Discharged from hospital - care package help and out of area

nightsky224

Just looking for some advice if people have been in similar situations, if it's in the wrong place let me know and I will move.

My grandad has been in hospital (first in critical care now a specialist ward) for 2 weeks. He has been very unwell (had a heart attack and fluid on his lungs) his treatment is ongoing but today they mentioned to my Nan that he may go home Monday. They have said that they can not support with setting up care as he lives out of area (he was sent to specialist hospital an hr away from home)

Simply put both my nan and grandad are disabled and muddled along at home before this happened (just!) but now my nan will not be able to cope, she is not physically able to support him.

He can not go home until something is in place but I'm not sure how we go about it esp as out of area. If anyone has any advice or knowledge it would be really appreciated.

Counting_Pennies_2

That is dreadful, they must surely have a link to social services in other areas.


I would suggest contacting your GP surgery first thing and ask for the GP to call you back in the morning and say it is urgent. I would also contact the social services department in their area.


hth

peachyprice

They need to contact social services in their own health authority to make the necessary arrangements, their GP should have the contact details.

Rambosmum

Call adult social services in the location your grandparents live.

They will be able to liaise with the hospital and organise something, either intermediate care, where your grandfather has a period in a special care home to help him get physically better (rather than medically) with special occupational therapists and physios to support him or with intermediate home support which provides carers to help with washing dressing, taking meds, meal prepared etc for a short period of time-usually up to 6 weeks. If after this they feel he needslong term support they can help organise that too. The sooner you call the better. But if hospital start discharging him before you have any help say " I strongly advise you don't as you will be facilitating an unsafe discharge' which they can get in trouble for!

Please feel free to pm me that if you want more help, it's my day job!

nightsky224

Counting_Pennies wrote: »

That is dreadful, they must surely have a link to social services in other areas.
hth

You would hope so! Thank god we are there to help him, what happens if you don't have any family!

peachyprice wrote: »

They need to contact social services in their own health authority to make the necessary arrangements, their GP should have the contact details.

Rambosmum wrote: »

Call adult social services in the location your grandparents live.

They will be able to liaise with the hospital and organise something, either intermediate care, where your grandfather has a period in a special care home to help him get physically better (rather than medically) with special occupational therapists and physios to support him or with intermediate home support which provides carers to help with washing dressing, taking meds, meal prepared etc for a short period of time-usually up to 6 weeks. If after this they feel he needslong term support they can help organise that too. The sooner you call the better. But if hospital start discharging him before you have any help say " I strongly advise you don't as you will be facilitating an unsafe discharge' which they can get in trouble for!

Please feel free to pm me that if you want more help, it's my day job!

Thank you both I think social services will be the next step for us. My aunt is ringing to speak to the consultant about his condition as we are getting mixed messages.

Thanks for the unsafe discharge point. I also found this on carers UK https://www.carersuk.org/help-and-advice/practical-support/coming-out-of-hospital so will ask them if all the relevant bits have been put in place. It's a nightmare, he's only just started eating a small amount and had his chest drain taken out yesterday. His lung is collapsed but they don't think his heart is strong enough for an opp how can they just send him home!!!!!:mad::mad:

Person_one

Are you sure they're talking about actually sending him home? Its common for specialist hospitals to send patients back to their local 'general' hospital near their home once they no longer need the specialist care, is it possible that's what's being planned? If that' the case then social care referrals would be done by the local hospital once he is there.

Hopefully this is just a miscommunication issue, is your nan finding it difficult getting all the information about what's happening?

nightsky224

Person_one wrote: »

Are you sure they're talking about actually sending him home? Its common for specialist hospitals to send patients back to their local 'general' hospital near their home once they no longer need the specialist care, is it possible that's what's being planned? If that' the case then social care referrals would be done by the local hospital once he is there.

Hopefully this is just a miscommunication issue, is your nan finding it difficult getting all the information about what's happening?

Am almost sure, he would refuse to go back to the local hospital if they suggested (unfortunately he has very poor care there in the past) but my aunt has rang and asked the consultant to ring. We get bits and pieces of info and we need to have one point person that they speak to (aside from my grandad) they will sometimes speak to my nan but it's all a bit overwhelming and she finds it a lot to take in

Person_one

nightsky224 wrote: »

Am almost sure, he would refuse to go back to the local hospital if they suggested (unfortunately he has very poor care there in the past) but my aunt has rang and asked the consultant to ring. We get bits and pieces of info and we need to have one point person that they speak to (aside from my grandad) they will sometimes speak to my nan but it's all a bit overwhelming and she finds it a lot to take in

I think that's a really good idea, unfortunately, it is all too common to get mixed or confusing messages from different teams in hospitals, especially if the person getting all the info is struggling and feeling overwhelmed with it.

I'd decide who is going to be your 'go to person' asap and confirm that your nan and grandad are happy with that choice. Then get them all to speak to the ward manager/matron/sister (tomorrow, because they won't be there over the weekend) to let them know who that person is and to express their concerns. Hopefully things will get clearer, and you'll get some answers to your questions.

AnnieO1234

You need to speak to the discharge co-ordination, I suspect you've just spoken with someone who obviously doesn't know their behind from their elbow. They will no doubt, especially as you say it's a specialist hospital, have contacts already in your grandparents local area including with Social Services. We had the exact same last year, two totally different primary care trusts and hospital trusts when my DH came home from a specialist cancer hospital in a nearby city. It was all arranged for the equipment etc to be delivered via the hospital, didn't need to get the doctor involved at all at that point.

Your grandad must leave hospital with a care plan in place, even if that document says "care refused" anything less than that document means the hospital is simply kicking him out too soon. Sorry to be blunt.

Xxx

Mr_Toad

The hospital has a duty of care to the patient but they do like to discharge people and pass that duty of care to someone else.

As a first step your Nan should simply tell them she is unable to cope or care for him. I have no doubt they will try and cajole her with promises of help and that things will get sorted but she should stand firm until things are sorted. If she lets them send him home she/you will find that you will have to arrange things and then the problems start.

If you do you accept the discharge you will find getting anything sorted can take an age, meetings, funding, social worker case load etc. and all the time this is happening your family have to cope and there is little incentive for the Social Services or the NHS to do anything quickly.

It is a sad fact that whoever currently has your grandfather is responsible for his care and care plan. As they want to move him on either for financial reasons or to free up a bed this fact lone concentrates their minds and they have to sort it out.

What people have said above is good advice.

It might seem harsh but whoever has your grandfather has the responsibility to ensure care is in place and they know it.

Beckyy

Where do you live?

Contact your local social services/community care at your LA. It's different for each area so would be help to know if you're in England/Scotland/Wales and your county.