panicking again

soolin

I just need some hand holding again please as I'm panicking.

Dad has settled really well into residential accomodation although he has become more and ore frail and the dementia is worsening. He spent Christmas and new Year in hospital after a small fall and was discharged back to the care home with no further diagnosis, He fell agan 10 days ago and was found unconscious and rushed to hospital but recovered after a few days on a potassium drip although he is no longer mobile. He unfortunately spent a week on an assessment ward where although it is still 'proper' hospital it tends to be an extension to the A and E and so extra therapies are limited. he therefore spent the full week in bed and he has no movement at all below the waist, he is also doublty incontinent.

He has now been medically discharged but care home won't take him as he is not mobile. Hospital are getting cross at me as I won't take him either, so they have moved him to a real ward and have promised him physiotherapy to regain movement on the basis that the home will then take him back.

My question, through the panic is, do I need to do anything now or do I wait and see what happens as a result of the physio (if they ever provide it?). We are obviously paying the full £525 a week to the care home and I would really want him to go back there if he can as he was so happy, but they only hold the bed while i pay the full fees. After a few more days apparently they can decide to pt Dad on 2 weeks notice and then let his bed go after that notice period. Should I have a back up home in place..or should I wait and see? The nursing homes locally will be almost double what dad is currently paying and they are not as nice as his current place..help..

seven-day-weekend

Soiolin, I don't know the answers to your questions, but just to say what a terible dilemma you have and I'm sure someone will come along soon who can help.

bryanb

Not sure if I can offer any real help, I have a mother in similar circumstances. I believe you should be able to have your Dad assessed regarding his need for nursing care, which should then be paid for by NHS rather than private or county council. Only the nursing element of care, not personal care. He obviously needs a place in a nursing home. My very strong advice would be not to take him home even if he becomes mobile. It won't last, and living at home (or ordinary residential) is not a possibility then. As long as he remains in hospital the authorities will be interested in a solution to the problem, the moment he is discharged they will only pay lip service to their responsibilities.When my mother was in this position, she was transferred to a local hospital and eventually a nursing home with part NHS funding. Hope this helps, you need to be strong to achieve the best outcome. BB

soolin

Thank you.

The nursing homes locally tend to be in the region of £950 a week whereas at the moment he only pays £525 and am I right in thinking that there is a limit to the nursing care element that the NHS actually pay?

I understand that the long term prognosis for people with severe vascular dementia is not good, but just in case I want dad's money to stretch as far as possible so that he can always remain in a home of choice rather than be put where Social services have a contract.

EdInvestor

http://forums.moneysavingexpert.com/showthread.html?t=734947


Useful thread on getting NHS to pay.

Savvy_Sue

Thanks Ed, you found that post before I got round to it.

margaretclare

Soolin, I feel for you, and for your Dad. Some of the suggestions which have been made to you by the hospital are outrageous. Because of what has happened to him you can't possibly be expected to cope with him at home. 'The care home won't take him because he is not mobile....' well, how in the name of goodness are you expected to take him home? I can well see that the powers-that-be would then be able to wash their hands of the problem, until the next time, but you shouldn't have to worry about what they think. Care homes and hospitals have experienced people on their feet for 24/7. You'd be alone, with no help, and you have to eat and sleep sometime, haven't you? I have the greatest sympathy for your Dad, but I also have some experience of dealing with problems of this kind in the home, and it just is not possible.

It seems that a kind of emotional blackmail can be applied in these circumstances, from those who have power to those who are asking for something to be done. Additionally, the situation would not remain as it is. Your Dad may seem fine at one stage and then have swung back to the opposite extreme within a very short time, and I mean hours rather than days.

Physiotherapy may or may not work, but in that case, why hasn't Dad been having physio already?

Please don't even consider taking Dad back home. Believe me, you just could not cope with the problems.

Best wishes

Margaret

soolin

Thank you everyone again.

The problem I think is because the local hospital is on red alert as they have run out of beds, and as dad has technically been discharged they obviously want him out and not (horrible phrase) Bed blocking. The home he lives in is lovely and I would prefer him to return there as he is happy, but as they are purely residential they obviously can't take dad back as he is.

I am in a Catch 22 position really, if I go to visit dad I am just continually asked when I am going to make arrangements to remove him, yet no one has told me exactly what I need to do now. The home are happy to wait a few more days (another phrase that fills me with dread) before they consider their position and either re assess dad or put him on notice to leave. As at yesterday dad had not even seen a physio and unless they can work miracles I can't see a quick one or two visits being able to get Dad mobile again especially as no one knows why he can't walk. He doesn't have reflexes in his legs though when they do that little hammer test thingy.

I have had a quick look at the other thread referred to, thank you. At the moment though I am not quite at the stage of needing to argue about nursing fees as no one has told me that I should be looking for a nursing home. Do you think that I should be looking for a care home, or should I leave it and just hope that in a few days dad may well recover enough to be accepted back at his residential placement?

Those that remember my original thread will recall that I struggled to find any places locally anyway, so if I do have to go down the nursing home route it won't be a matter of choosing, it will just be hassling to find out who is likely to have a bed first. Locally we are already over capacity.

One last question, although not urgent yet is if I do have to fight for nursing fees to be funded which local authority do I approach? Both the SS where dad used to live and the SS where he currently resides have formally written to me to say that the other authority has responsibility and that no files are kept on dad as he is not under their care.

EdInvestor

soolin wrote: »

One last question, although not urgent yet is if I do have to fight for nursing fees to be funded which local authority do I approach? Both the SS where dad used to live and the SS where he currently resides have formally written to me to say that the other authority has responsibility and that no files are kept on dad as he is not under their care.

Incredible isn't it. Is Dad lost in space? :mad:

Actually what you would appear to need is a new assessment with a view to getting Dad funded for "continuing care" under the NHS, wherever he ends up.

One wonders who will do the assessment if no LA wants to take responsibility.On no account should you move Dad out of the hospital before a new assessment is performed.It seems clear his earlier assessment is no longer valid as his old care home can't accept him.

If I were you I'd give the Alzheimers Society helpline a call (they deal with all types of dementia) to get some more detailed and expert advice on the way forward.

soolin

Thank you. I have been to see Dad today and he has apparently been out of bed for just 30 minutes, and no, there hasn't been any physio.

The hospital told me that the home is assessing dad tomorrow to make a final decision and they assume he will go home then back to his 'nursing' home. They seemed a bit put out when I corrected them and said it was not a nursing home. Frankly though looking at dad today he is bedridden, doubly incontinent and has a query in his medical notes about renal failure and side effects of him taking a particular statin to prevent further strokes. Unless something wonderful happens overnight I greatly fear that dad won't be going back to the place he considers 'home' again.

So, I will wait to see what hospital says tomorrow and then if necessary get the hospital to help me get a social services assessment done and then look for a new place for dad.Hopefully the hospital can put more pressure on SS than I can, especially as our hospital trust is 40million pounds adrift from their budget and with no beds left.

I feel so horribly sad for dad, he trusts me to look after him and he just wants me to take him 'home'.

saving-grace

Soolin I have only just seen your thread or I would have replied sooner. You are in a horrible position.
You need to ask for a nursing assessment so that you know the type of care suitable for your Dad when he leaves hospital, whether he can go back to his residential home or whether he needs a nursing home. Then at least you can come to a decision regarding the home he was in before.
Also ask for an assessment regarding eligibility for NHS continuing healthcare funding (google NHS continuing healthcare checklist, you will be able to get some idea yourself about whether or not your Dad may qualify)

Have you looked at the Age Concern website? they have some good factsheets.
http://www.ageconcern.org.uk/AgeConcern/factsheets.asp

Take a look at Factsheet FS37 Hospital Discharge arrangements and FS20 NHS continuing healthcare, NHS funded nursing care.

Even if your Dad doesn't qualify for NHS continuing healthcare funding, surely he must be eligible for NHS funded nursing care which would help a little with his nursing home fees.
Make sure he is properly assessed before they try to discharge him!

Look after yourself, this is very stressful for you, I hope you have some support for yourself from family or friends.