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Patients with Covid-19 being sent home from hospital

50 replies

ToWalkaMile · 20/01/2021 23:16

I posted about this the other night, then asked for the thread to be deleted as it potentially identifying. I've since discovered that the people involved are minded to go to the press about this, so I'll post again.

The matter is now being taken up by the couple's constituency MSP. This post is pretty much the content of the email I sent to him last night, with names changed. I wrote to him with the wife's knowledge and permission.

"John is in his late 80s, and is physically frail with a number of health problems. He has been in Local Hospital with a physical health issue for which surgery is not an option due to his age and frailty. However, as he was better in himself, it was planned that he be discharged from hospital and return home on Friday, 15th January. While in hospital he had been tested for Covid a few times - always negative, until Friday, when he tested positive.

When Janet received a call from the hospital on Friday to tell her that John had contracted Covid while in hospital, she expected that he would remain in hospital. However, the hospital wanted to send John home. Janet pointed out that she is vulnerable, being in her 70s with angina and diabetes. John and Janet have been more or less shielding since March, and have hardly left home in that time. Janet found herself in the distressing situation of having to refuse, repeatedly, to have her sick husband at home in case she contracted Covid from him. Their house cannot accommodate a couple with one self-isolating.

After some discussion, the hospital eventually agreed not to send John home.

On Sunday morning, the hospital again contacted Janet, said that John would need to come home and that as she couldn’t collect him, they would arrange a taxi. Janet again stated that she couldn't have John back home, but after repeated pressure from the hospital, felt she was left with no other option. With help from various sources, arrangements were made for John to self-isolate in a neighbour’s house which is currently unoccupied.

On Sunday evening, Janet was advised that the taxi firm had refused to take John as a passenger, so he remained in hospital.

Over Sunday night, John developed a high temperature, and the hospital contacted Janet on Monday morning to advise her of this and that John would now remain in hospital as a Covid patient.

On Tuesday, the hospital contacted Janet to let her know that John’s temperature was now back to normal, and that he would be discharged. John came back to home village in an ambulance on Tuesday afternoon.

John has Covid-19. He is a frail, elderly man, who can’t use a mobile phone and struggles to use a land-line. He is on his own in someone else’s house. There is no care package in place. There is no one with him to take action if his Covid symptoms worsen. It is entirely possible that he becomes ill and is unable to phone for help. He does have a care alarm button, but he is vulnerable, distressed and ill with Covid-19, and needs much more than that. Janet is taking food and medicines to the doorstep. He is frightened that he will give Janet Covid, and she is scared for him and for herself.

John and Janet are both extremely distressed and I would say traumatised by what has happened since Friday and the on-going dreadful situation in which they find themselves. Janet has said to me that she feels that she was bullied into this. She would much rather John was in hospital, with medical staff there if his condition deteriorates.

Why are vulnerable patients with Covid-19 being sent home from hospital?

Why are people like Janet being ignored when they say they cannot have a patient with Covid back home?

Why are they being sent back into the care of people who are themselves vulnerable?

Why are elderly vulnerable people with Covid-19 being expected to care for themselves in self-isolation without any medical attention or care?

Why are they not being sent to, for example, the Louisa Jordan Hospital which was set up last year for precisely this purpose?

How many other patients are being sent home with Covid?

I am horrified by what has happened, and is still happening, to John and Janet. I cannot comprehend why a frail, elderly man with Covid-19 has been discharged from hospital. He should be in hospital, being monitored and receiving appropriate care from medical professionals."

When I spoke to Janet today she says that John had told her that other patients were being sent home after testing positive for Covid.

Yesterday, when I was talking to her about what to do if John's condition worsened, I mentioned that the various bits of paper she received when John was discharged, might contain helpful information and an emergency number to call. Nope! The paperwork he was sent home with refers only to the physical condition he was admitted with - nothing at all about the fact that he has Covid-19.

And in terms of the pressure that was placed on Janet to accept having John back home - during one phone call a doctor said to her, "your husband is sitting here crying because you won't allow him to come home".

So, I can't go into my local chippy, but patients, including the most vulnerable, with covid are being sent back out into the community.

Oh, and the hospital said they weren't sending John home because they wanted his bed. They were sending him home in case he caught something in hospital!

OP posts:
Calyx72 · 21/01/2021 16:49

Vaccine takes a few weeks to work.

There isn't anything the hospital can do. When his temp went up they kept him in, once he was asymptomatic they had to discharge him. Care homes are taking some I think, also intermediate beds in the community are being arranged in some areas.

It's a horrible situation and yes, wasn't handled well from the beginning. But hospital staff can't keep everyone who is positive in. Maybe Age Concern or Social Work or someone could help in some way for Janet & John?

ProseccoThyme · 21/01/2021 16:52

@iquitelikenormalityafterall - probably because they are unwell - for example if you have a temperature, haven't got capacity to consent etc.

Plus it takes around 2 weeks to start being effective & needs a 2nd dose of the same vaccine 12 weeks later.

iquitelikenormalityafterall · 21/01/2021 19:17

I know the vaccine takes a few weeks to work, but if someone is in there anyway I had thought just get them vaccinated. Some hospital stays can last weeks, it would provide some protection? Hadn’t thought of the fact you’re normally asked if you’re feeling well before a vaccine though, good point. But if an elderly person goes in with a broken hip then dies of covid I think it’s worth a try?!

SnowFields · 21/01/2021 19:22

I’m so sorry for John and Janet. I do agree that hospitals are so stretched and unless John is ill enough to need to be there, which it doesn’t sound as though he is, that it isn’t acceptable for him to take up a bed.

I really wish we had the resources in this country to use the nightingale hospitals for recuperation for people in this exact sort of situation. If they have healthy children, I would ask for one of them to either stay with John to keep an eye on him or let him temporarily move in with him.

I wish those that selfishly flout the rules realise this pandemic isn’t just about stats but about situations like this as well.

SnowFields · 21/01/2021 19:23

@iquitelikenormalityafterall

I know the vaccine takes a few weeks to work, but if someone is in there anyway I had thought just get them vaccinated. Some hospital stays can last weeks, it would provide some protection? Hadn’t thought of the fact you’re normally asked if you’re feeling well before a vaccine though, good point. But if an elderly person goes in with a broken hip then dies of covid I think it’s worth a try?!
You have to be clear of covid for four weeks before having the vaccination.
SimonJT · 21/01/2021 19:28

Hospital beds are only for those with a clinical need, by allowing this man to stay in hospital we would have to allow everyone in hospital with a positive result to stay there until they test positive.

If beds are full of people who are well and covid positive how do we treat those who actually need hospital treatment?

Would you want your mum, dad, friend etc to be denied appropriate treatment because well people were taking up hospital beds

DamnShesaSexyChick · 21/01/2021 19:32

Of course we send people home with Covid as long as they are otherwise medically fit, they are better off being at home with their comforts and familiar surroundings instead of being on some horrible hospital ward.

anon444877 · 21/01/2021 19:42

Sending people home with covid isn't the issue though - sending people home with covid to be cared for by another vulnerable person or nobody at all is the issue.

TheMadBat · 21/01/2021 19:47

Absolutely dreadful situation, which is probably being replicated and repeated up and down the country. I'm in England and know of one similar case.

I don't know if this applies to Scotland as well but this is the Government discharge and operating guidance.
www.gov.uk/government/publications/hospital-discharge-service-policy-and-operating-model/hospital-discharge-service-policy-and-operating-model

In it, it is basically pushing to speed up and circumvent normal discharge procedures. It is clear that hospitals are needing to free up beds.

In the guidance it states that there must be an assessment and discharge plan in place as soon as someone is admitted!

It sets targets for discharge to residential, and rehab and states that they wish to see at least 50% discharged to their home residence.

In terms of testing positive, care homes must be told and have the choice to decline, the patient should then go to a so called 'Hot Home' until they test negative. They are isolated and cared for pending move to care home. In the case of people being sent home they want to see no more than something like 25% of cases receive a package of care. Even if someone tests positive there is nothing in the guidance that stipulates that domiciliary/community care providers need to be informed of the patients positive Covid status.

In the case that I know of someone has been sent home with advanced cancer in their 90s. Unable to stand, unable to drink, or feed themselves but determined to try and walk around and fall over. They have a very bad chest infection and other symptoms of Covid. we have been told that we do not need to know if the person is covid postive, or was at time of discharge. We can not get this person a test. This person became increasingly unwell within 3 days. They live alone. we can not keep them safe. I have reported back that we are now looking most likely at palliative care. Unable to get a GP to them, because GP will not go in the house. The person refuses to go to hospital. person reports "Lots of people had this in hospital, I think I caught it there" meanwhile over 4/5th of staff are now sick and isolating. I suspect there are dozens of cases where the elderly are being sent home to die, if they are lucky they will receive care.

Its truly heart-breaking.

babbi · 21/01/2021 20:03

Those who are citing care packages as being required are correct but there is no one to do these roles .
My friend called to enquire about it for 2 elderly parents both in hospital at present - separate hospitals- they were going to fund privately and was politely told she’d be lucky to get something in place before June Every organisation was fully booked and short staffed .. they confessed to letting their current clients down regularly due to illness .
These 2 very vulnerable people are taking up 2 beds because they cannot be assisted at home .
My friend cannot move in and help them as she’d be putting them at risk due to her job .
It’s almost impossible for care to take place as it should ..either in hospital or the community- the resources Steven just not there . It’s terribly sad .
We are in Scotland. Cannot speak for the rest of the U.K.

babbi · 21/01/2021 20:04
  • resources are .... no idea where Steven came from .
TheSockMonster · 21/01/2021 20:06

Horrifying Sad

Is there no care package in place for John at all? Would he still have been discharged if he lived alone?

iquitelikenormalityafterall · 21/01/2021 21:57

@SnowFields then surely you’d not be too worried about needing a vaccine if you’ve already had and recovered from covid?

vdbfamily · 21/01/2021 22:37

If someone is well enough not to need a doctor then they should not be in hospital. So many people seem to think hospitals are hotels. Of course people are sent home with Covid. Many elderly people who contact Covid in hospital remain totally asymptomatic. One of the reasons the NHS is under so much pressure is that families, care homes, care agencies are refusing to have patients home until they test negative. This can take 3 months but Covid patients are only shedding virus for first few days.Another side of this that people often do not understand it's that if we have an adult in hospital who has capacity to think for themselves and says they want to go home, we have absolutely no right to stop them going. If this gentleman was crying and saying he wanted to go home and he had been assessed as being able to safely manage toileting and mobility, I can see why the hospital would push for discharge. One of my team of therapists spent most of this afternoon trying to calm down a son of a patient who we are sending home because the son thinks his dad needs a residential home. Patient has passed all his assessments and although he will remain a falls risk, he knows and understands this and wants to go home anyway. We cannot detain people against their wishes.
It is hard to fully judge without knowing everything but my guess is he was wantjng to go home. I would also guess that they were offered hot meal delivery service etc but wife may have said if she has to cook for herself she might as well cook for him.

vdbfamily · 21/01/2021 22:43

I just want to clarify that if John is actually unwell then my comment does not stand but having a positive Covid test does not mean you are unwell, even when you are elderly and frail. Lots of patients are very surprised to be told they have tested positive as no symptoms at all.

Justpassingtime1 · 22/01/2021 06:41

Sad to say but similar, not quite as bad, things were happening long before this. Resources for health services have been cut for many years.
Still, I understood that elderly Covids were now being discharged into
special nursing homes in some areas.

Justpassingtime1 · 22/01/2021 06:44

To add if people want all these services they need to be paid for:
they have them in other European countries but their taxes are higher
but they do not have as much property ownership as we do.

BabyYodaYada · 22/01/2021 06:47

Sorry OP, but what exactly would you tell the press. Hospital asks man who does not require Hospital treatment to leave hospital?!

Covid doesn't always require hospital admission, even in the vulnerable and elderly. Most people can be cared for at home.

WinstonWolf · 22/01/2021 07:00

Does Janet have another condition that makes her Clinically Extremely Vulnerable, (as you mentioned shielding)?

The angina and diabetes should classify her as "just" Vulnerable (alongside her age) which will also be why the hospital weren't more sympathetic. There is a definite distinction made between CEV/CV.

It's really a shame that the Nightingale's weren't set up for this type of treatment, similar to what we saw happening in China. Not everyone is able to provide home care for an ill relative, or risk getting ill themselves, not to mention adults living alone.

PurpleWh1teGreen · 22/01/2021 07:31

I'm so sorry. ThanksThat sounds horrendous, you are also correct in your assumptions I'm afraid. We have also had similar, with elderly MIL discharged to us after acquiring CV in hospital. DH & I are in our 50s, so not at the same risk as Janet, but certainly not invulnerable.

Adding to our frustration was the complete lack of planning or information and while I appreciate the current situation, the pressure on individual families picking up this burden is horrendous.

HelgaDownUnder · 22/01/2021 07:59

Are a significant percentage of covid infections acquired in hospital, or via indirect contact (such as if Janet or another family member caught it from John)? I.e. are hospitals major vectors for transmission.

Part of the problem with the hospital's stance is that after all John and Janet's sacrifices to stay shielded it was bought into their home via the health care system. It seems rotten to infect him, then kick him back into the community.

Totallydefeated · 22/01/2021 08:19

Not surprised at all, OP, my experience with elderly relatives in hospital before this shit show was that there was a desperate push to get them out of hospital at all costs, regardless of whether they would be able to manage at home.

Rehab had to be pushed and pushed for by us, the relatives, and we had to contend with some staff members lying about the abilities of our relatives, eg saying they walked the length of the corridor unaided, when they couldn’t actually walk past two beds to get to the loo in the corner of their bay. It was only once we showed them a video of that relative doddering slowly and unsteadily across the floor while needing to hold onto furniture, and stated we would be there videoing the next physio session that they relented, and suddenly a rehab place could be found after all.

I shudder to think what happens to elderly patients who don’t have relatives to advocate for them.

I get that beds are scarce, but there needs to be a solution here, other than sending home a vulnerable and frail elderly person to manage alone, or potentially fatally infect another vulnerable person.

Yet another example of our piss poor government failing to plan or give a stuff about the plebs.

Moondust001 · 22/01/2021 08:22

Are a significant percentage of covid infections acquired in hospital, or via indirect contact (such as if Janet or another family member caught it from John)? I.e. are hospitals major vectors for transmission.

Yes they are. I last looked at the figures back in late October and hospital acquired Covid transmission (only testing positive 14+ days after admission) was running at an estimated 25% back then - it has to be much worse now.

I am afraid that I have to agree with the majority here - it's horrible but this is "what we paid for" - hospitals that can only maintain beds for those who are in highest need, and a creaking care system that didn't perform well at the best of times. None of these things are secrets and this has been happening for a very long time - long before Covid. Smaller numbers then more often than not, but it's nothing new. Covid has simply brought more pressure to bear and the system is now broken. I have heard many of these stories across the country - it isn't just Scotland.

As for hospitals, what are they supposed to do? They have people in beds who are not sick enough to warrant being there, and are expected to turn away someone who is desperately sick (of anything) because the beds are full? Then someone will be complaining about a relative turned away or dying in an ambulance. There's no win here for anyone.

PurpleWh1teGreen · 22/01/2021 10:56

If you widen Moondust's definition to all healthcare settings and include care homes, the data is even worse I'm afraid. I'm struggling to find the article, but I have a figure in my head from back in the summer, that something like 48% of covid infections in the first wave were healthcare acquired. And while I may have misremembered the exact stat - it was definitely shockingly high.

iquitelikenormalityafterall · 22/01/2021 11:44

This thread enforces to me the fact that covid restrictions themselves are putting hospitals under more pressure than the actual virus. Staff having to self-isolate, many patients in hospital asymptomatic that can’t go home to vulnerable relatives. I heard one a&e nurse saying she couldn’t save a patient having a heart attack because it took her so long to get her ppe on. I’m in no way blaming nhs staff, it is definitely the government’s fault. There needs to be more balance.

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