Making sure Mum gets the right care

[ontheverge]

I agree with @henry's cat - go to your MP. They are normally thick as pig ****, hate constituents badgering them and will fire off emails to the higher up managers and get a response.

Good luck and I hope you get the results you wanted.

[Alison_220212]

Hi,

We haven't had a reply from social services at all.

Now Mum has gone from a hospital to a care home hub bed. When I saw her yesterday, the care staff were telling her it was for physical re-hab then home in a few days. Her Consultant Psychiatrist told her it would be two weeks, then review.

She hasn't been allocated a social worker yet so I have nobody to call. It's so clear to me that she's not going to cope at home again, so I have started care home research, but I find it quite overwhelming.

I am also finding that though some homes are unclear about it, some will not take a person with a psychiatric diagnosis, even though they offer dementia care.

My Mum is nice as pie to staff, then really oppositional and difficult with me. Her short term memory is really poor. Today I had to stop her giving the contents of her ISA to staff to pay the NHS.

[bowlingbun]

In that case, you need to explain to her bank/ISA manager that she is unwell and a very vulnerable client who they must protect from financial abuse.

[Charles_2112]

If your Mum's case isn't allocated, you can talk to the duty worker. They won't want to discuss it because it's not allocated but they have to see her before discharge, according to the Care Act. And although the Coronavirus regulations allow some flexibility on that, councils have to declare the fact (and justify it). No council is currently in that position - so they have no choice, as long as it's pointed out to them.

[bowlingbun]

If looking at homes, you need to know how they are going to be paid for and what sort of home to look for. From what you describe it needs to be an EMI home, is one for the Elderly Mentally Infirm. This should be mum's last move so they can cope with all aspects of her care for the rest of her life. This is the sad reality I'm afraid. You should find them on the CQC website.

[Alison_220212]

Thanks, this is all so helpful.

I am going to look at a care home today, and wonder if I should do one visit to just get first impressions, then another with specific questions.

[Henrys Cat]

She'll be under the social worker from the hospital discharge unit (if it's like our local ones). They are the ones that do the review about what happens next & this MUST be done before she leaves the hub. I made sure that Dad's SW from the hospital came out to see us well before the review date because I didn't want them to say "oh he needs full time care" on a Thursday afternoon and that they were withdrawing the care on the Friday. Which is exactly what happened until I put my foot down. Unfortunately / fortunately, with Dad insisting on going into a home, she was resolved of her involvement and once that happens you don't get them back. We are now 10 weeks into a 12 week wait for another social worker to be assigned. It's a moot point now with everything else that's gone on but maybe that's the idea (that's me being cynical of the NHS in general at the moment, not their fault).

With home research, that I can definitely help you on. There are so many questions I wished I'd asked and none of them covered on the advice that I found anywhere! "Yes we've had people who are *insert variety of conditions" doesn't mean they have proper experience of it. Go back at least twice if not more. One to get a feel, another to ask specific questions, another with the proposed resident. Obviously you'll want to know specifically about challenging behaviour although often people are different with their own family as you say. What facilities do they have for end of life? What functions can they perform in situ (things like prescribing antibiotics quickly, IV administration, etc). How does their buzzer system work (and listen out for it and how long it is ringing for!) How will they identify & incorporate cultural preferences? What is their protocol if someone needs to go to hospital in an emergency (as in do they accompany or just leave them to it)? Definitely see a room and try and have a look in other rooms as you go past in the corridors. In your MIL specific case, the SW should be able to provide you with a list of suitable homes that would meet her needs but until she's had a proper psyche assessment they won't know what they're dealing with. The hub might be able to refer her to the OPMH team and the SW definitely can... if you can find out who they are!

[Henrys Cat]

My apologies! Getting two mums / MILs mixed up.

Most of my previous response still stands but it sounds like she already has psyche involvement so ignore that bit!

I've just discovered today that one of my local health boards has a carers team and one of the things they do is promote and make sure their facilities are using the "Triangle of Care" which is basically the carer, the staff and the caree. They're supposed to value the carers involvement because they are experts etc. Hmmm... It doesn't cover the hospital / organisation we deal with but the Triangle of Care is a nationwide thing. It might be worth seeing if your LA has a department responsible for facilitating this Triangle?

[Alison_220212]

Thank you - I think there is multidisciplinary meeting about Mum tomorrow, but I don't really know who that involves. Nobody from the mental health team has visited her at all, which concern me, she only seems to have seen the OT.
I still wonder if she needs psychiatric in patient treatment, but I don't know who to ask about it. As she's still under the care of the hospital team, I think she may have the same consultant.

I find it very hard to be with her and see fixated behaviours seemingly unaddressed. She spends all day writing out her worries in a repetitive way. Pages and pages of notes about the same things, and that's also all she wants to talk about. She doesn't believe information I give her, even though I show her written evidence and get staff to confirm. She is still trying to pay for the hub bed, though we have taken all her financial information away.

I don't know what's helpful and what isn't. She gets stuck in a pattern and there's no getting out of it, despite all distractions.