Stepdown care.

snookerloopy96

Hi, I hope this question is allowed as technically this does not involve money at this stage.

My Mom is 84 and has spent 18 days in hospital following a fall plus a severe infection.

She is now 'medically fit' to come home, however she is VERY immobile and has only had a couple of physio sessions, she is yet to do any steps/transfers unaided.

Imo there is no way can she live alone how she is, even with carers and me visiting regularly.

I have been told about short term stepdown care which if paired with regular physio may make all the difference.

I cannot be with her 24/7, my wife has a life limiting illness so I am in quite a horrible position.

What 'rights' do I have to ask (or if not exactly insist, strongly fight for) about stepdown care?

I do not have LPOA, we are discussing itas we speak.

I admit my Mom isn't keen on the idea (stepdown not LPOA) but I honestly believe this is her best chance of being strong enough to come home for the rest of her life.

Any advice is very gratefully received.

YBR

If Mom has the funds she can go into an appropriate level care home for a period on a private basis (not very MSE but …), there will be some homes do short term, perhaps respite care - check the situation as to whether they'd help with physio.

If that's not an option then keep voicing your concerns at the hospital that she should not come home without a care package in place that is appropriate for her immobility and does not rely on family/friends. This may actually be better for her mobility - there are several people I know spent days in hospital either in bed or in a chair and not moving, thus their mobility only started to return once home.

KxMx

Do make clear your unavailability to provide care- it will be assumed otherwise.

You can express your concerns and ask for step-down care, but they might decide a temporary care package of up to 4 carer visits a day and visiting physiotherapy is sufficient. The NHS will fund the care side for up to 6 weeks, after which your local authority takes over (assessment processes will already be underway).

Aids & equipment can also be provided prior to Mum leaving, to help a safe discharge home.

Sadly at your Mum's age and especially after a fall a full return to previous mobility might not be possible.

There are entirely house bound, even bed bound people who are cared for at home by various visiting services, because their needs do not meet the threshold for a funded care home and they themselves cannot fund.

elsien

Medically fit for discharge simply means that she no longer needs to be on an acute ward. Has the discharge team actually talked about her returning home with care or is that a supposition she is making/expressed a wish for?

I think the systems work differently in different areas but where I am sometimes people can get transferred to another ward which is slightly longer term for re-enablement, or they may be discharged to a care home. Again for further assessment and Support . With the caveat that care homes may continue to reduce independence because they are not all very good at promoting the person to practice et cetera in between physio .
If there is a real conversation about her returning home at the moment, then raise it as a potentially unsafe discharge with the hospital. Risk of further falls if she tries to move on her own et cetera. Have they done a home OT assessment?

Although if your mother has capacity having power-of-attorney for health and wealthfare would make no difference at all at this stage because it can’t be used until the person loses capacity around the specific decisions.

And if she absolutely wants to return home and understands the risks, you are left with persuasion to try and convince her that she stands more chance of staying at home in a long-term if she goes somewhere that will promote mobility now.

MEM62

If Mom has the funds she can go into an appropriate level care home for a period on a private basis (not very MSE but …)

I would say that using your assets to ensure that you have appropriate care and ensure your comfort in your later years is very MSE.

snookerloopy96

https://forums.moneysavingexpert.com/discussion/comment/82177830#Comment_82177830

There is an NHS facility right by us which specialises in physio for elderly people following hospital stays.

Personally I think that would be ideal assuming it meant she had more physiotherapy than if at home.

The lady in the bed opposite has just been given a place there and was very pleased, my Mom needs a lot of convincing so we'll see.

Its no exaggeration to say I have informed every Dr, nurse, physio, OT about the need for a care package.

Thanks for your advice, very much appreciated.

snookerloopy96

@KxMx

I have made it quite clear although I do sometimes get the feeling I'm talking to myself.

She wasn't very mobile to begin with, I'm just hoping that any availability of this facility near us will benefit Mom (as has just been offered to her 'ward' neighbour).

I do think its worth a go if nothing else but as you say they may decide the carer visits are sufficient - I agree with this however I think IF its possible to get Mom just a little more mobile it would make a huge difference to her quality of life.

Thanks so much for your message, really appreciate it.

snookerloopy96

As of yet they have not said a word to me so I was trying to be as prepared as I could.

We are fortunate in that this local unit is tailor made for this type of thing so I'll just have to see.

Of course being her son I'm biased but imo to send her home like this is nowhere near ideal, it only seems common sense (if possible) to attempt to get her more mobile.

The LPOA was mainly to help with logistics, Mom is very much a chequebook/cash person so its just a convenience thing for me as I don't want to be constantly taking letters of authorisation to building societies.

Thanks for your help, very kind of you and I appreciate it.