what is possible at a care home?

Brie

trying to organise my thoughts to help out with what might be possible to get my aged MiL out of hospital....please redirect me if needed.

so she's currently in a small community hospital a bit of a distance from us - a visit takes an afternoon which is driving there and back and about 20 - 30 minutes sitting chatting or watching her snooze. 

medically there is nothing the matter with her and they'd be happy for her to come home except that she can't walk, can't get herself out of bed without assistance and we can't help with those things on an ongoing basis.  There is talk of having carers in the home 4 times a day to assist but we'd need to be here 24/7.  of course all of that is possible.

the big problem is that she doesn't want to eat (possibly she doesn't like what she's being given but is too polite to say) and she won't drink (an ongoing problem for years) and the net result is that she needs an IV every day or 2.  

I think that the IV would stop her being able to come home unless a nurse came to see her most days.  obviously the carers or ourselves couldn't handle something like that.  But would that be possible at a care home?  And if so would that medical treatment need to be self funded or would that be an NHS cost?  obviously she would need to fund a care home in general as I understand it until her savings reduce dramatically.

any thoughts greatly appreciated.

and no there's no LOA and it's too late for that.

JGB1955

It sounds as if your MIL needs to be in a Nursing Home.  I would have a word with the discharge team at the hospital - pointing out all the 'negatives' of her returning home with only a social care package, rather than a medical one.

Hopefully she is receiving Attendance Allowance?

tooldle

My best advice would be to call a few and ask. My mum is in a care home and they do deal with some medical matters, otherwise you would be looking at a nursing home. Are the hospital looking at discharge? If so they should be able to confirm what settings are being / have been considered.

Flugelhorn

my experience of working in primary care and seeing people in care homes and at home is that neither setting could manage an iv for fluid replacement. occasionally people were given iv antibiotics (process took about 30 mins - nurse in attendance at all times) and sent home with the cannula but that was very different..
There were occasional mutterings about people having ivi at home / care home  etc but I never saw it as far too risky - on odd occasions people were give subcutaneous fluids (doesn't need so much supervision) but is short term and only a small amount of the daily requirement. 
TBH not sure that "nursing homes" would be happy either - there is the issue of what happens if the cannula tissues, who will replace it ? who monitors the blood tests ? 

Brie

@JGB1955
yes she's getting the full AA.
@Toodle and @Flugelhorn
thanks for the input.  I was wondering about going and seeing a place local to us (5 minute drive so daily visits possible) to see what they would be able to do.  And to ask about pricing too of course.

The hospital has, so far, been very good and appreciates the difficulties we are facing.  They have confirmed it would be a "few weeks" but we know from previous experience that things can change quickly.  Last time we were given about 30 minutes notice to agree to moving her to a care home for recuperation before returning home but things have progressed since then, her memory being very much in decline now.  But as mentioned as there's no LOA it's up to MiL what happens officially but given she doesn't even know where she lives anymore it's not like they are simply going to open the front door and say "off you pop!"

Marmaduke123

It sounds as if your MIL lacks competence to make any decisions for herself now. If so, and as you don't have power of attorney, she should have a social worker from her local authority adult social care department who could help with identifying a suitable placement for her. Has she got one?

Brie

Marmaduke123 said:

It sounds as if your MIL lacks competence to make any decisions for herself now. If so, and as you don't have power of attorney, she should have a social worker from her local authority adult social care department who could help with identifying a suitable placement for her. Has she got one?

No - nothing has progressed that far.  The local authority seem completely unconcerned for her wellbeing frankly.  Last call we had was from someone who had been told to call us.  And asked us why we needed to talk to her.  Without telling us why she was calling.  When my OH explained the situation she just said OK, I'll get someone to call you back.   That was 2 weeks ago and we've heard nothing further.  No point in calling them as no one seems to know what they are doing.    

Not much different than the hospital she was in prior to the community one where she is currently.  They rang up to inform my OH that MiL had being discharged.  Two days prior to the call.  When he asked about this they said they didn't know where she was.  This despite being the facility that had arranged for her move to the small community hospital!!  that said they did manage to forward a few cards that had been received for her from concerned relatives.

Sorry - this is turning into a rant - I know the hospitals are overstretched and given the over 60s are about 35% of the population locally I know it's a massive challenge for anyone.   I'm just grateful that the individual nursing staff seem so compassionate not only of MiL but are concerned for our wellbeing as well.

Flugelhorn

even though there is no POA  if someone doesn't have capacity they should hold a "best interests meeting" where anyone who is invovled (relatives/ carers / social workers / nursing staff) can come to a decision. 

Brie

yes no POA!  Not LOA!  apologies for the confusion.

And yes - the nursing staff are very concerned that we are all in agreement of next steps which is reassuring.  I think it's that they see things from a practical point of view rather than some social workers' bureaucratic vision of keeping the local authority from having to pay for anything.  

Marmaduke123

Brie said:

Marmaduke123 said:

It sounds as if your MIL lacks competence to make any decisions for herself now. If so, and as you don't have power of attorney, she should have a social worker from her local authority adult social care department who could help with identifying a suitable placement for her. Has she got one?

No - nothing has progressed that far.  The local authority seem completely unconcerned for her wellbeing frankly.  Last call we had was from someone who had been told to call us.  And asked us why we needed to talk to her.  Without telling us why she was calling.  When my OH explained the situation she just said OK, I'll get someone to call you back.   That was 2 weeks ago and we've heard nothing further.  No point in calling them as no one seems to know what they are doing.    

I think you need to keep on at social services and ask them to allocate a social worker. If need be involve your local councillor or even your MP. As suggested, a best interests meeting might progress things for you.

tooldle

Does the hospital  have a social work team?