Dad with dementia in hospital - Can they force him home

ss2020jd

I have just been through something similar with my mum. Although she didn’t have dementia she fell at home and broke her ankle and two vertebrae in her back and the hospital were saying at first she could go home with carers despite there being no facilities downstairs and she couldn’t get up and down the stairs with the boot on her foot. 

Because my mum was self-funding we were able to find a place that we were happy with without risking her being forced home alone or being put somewhere social services had chosen. Although I have still not yet had a call back from social services - their assessment time was eight weeks. 

Age uk were very helpful with advice and options. The hospital do an assessment and in our case they did this with the home over the phone and the care home do the rest when your dad gets there. They explained that if a patient is able to self-fund then social services do not need to be involved. 

ian16527

We have been given 4 in the local area to consider so will be looking tomorrow.
Seeing Dad today he can not look after himself at the moment

pollypenny

EnPointe said:

pollypenny said:

You will have a battle, which won't be helped if your father is like mine and full of pride, maintaining that he was fine and able to cope. Stick to your guns. 

Do you understand the Mental Capacity Act ? 

if an individual has Capacity that can refuse / reject/  state they  require  less input than the professional assesmsent  says  and  there  is nothing whatsoever that can be done  in law about it 

  Yes, I certainly do! 

 However, hospitals can be all too keen to believe patients who clearly will not be able to cope alone. There's physical capacity as well as mental capacity; medical professionals should not ignore the former.   Furthermore, there are still some old people who 'don't want to be a bother' and will tell staff what they want to hear. 

elsien

ian16527 said:

Thanks for your replies.
Update is that last week they moved Dad to a step down bed. His delirium hasn't returned, but is back to his more normal state of demetia, i.e no short term memory. He knows he is in a hospital sometimes. They are still watching him all the time in case he has another fall. I havent seen him walk about yet.

Had a social worker phone this morning suggesting to send him home with 4 carers a day. I have no problem with this but he is not an early riser and He locks the doors and puts chairs behind them which would cause entry issues. I cannot stop this behaviour.   

If I removed the keys this would send him into a search for them ultimately phoning me. She has not seen Dad and did not realise his level of logical thinking is zero. She said she lives too far away. 

The next suggestion was a temporary care home, which I think is the best step, which he would have to fund. The Social worker
I have no idea if they have done a care act assessment or done any capacity assessment, but I will try and find out today.

My wife has cancer and just being diagnosed with angina( never smoked or drank alcohol) and cant do much now and I have Crohn's disease and just had an ablation for AF so not up to providing the care he now needs. Conversely, if he can get home with carers safely then I would facilitate this as best I could. But we can only do so much but need some life of our own as well, which at the minute sounds selfish but there is only so much we can do. 

Not sure if they have decided he has capacity yet, but the LPA's will be issued after today.

Its very difficult when you dont know the process.  

No, that isn’t selfish at all.

You have to look after yourselves as well because you can’t look after anyone else if you don’t take care of yourself.
I think it’s probably reasonably safe to say that if your dad had a full grasp of his situation, he wouldn’t be wanting you to put your own health and your wife’s health at risk to look after him.

The short term care home seems like a good option for now if he is amenable although I would suggest that while he is in hospital you make sure he has had an OT assessment around his walking.

in my experience, when people go to short-term care homes for assessment, there can be very little in the way of assessment and people get de-skilled quite quickly. 

So if they can assess his walking in hospital , and see if he can move independently with our without a frame or anything else that would be a positive thing to happen. You don’t want him going into a care home and then being left sat there or in bed because no one is sure how much of a falls risk there is. 

I would also suggest that the social worker trying to do an assessment and look at options without actually meeting the person is incredibly poor practice. However, far away they are. 

sheramber

When my mother was in a temporary care home afer a hip replacement operation she was assessed by an OT.

She had to be able to go up two stairs before she was allowed home.

pollypenny

sheramber said:

When my mother was in a temporary care home afer a hip replacement operation she was assessed by an OT.

She had to be able to go up two stairs before she was allowed home.

My father had a similar assessment after breaking his hip. However, there was a big difference between practising on the wide stairs in the hospital to using the narrow stairs, with a turn, at home. 

ian16527

elsien said:

ian16527 said:

Thanks for your replies.
Update is that last week they moved Dad to a step down bed. His delirium hasn't returned, but is back to his more normal state of demetia, i.e no short term memory. He knows he is in a hospital sometimes. They are still watching him all the time in case he has another fall. I havent seen him walk about yet.

Had a social worker phone this morning suggesting to send him home with 4 carers a day. I have no problem with this but he is not an early riser and He locks the doors and puts chairs behind them which would cause entry issues. I cannot stop this behaviour.   

If I removed the keys this would send him into a search for them ultimately phoning me. She has not seen Dad and did not realise his level of logical thinking is zero. She said she lives too far away. 

The next suggestion was a temporary care home, which I think is the best step, which he would have to fund. The Social worker
I have no idea if they have done a care act assessment or done any capacity assessment, but I will try and find out today.

My wife has cancer and just being diagnosed with angina( never smoked or drank alcohol) and cant do much now and I have Crohn's disease and just had an ablation for AF so not up to providing the care he now needs. Conversely, if he can get home with carers safely then I would facilitate this as best I could. But we can only do so much but need some life of our own as well, which at the minute sounds selfish but there is only so much we can do. 

Not sure if they have decided he has capacity yet, but the LPA's will be issued after today.

Its very difficult when you dont know the process.  

No, that isn’t selfish at all.

You have to look after yourselves as well because you can’t look after anyone else if you don’t take care of yourself.
I think it’s probably reasonably safe to say that if your dad had a full grasp of his situation, he wouldn’t be wanting you to put your own health and your wife’s health at risk to look after him.

The short term care home seems like a good option for now if he is amenable although I would suggest that while he is in hospital you make sure he has had an OT assessment around his walking.

in my experience, when people go to short-term care homes for assessment, there can be very little in the way of assessment and people get de-skilled quite quickly. 

So if they can assess his walking in hospital , and see if he can move independently with our without a frame or anything else that would be a positive thing to happen. You don’t want him going into a care home and then being left sat there or in bed because no one is sure how much of a falls risk there is. 

I would also suggest that the social worker trying to do an assessment and look at options without actually meeting the person is incredibly poor practice. However, far away they are. 

He is toddling around the hospital but they are watching him in case he falls again. His mobility is affected by his bad back and postural hypotension, although they have reduced the bp pills. He wasnt too bad in his own house but when the falls happen we just dont know, and the toilet is upstairs.

We have picked a care home today and set the ball rolling but the hospital has just phoned and Dads now got Covid. So whether the home will keep the room open we will have to see. 

Gavin83

pollypenny said:

EnPointe said:

pollypenny said:

You will have a battle, which won't be helped if your father is like mine and full of pride, maintaining that he was fine and able to cope. Stick to your guns. 

Do you understand the Mental Capacity Act ? 

if an individual has Capacity that can refuse / reject/  state they  require  less input than the professional assesmsent  says  and  there  is nothing whatsoever that can be done  in law about it 

  Yes, I certainly do! 

 However, hospitals can be all too keen to believe patients who clearly will not be able to cope alone. 

They haven’t got a choice in all honesty.

If I was to pick up an injury and end up in hospital, no matter how severe/life threatening they couldn’t stop me walking out, assuming of course I could. Thats a fundamental right. That doesn’t change just because you’re old. This does assume capacity but if they have it the hospital couldn’t stop them leaving.

johnswife

so sorry so sorry for your situation.
15th December 2022 , my father in law was sent home against the families wishes. He had dementia and the were arranging for carers to come in through the day and meals were arranged. When the first carers attended they could see immediately that he had no idea how to look after himself or even could answer any questions. They immediately contacted their department to red flag it. They deemed it an unsafe release from hospital.
The only thing they could advise us to do as this was a Friday, was to take him in to A&E to get him readmitted. They social services/carers tried unsuccessfully to get him an emergency bed that same day. 

So the next morning my husband took him back and he was readmitted to the hospital. My husband wrote a long letter of complaint.
after a couple of weeks he was sent to a care home for a proper assessment. 

His condition worsened and he died there 11th October 2023.

As others have said, it can be tough to get the right care for you dad but you have to be strong.
it sounds like you have enough on your plate so tell the hospital your circumstances and you will not be able to be there for you dad like you would want. 

They must do a proper assessment before any release and you have a right to be there if you want.
good luck.

elsien

They don’t have a right to be there if the relative has capacity around the assessment and doesn’t want them there. Just to be clear.