Dad 'bed blocking'

ukmaggie45

Soolin, I don't have any words of wisdom for you, but just wanted to say that I'll be thinking of you and your Dad. Some hospitals are appalling when it comes to communication. When my Mother was in hospital they put her on the Liverpool Care Pathway for the Dying and didn't even bother to let me (next of kin) know. I do sincerely hope that the hospital can make your Dad comfortable, I know just how awful it is worrying about ill parents. Best wishes.

Farway

clemmatis wrote: »

when my mother was in hospital I read her notes daily, openly. .

We did that with my mother, when we started questioning the staff as to why certain things were not being monitored or recorded, such as weighing her, we found the notes had vanished, presumably hidden away so we could not read them

Great Western at Swindon BTW, mum now dead so not an issue any longer

Errata

Soolin - it sounds like going back to the care home is the best option for your dad to receive the care he needs. Good to hear the staff at the home will be catheter trained, please make sure the home understands that your dad is capable of pulling his catheter out and can give you an undertaking that they will have catheter trained night staff if it happens during the night.
HTH

picasso2

Surely District Nurses provide support to residential homes with such as catheters ? And can advise on or perform re insertion if needed overnight.
I have worked in healthcare in Yorkshire for many years and this has always been the case. Sometimes though a catheter will have to be passed in hospitals if it is a tricky one. But I would say the care homes first point of contact would be the DN as soon as he gets to his home who can get a care plan in place for catheter management and will contact the necessary people to find out where changes will be done.

Savvy_Sue

soolin, I will be thinking of you, and I am sorry the hospital are not being communicative. When Dad was in hospital we were able to speak to his consultants by phone, or make appointments during visiting hours, but it wasn't always easy especially when several 'specialities' were involved.

I hope he can get back home soon, is he less distressed by your visits there?

Paul1_2

Arthurian wrote: »

Sorry for the disgraceful treatment you are experiencing, OP. Could someone explain what an "abandoned senior" is? It's the first time I've heard the phrase and neither google nor directgov help explain the implications. Does it mean relatives have a legal responsibility to take on the care/responsibility of that person?

Well "abandoned senior" is a new one on me after 25 years practice, including work around safeguarding vulnerable people.

There are a number of issues in the post, first of all the crucial test here for both the hospital and SS is does the gentleman have capacity to make specific decisions around care and treatment. If not then under the Mental Capapcity Act there is a need for a best interest decision and this should include the next of kin, family and friends.

There is clearly no issue with bed blocking from the information described here. Bed blocking is a nice term that refers to SS not responding under the Delayed Discharge Act and it allows health to fine SS £100 per day if it occurs. Bed blocking cannot start until the patient is medically fit for discharge: all tests and assessments completed etc, this may explain SS reluctance to progress anything until the patient was fit, but they should have spoke to the next of kin. If you have any concerns about the SW role contact the Team Manager.

SS should be more proactive than your post would suggest, I would suggest that you as for an assessment under the Community Care Act from SS. This is a right for anyone and being self funded does not preclude you from an assessment, but as mentioned previously this will not normally start until the patient is stable and fit for discharge.

The other areas of concern appear to be around the potential need for Nursing Care. A catheter alone is not a reason for an individual to have to move from their home (and the residential home your father is in is his home). There is a decision to be made around wether his "nursing needs" can be met by District Nursing Services, based on frequency and complexity. Remember there are lots of people living in the community with catheters.

I noticed the home were being trained in catherter care, this will be at a very basic level (emptying the bag, hygiene etc) as catheter care is invasive and a task for trained nurses.

The decision making process around nursing care should include the hospital, SS and the PCT. Nursing care is free at the point of delivery in England, so the nursing element of the care your father needs would be funded from the point of admission to a nursing home if this is needed. During this process consideration would also be given to decide if your father was eligible for fully funded NHS care, but on the limited information in the post this is unlikely to be approved. The bottom line is that he should pay no more than he is now if nursing care is needed (apart from the variations in the cost of residential care between homes).

I think the best option is to request a meeting with the Social Worker as they should be supporting you and helping you to navigate the system. If there are any concerns on their performance then as I said earlier contact the Team Manager. In most areas there will be a team based in the hospital.

I hope it all goes well for you and your father.

soolin

The abondoned senior was a result of the Government 4 hour targets in A and E. Dad was in A and E for a while before anyone took any notice of him, so the 4 hours was approaching rapidly which meant that they had to either admit him or discharge him.

They would not admit him, the home would not take him back so as far as the hospital were concerned he was there but 'abandoned' . Getting social services involved was probably to save them having to declare a breach of the 4 hour rule.

Notes were not available on beds, only obs and earlier notes from a different hospital had not been obtained. The notes i read were the 'sealed' notes from the scanning department addressed to the doctors on the ward.

As for nurses, yes the home has access to them but my area is one that has a severe shortage and it is not uncommon to wait several hours even on an emergency call and when desperate it is not unusual to be told to just go to A and E instead to get sorted out. Obviously transporting Dad back and forth to A and E was not good for his health.

Dad apparently is fine and well. They had put a different sort of fixed catheter in now which is a bit more 'fiddle proof' and hopefully it will mean dad will leave it alone.

Thank you all for your kind thoughts and sugegstions. Isn't it a terirble thing when those who can't speak up for themselves end up being so vulnerable in a health system. The fact that the population is getting older overall means this situation is likely to get worse as the years go on.

margaretclare

soolin wrote: »

When I spoke to the hospital and they finally admitted there was a problem they did say they would be no investigations, and I am happy with that. They sort of skirted round the idea that a younger or fitter man would have an operation, but my father is too frail for it (and i agree) so making him comfortable is the only way forward. They also sort of half mentioned that even if tests did show it to be any sort of real problem we still could do nothing about it.

He was in another hospital last week with his usual heart issues but because i refused consent to an operation there for the heart they sort of ignored the fact he can't pass urine and sent him home still with no urine function, hence the ambulance the next day to a different hospital.

I just want dad to be comfortable, I don't really care what he has or has not got as long as he is in no pain but it just feels like we are playing politics sometimes with the hospital.

God in heaven. It does sound as if your Dad has got BPH (benign prostatic hypertrophy, or enlarged prostate) which is no surprise, given that it affects 80% of men over 70 and can easily be diagnosed by a rectal examination. However, not being able to pass urine is THE most uncomfortable thing you can imagine, and he was sent home with 'no urine function'!!! Words fail me.

While on a catheter, make sure he drinks plenty. There is the added risk of urinary tract infection. We are all advised nowadays to drink at least 8 glasses of water a day, but this is something that older people seem to be resistant to.

Mojisola

soolin wrote: »

Notes were not available on beds, only obs and earlier notes from a different hospital had not been obtained. The notes i read were the 'sealed' notes from the scanning department addressed to the doctors on the ward.

I found this has changed in our hospital. The notes always used to be kept at the end of the bed. When an elderly relative was in hospital recently we found that the only notes kept by his bed were things like liquid intake - all the others were kept on the nurses station. I know the patient can ask to see them but lots of older people don't want to "upset" the nurses by doing so.

Dad apparently is fine and well. They had put a different sort of fixed catheter in now which is a bit more 'fiddle proof' and hopefully it will mean dad will leave it alone.

Thank you all for your kind thoughts and sugegstions. Isn't it a terirble thing when those who can't speak up for themselves end up being so vulnerable in a health system. The fact that the population is getting older overall means this situation is likely to get worse as the years go on.

I hope your Dad keeps well. It's so difficult coping with all this. I'm caring for Mum and Dad and really sympathise.

Savvy_Sue

Actually, I'm wondering if your Dad would be entitled to Continuing Health Care: he has dementia so must need a certain amount of care; and he now needs to have his catheter looked after (and a 'well-managed' need remains a need!); plus he clearly has a number of other problems.

It won't be fun trying to get it, but if you feel up to it you could have a skim of this thread and see if this self-funding has gone on long enough ...

Not that it helps the immediate problem of lack of communication, which is disgraceful!