your dsis's dh may be shown as next of kin on her hospital notes but if he has senile dementia he does not have the mental capacity to make choices or decisons relating to her care or his own.

If, as would seem apparent, he is suffering from senile dementia, taking him out of his usual environment may manifest in him becoming even more confused and you should be prepared to be continually bombarded with the same questions repeated ad infinitum if you take him into your home and you may have to draw his attention to his personal hygiene which could provoke his wrath.

The best possible outcome would be for dsis to be discharged from hospital with a care package in place to ensure that she and her dh are able to remain in their own home for as long as possible, but in order to achieve this you are going to have to alert all the relevant agencies even though you may feel it's not your place to do so, or that to do so would be in some way going against your dsis's wishes.

Talking to nursing staff may make you feel you've 'done your bit', but if you don't become more proactive it's likely that the periods between dsis's discharge and re-admission to hospital will decrease with all of the attendant risk to her health this implies.

It sounds like he needs to be assessed by adult social care. The local council will have a duty officer you can ask to speak to. Tell them all you know and stress that he is a vulnerable adult who possibly lacks mental capacity to make appropriate decisions. The new care act means they have a duty of care to him that should be at least investigated.

This ^^

Before your sister is released from hosp there should be a care plan in place for her. Don't accept her home until it is in place. Her husband also needs a care plan - it sounds as though he isn't able to look after himself. Are they getting any benefits? They may both be eligible for attendance allowance. You need a social work assessment - and of their home - asap.

Agree re the hospital social work department. My mother was not looking after herself properly at all, and we ended up in a very similar situation.

But you need to write things down for them, and if you are able to take photos of the flat, or give any other kind of proof, this will really help. Sadly they would far rather discharge her, it's much easier for them, but if you have recorded the problems, they can't do that.