Bed blocking

Browntoa

If the hospital attempt to force discharge without agreement (ambulance turns up unannounced ) then refuse access . Tell the hospital that you will refuse to accept them home . It's a "failed discharge" and causes the hospital problems. You are totally within your rights to refuse as they must agree a plan for discharge.

Been there , seen it , done it

MoneySeeker1

Thanks both. By now I'm prepared to believe they (the hospital, the social workers, etc) might get up to anything.

This afternoon has seen someone ring me up (for a second time!!!) to tell me Hospital Parent is dead!!! Again, I had to ask myself whether they "felt dead" to me and they didnt. So, that was some more checking by me and, sure enough, they are still alive. At that point I blew up and read the Riot Act to this second wrong conveyor of Bad News and then rang up the PALS office at the Hospital and put in an Official Complaint that it's twice now I've been told they are dead when they arent at all. The only thing to be thankful for is they didn't ring At Home Parent with the wrongful news, as their ears would be "scorching" even more than they currently are, as I would have had Other Parent on my hands being Major Upset for nothing.

Whenever it is I actually get correctly rung up with this news, I do hope my intuition has told me in advance that this is so, as I won't know whether I can believe the hospital or no if they say it to me again. Thank goodness my intuition told me not to believe them the first couple of times they've done this or I'd have been on the phone to break the news to Other Parent for nothing.

I cannot believe such careless inefficiency.

lisyloo

Unbelievable (I do believe you, I mean it’s just hard to fathom how that can happen)

MoneySeeker1

Indeed it is pretty unbelievable. But I've just been talking to him on the hospital phone myself - so I can indeed confirm he is alive (if not well). I know this is a large hospital in a city that has become pretty fast-moving, but it's ridiculous. Thankfully, my intuition has been coming into play several times helping me out in recent days and I don't know just how bad things would have been if I'd not listened to it and believed what it was telling me, rather than what I was being told by other people iyswim.

lisyloo

A formal complaint is justified.
have you asked the local authority for their budget?
there is no point looking at places that greatly exceed their budget if you aren’t prepared to top up.
there is no obligation to top up if you can accept the LA standard, but sorry but you cannot expect to choose 5 star and refuse to contribute.
we got the best of the LA places by going to “panel” and making our justifications.
i believe the home also came down a bit on their rates, so it’s all negotiable if they have vacancies.
i would ask them do they have any fully LA funded residents, if they have none at all and the rate is way above the La rate, then you should rule them out if not prepared to contribute,
sorry, this isn’t my personal vies, just trying to present the reality that the state is a safety net and the standards can be appaulling.
would it be the worse thing if your parents had to contribute to a better quality of life?

MoneySeeker1

So it sounds like we need to work out a basic rate the State would pay from what you say - and...yes...then "top it up" with deferred house grab (once their savings are down to whatever level it is they are allowed to keep of their own money - which they may, or may not, already be down to) in order to get the home we would choose (ie obviously the best one).


Clearly, if the State grabs, then the State grabs and, if that's what it takes to resolve the situation in the best way possible for my parents then that will be what happens I guess. I know my parents themselves don't want the State going for their hard-earned money (they've long ago told us they don't want the State doing that) and I don't blame them - and it may be that they land up having to "swallow that bitter pill" that the State won't care about that and allow for them doing that - in order to get the best quality of care they can get.

The priority has to be getting them the best standard of care, as they require it - even if they are furious with the State in the process for doing that.

lisyloo

If you want to choose without LA budget restrictions then yes you need to consider topping up and I would suggest that may be in their best interest.
have you ruled out that any of the LA funded ones are suitable?
we got a fully LA funded home to our satisfaction albeit having to fight and go to “panel”

Did your parents make the decision about the state grab in full knowledge of what the safety net offers? If you are saying that’s what they want but there is nothing acceptable available then it sounds unrealistic? Best available has never been available from the state.
If they thought they could have the best on the state then they were sadly wrong.

You first step needs to be to establish whether anything acceptable is available that is fully LA funded. Have you done that yet?
note that private rates are different to LA rates.

have you also looked slightly further afield.
our parents lived in bath & NE Somerset which is expensive, we found lower rates in south glos (Bristol) just a few miles away. That helped us and we did cross a local authority county boundary so it is possible. Would a cheaper area help in your case?

note LA wanted to split up MIL & FIL after 60 years of marriage, him being bed bound, her wheelchair bound, travel would have been infrequent and put him 15 miles away. I don’t think people saying they want the safety net and zero costs appreciate they might be split up from family and some distance away.

MoneySeeker1

I understand that choice of homes isnt restricted to their home area. But it really is the most feasible thing all round to look in their town only and that's when I already found there are only 2 possibilities. One good, one bad. So it really does boil down to Hobson's Choice and has to be the good one in their own town, even if it does land up being dearer than the bad one. If it comes to it (which is looking increasingly likely) then there really is no viable option but to pick the good one regardless and hope it's still got spaces (as it had when I checked). We've had an added  few spanners chucked into the works now, as home spouse doesn't want to see him now by the sound of it (as they are finding this all very upsetting and don't feel they can cope). But it will be by far the easiest option all round to choose their own town anyway, in the hope they'll change their minds and because we are scattered across the country and need to be able to see both parents in one visit. For different reasons both "children", ie myself and the other one both really struggle with visiting the town they are in anyway, so added struggle to visit two different towns isn't a feasible proposition. My own circumstances are that I now live one heck of a distance away from them and have to rely on poor public transport (taking me hours) to get back for a visit and other "child" has different difficulties going back to their town (even though they are much nearer than I am and have a car).

elsien

Capacity is time and decision specific. It is possible that BB parent has capacity for some decisions and not others.
If BB parent has capacity around his care needs and discharge destination he can discharge himself from hospital and go home regardless of the professionals opinions. Other parent also has the right to say "this is too much for me, I'm not doing it." That is a conversation they need to have with each other. 
If he decides not to go home, then the choice of place is his if he has capacity, and that of the LPA if he doesn't.  Unless they ask you to get involved, as has already been pointed out it's not your decision.
A lot will depend on their assets if self funding for now. "Obviously the best one" may not be realistic. I have seen families put people in the most expensive homes, knowing the money will only last a few months, then create merry hell when the person then has the upset of moving somewhere cheaper. The LA or CHC aren't going to pay a grand a week when their normal rate is closer to £400.





 

MoneySeeker1

I do know what you mean by pointing out that "obviously the best one" might mean an enforced move if the Local Authority gets awkward on money running out. As it is the position is that there is enough "house equity the State could grab" to fund (if need be) for some time and parent would have to live to over 100 for that to apply and I don't think that's likely (though I wouldnt want to see just how upset the parent was if they thought they'd live that much longer - as they would be extremely upset indeed at the thought of having to live with ill health for that much longer on top of what they've already had).

Other parent is being pretty clear they can't handle even meeting Hospital Parent now (because of the state their health is). So it does look like there isn't a "conversation to be had" any longer on that one, as they just get so (understandably) upset at the thought of having Hospital Parent home again ever. The way things are going equals I wouldnt actually be surprised to hear that Other Parent has locked/bolted/secured every door etc to their house in order that no-one can get in the house at all ever, as they are now scared stiff/angry that there is the risk that anyone would get in and find them ill and revive them again (as has happened a couple of times before and they haven't forgiven them for it). Both parents are very upset and angry at still being alive in fact (courtesy purely of modern medicine) and any medic that comes anywhere near house parent ever again is likely to get read the Riot Act for doing so and it is upsetting to witness all of this going on.