Discharged without a care package

northwest1965

My father who is 87 was discharged from hospital today, He was admitted on Sunday morning after a fall due to a urine infection. Discharged later in the day. Re admitted the following day, as the infection has gone into his blood. (Monday)they just seem to want to get him out all the time. He was discharged this afternoon again with no care package. My sister tried to tell the sister that he cannot get out of bed on his own. He cannot get in the shower alone. Her answer was to mention it to the company that are coming to administer his antibiotics by injection.

It has been appalling, it took us 1hr 30 yesterday on the phone as they had no record of him being admitted.

Should he have been discharged without a care package?

DomRavioli

Did your father speak to the hospital social worker regarding a care package? Is the inability to care for himself temporary or permanent? Did your father/NOK (next of kin) raise any issues with care at any point during his hospital stays (as in requesting a care package by using those words)?

If the answer to any or all of these are no, then they cannot read minds, nor provide care if it is refused. If a patient refuses care and is mentally competent, there is nothing that the hospital, or anyone else (including family members) can do apart from accept the person's decision, or if in serious doubt regarding their mental state and competence, they could attempt to get their competence checked.

If it is temporary, it may not be possible (due to massive budget cuts) to provide simple home care through the LA (this is wholly dependent on circumstances, and judged usually on a case by case basis). If the inability to get out of bed or shower is not temporary, I would have thought that there would be a care package in place already, and that would have been the assumption of the ward sister. Was it specifically mentioned that there was no home care and that a package needed to be provided on discharge?

If your dad didn't want or refused a care package, or it was not felt necessary that he needed one, then yes, he can be discharged without one.

In order to answer your issues fully, you will need to provide material facts however, based on the questions at the beginning of the post.

northwest1965

My father is fully open and accepting and wants extra help.

He was only in hospital overnight, so we never had chance to raise the issue of a care package with any staff.

He was sitting in a wheelchair in the entrance when we arrived so we only spoke to a ward staff member by telephone.

When my MIL was needed extra care, it was sorted very quick. If I remember rightly, it was for an initial 8 weeks and then it had to be funded by herself.

I know there are cuts to budgets, but after his fall on the Saturday, he was admitted and they never even cleaned the cut on his head!

moneyistooshorttomention

Would it help if there was a "paper trail" for this sort of thing happening (ie to try and prevent there being no careplan in place)?

I'm wondering whether if you formulated in your mind what care plan was necessary and "standard practice" to be provided in these circumstances. Followed by writing a letter (copy kept) to those who are supposed to be providing such a careplan and saying words to effect of "My father will require the following careplan and I look forward to discussing with you (named person) how this is to be provided".

I'm guessing it would be harder for them to wriggle out of dealing with this if you had written evidence of what was necessary/expected - preferably backed-up by a supporting letter from his doctor.

I'm not experienced in providing suitable tactful (but FIRM) words to "hold the powers-that-be to their responsibilities" in these circumstances. Someone else may be able to draft something suitable for you.

fuzzyduck22

I guess it's time to get the ball rolling now, ask your Dad what care he needs/wants/will accept and start arranging it . I'm not sure but this may be done through his GP, if not then I'm sure you will find out who/where from his health centre.

ceegee

Contact your county council social services department and request an assessment, although, as has been said, budgets have been savaged and most councils will now only provide care where the care "needs" are substantial or critical. They may at least be able to point you in the right direction or provide enough information for you all to be able to work out the way forward for your Dad.

Hope you get something sorted.

lisa110rry

You might also contact Age Concern to discuss the way forward. If in the end you write a letter use as many "buzz words" as you can like "joined up care" and "quality of life" but keep all emotion out of your letter.

moneyistooshorttomention

ceegee wrote: »

Contact your county council social services department and request an assessment, although, as has been said, budgets have been savaged and most councils will now only provide care where the care "needs" are substantial or critical. They may at least be able to point you in the right direction or provide enough information for you all to be able to work out the way forward for your Dad.

Hope you get something sorted.

I admit to instantly translating "substantial or critical" into meaning "The person will die or there is high risk of extra unnecessary illness if they aren't dealt with"

- which then cynically got translated into "Tell them if they kill or injure your loved one the word 'compensation' and the other word 'publicity' will be hanging very heavily in the air" - suitably tactfully phrased of course....

One shouldn't have to be so "firm" with the powers-that-be - but my suspicion is that people are going to have to get "firmer" and "firmer" with them the more that budgets are cut.

northwest1965

The wheels are in motion. The company administering his IV antibiotics have started the process.

oldandhappy

My mother in Uk is 87 and been admitted recently to Hosptial for urine infection and is very confused state of mind again.She has only been home from another hospital long stay jujst 2 weeks ago.She now says she wants to go home but my sister who sees her regulary has said she is not fit to be at home alone. She is also not mobile at all and incontinent.No idea right now
where Mum will end up....

margaretclare

I have something in common with the people being discussed in this thread, see what I wrote in another place (copied). It appears that UTI is extremely common, ref northwest1965 et al.

"The new year could hardly have started less auspiciously - I was in a hospital ward labelled 'care of the elderly'. Almost the last place I ever wanted to be or the last way I ever wanted to be labelled. On Tuesday afternoon I didn't feel well - weak and feeble, sicky, no wanting to eat, in bed very early. Next day didn't do a lot but during the night I tried to get up, slid and slithered to the carpet, couldn't get up and my dear other half couldn't help, apart from calling out the paramedics. They were brilliant, after returning me to a more civilised posture from on my back on the bedroom carpet, decided I had a very low blood pressure, low O2 Sats and they wanted this further looked into - as well as the reason I'd gone so feak and weeble and sinking gracefully to the carpet to rise no more unaided. Admission to A&E. They found raised inflammatory markers hence UTI. I was admitted to a medical ward. However, the word 'fall' seems to act like a dog whistle pointing to admission to care of the elderly. So just when I'd got settled in one ward I was whizzed through to the next door ward without a by-your-leave. I think all the other 5 out of 6 there had had falls, judging by the bruised heads and faces. In vain I explained that it wasn't so much a fall as.. but to no avail. I was then interviewed by a lady from Social Services (new experience for me) although I hadn't agreed to a referral to them. We had a perfectly polite conversation, she was charming, but had to agree that there is unlikely to be any help they can give us in the near future. Next to come was a lady from the Memory Team. Apparently they visit any hospital admissions over 75 and ask questions designed to show if your memory is failing. Mine isn't. I was treated with IV co-amoxiclav and now on to it orally at home. Bit ironic - I've been treated for hypertension for many years, now it seems I've got hypotension so no point in going on swallowing medication to reduce my blood pressure when it's too low, a new prescription. I was out of there with all speed this morning, they're not used to what they see as 'oldies' making own decisions and acting thereon. I still have little/no appetite and will have to be extremely careful not to slip or slide when getting out of bed! All that said, a very Happy New Year to all and I hope all our troubles will be little ones, as they used to say where I came from. I still don't feel like a geriatric!"

Judging from what others have written here, I received excellent care and treatment. Had I shown any signs of requiring help, the SS representative whom I saw would have arranged a 'care package' for me on release from hospital, although it might have meant my release was delayed due to Bank Holiday conditions. I escaped on Friday morning and the world will not yet start getting back to normal until tomorrow (Monday). My main gripe about that particular ward was that, although modern, it wasn't possible to get a shower and this is a real hardship to me. There is a sort of little mini-wet room but the shower head is useless, just like a normal tap outlet, too narrow. Most of the old women there were being washed in bed with bowls and disposable cloths, then asked if they'd like to sit out. My first stop on reaching home was the shower - bliss. We have a surveyor coming on Tuesday from Mobility Plus to measure up our new bathroom to the millimetre and produce working drawings and plans. There will be a level access walk in to the shower, a seat, ad the whole thing done to modern hygienic and convenient standards.

I'm still not the best, the effect of powerful antibiotics has a disastrous effect on my insides. Because we eat less frequently than most people, we probably don't drink as often as we should. Must remedy that.

PS: My UTI has not caused any 'confusion'.