I’m A Carer Again

Tell us a bit about yourself here.
I recently posted that my caring for my father were over as I thought after nearly six weeks in hospital he would be transferred to a nursing home as I am no longer able to provide care for him.
After a meeting with the social care team it has been decided,after consulting my father on his preferences which I knew he would opt for, he is due to be discharged back home with up to four visits a day from the local Hart team for up to four weeks a day thereafter with his original caring team.
Since he cannnot walk unaided,requiring two of the hospital staff to take him to the toilet,he is going to be virtually bedbound and as he is almost incontinent for some of the night he will be wet or worse.
The assessment is to be done when at home and reviewed after the four week period when I hope he will be transferred to a nursing home.I cannot fault the care he has been given in the hospital but I know the next few weeks are going to be extremely stressful.In the past he has called out in the night , can be belligerent and very demanding and after over four years of caring I just cannot do it anymore.
Mark, that's bad news indeed!

can you remind us whether he would be self-paying if he went into residential care, or if the council would have to pay for him?

If the latter it's clear why they've sent him home - cheaper!

However, if he does not have dementia, and even if he is self-funding, that raises the tricky issue of 'forcing' him into residential care if he is expressing a preference for going home.

You may, alas, have to play hardball....

Do you live with him, or is he still in his own house, on his own?

If the latter you may have to deliberately 'stay away' so that the utter inadequacy of the care package he's been offered can be seen - ie, if you go there, and 'help' you are only letting them think he CAN 'stay home'.

If you live with him, could you go away and stay elsewhere for a couple of weeks?

I know it's horrible 'abandoning' your father, but if the best place for him is residentiall care, and YOU have reached the end of your tether at having any involvement in 'home care' then you may have to just force the issue.

If the care package is as inadequate as it sounds (as in, ONLY 24x7 care in a residential care home would work anyway!) then it is likely he will just end up back in hospital (revolving door!) and THEN be sent to residential care. This may just be SS's 'last chance' to avoid paying for him????

ALWAYS REMEMBER you have NO legal 'duty of care' towards your father - that can sound harsh, but it can b e necessary to remind both the hospitals and the SS of that brute fact - however much they might want you believe you 'must' care for him. You don't!
Perhaps the main thread CHC / NHS Continuing Healthcare & allied considerations is relevant here :

https://www.carersuk.org/forum/support- ... read-35998

Time to take it for a test drive ?
Mark, this rollercoaster of your father leaving and then coming back must be grim for you.

I have cross-posted with everyone else, but I'll let it stand in case it's useful.

Just to start the thoughts off, what does the care package say the carers will actually do for your father? (You don't need to say here, if you don't want to, it's just to introduce my ramblings.) For instance, will they be doing the washing? The same applies to everything else eg providing meals. If he now needs to wear pads at night, have arrangements been made for the incontinence service to provide them? Is it safe for him to be left alone and if not what arrangements have been made to ensure his safety when you are not there? Everything needs to be in place before he can be discharged. Just look around this site for references to 'unsafe discharge' to see. Someone else will be able to say for sure, but with my husband the assessment had to be done before he came home, not after and I was able to say clearly what I could do and what I could not and would not do. (I didn't get it right, but that's another story!)

If the care package is not working you don't have to wait four weeks. Tell everyone immediately - GP, Social Services, call an ambulance again if necessary.

Then how are you going to cope? You need to practice your broken record technique since you say your father is belligerant. I don't know what the pressure points will be for you, but for example as it now takes two people to assist your father to the toilet, you can't do it.

There are experts here who helped me with the discharge process; I'm sure they will help you too but if you just need to let off steam there's plenty of room for that as well.
Mark,

Is this discharge SAFE?
You have made it very clear that you CANNOT care for him any longer (I know from my own experience how difficult this is) so you are going to have to be very firm with all concerned that you will not help.

Of course everyone wants to live well at home until they die, but sadly people are being "saved" only to have to endure what I call a "half life". Still alive, still breathing, but with no quality of life whatsoever. Pushed from home to hospital to home again, again, and again.

With my mum, her unpredictable bowels, and the prospect of sitting in her own mess for hours until the next carer arrived (might be 10 hours away) was the deciding factor.

Before discharge, make sure that the care is actually arranged to start immediately, and you have full details including the details of the agency manager. What equipment is being promised? Hospital bed? Bathing arrangements? Lifeline pendant alarm? Out of hours number for the district nurse?
Unsafe hospital discharge ... again ?

Main CHC / NHS Continuing Healthcare thread ... link posted earlier.

Section : PREAMBLE / INTRODUCTION / CHARTS / HOSPITAL DISCHARGES

Were ALL procedures followed ... apparently not !!!!

Returning to CHC / NHS Continuing Healthcare , was either offered / considered / application rejected ???????

That thread again :

ANY HOSPITAL DISCHARGE PROCESS ... ASK THE QUESTION ... " IS CHC OR NHS CONTINUING HEALTHCARE ON THE MENU ? "
Thanks for your replies and yes it certainly is a rollercoaster.
Interestingly without even mentioning CHC I was told he was not eligible for it as he doesn’t qualify.Therefore I have contacted his GP to see if it is possible he may be eligible,colon cancer,incontinence and very little mobility if any after nearly six weeks in hospital and somephysio.
I suspect along with many others he will be a revolving door patient as when he does come home he will try to access the toilet and fall so the process starts all over again.
Interestingly without even mentioning CHC I was told he was not eligible for it as he doesn’t qualify.


Certainly not the first , nor the last !!!

https://www.carersuk.org/forum/support- ... 0rationing

WAS THE BEFORE OR AFTER THE INITIAL ASSESSMENT FOR CHC / NHS CONTINUING HEALTHCARE ?