Emergency nursing

And reported again.

Message deleted by Gransnet. Here's a link to our Talk Guidelines.

Thank you for the update, much appreciated

Hi, just an update, you were all so helpful when we needed some advice.My relative, sadly passed away last week , after being readmitted to hospital, after being collapsed on the floor, she never knew she'd been taken back into hospital, as she was unconscious and never woke up.I think maybe that was a good thing.Thank you for your messages .

Thank you ladies your a mine of information.I've just got home from work and was surprised how many replies there were . Not much further forward really, she's still refusing hospital and help of any kind, although she has a cleaner once a week,she did allow her to change the bed this morning.A Dr is coming to visit sometime today, so hopefully something may come of that.Let's hope so.

My friend's mum has the maximum 4 visits per day by 2 carers as she also refuses to go into any kind of home. They hoist her into bed at about 7pm and hoist her into her chair in the morning and she is pretty much lying in a nappy all night. Her choice though - and as she has full competency at 93 there is nothing anyone can do. Now she is struggling to swallow and they have sent round a dietician and a speech therapist. She seems to get very good service despite refusing to go into a home ?

I agree, mcem I had 6 weeks free assistance after knee replacement discharge earlier this year. I would have coped, living on my own because I could put both feet on the ground. although I used a Zimmer or crutches.

A few years ago when I broke my ankle and had it pinned and plated I was non-weight bearing, could not cope so a friend stayed with me for over a month. I was expected to pay for all help if I had accepted it and frankly I could not do it.

I was so lucky when I was discharged from hospital earlier in the year.
Occupational therapist met DD at my home and delivered loo seat before I was home. Zimmer and stick came with me from hospital.
Physio's worked with me for 5 days to make sure I could manage my front door steps.
Was visited once home for 3 days, by physio.
Lost count of how often we discussed support at home and when DGD couldn't change a shift, I was kept for an extra day so that everything fitted together.
I am appalled at the poor service I'm reading about on this and other threads.

MawBroon it doesnt sound like the family are unwilling to help, just themselves physically unable to do the physical side? That's how Im reading it anyway

she has already been in hospital three times recently, they send her home, barely able to cope - so common now and a sad indictment of the situation that the NHS find themselves in. There are supposed to be discharge protocols on every hospital.

However it may be that this lady insisted on going home - it sounds s though this is where she wishes to be.

She can of course get care at home, either via the SSD of the LA or continuing care funding. It is very often a question of fighting for it. The crux of the matter is would she accept this? A family member will need to badger SSD today - mention the words "vulnerable adult" and safeguarding" and "duty of care."

OP said “full time” so I suppose I was optimistically thinking they could sort something out between them in the short term.

"There isn't anybody that can help physically"

I was assuming family would be there as I was when Paw was discharged but needed full personal care from me.
(Misunderstanding on my part as I assumed the family would not see her stuck in the short term. )

It was distressing to see and hear patients calling for a commode or to be cleaned up, often waiting upwards of 10 minutes.

Thats less of a wait than at home unless you can fund 24 hour care.
The maximum funded care package is 4 times a day double up. (end of life care and reablement can be different). So you could wait 4 hours soiled at home! Or all night!

Emergency admissions wards can be hell too, short-staffed and under pressure so patients are left waiting for essential care.
I can therefore understand her reluctance if she has experience of this, Katyj.

Her GP must surely have more information that you can access or the surgery can contact, rather than just deciding that there is no more he/she can do.
Depending on your area, perhaps a convalescent home (there are still some in existence) or a local 'cottage' hospital could be the answer. We know people who have been discharged from the main hospital into a ward in the small local hospital where they receive nursing care.

I had experience of a geriatric Ward notanan as Paw was in a side room off a Geriatric Ward for four weeks when he had sepsis in August 2017.
I takeyour point about pressure sores and everything else, just saying that incontinence products are available at home and do not constitute nursing care. It was distressing to see and hear patients calling for a commode or to be cleaned up, often waiting upwards of 10 minutes.

You can't promise to stay. It would only be even considered if she happens to end up in a side room.

Its scary enough being in hospital at night without other peoples relatives milling about the bay so won't be considered in a main bay.

This is an out of the box idea but ....... would she agree to be admitted if you could go with her and stay overnight? Only talk about the first night. That way you would be with her but have the nursing care. You would need to work out if being alone in the hospital is part of the problem rather than the hospital itself. Also she may feel overwhelmed and not consulted enough on her care once in there. I have been in this position with both of my parents and it is very difficult when someone has capacity but makes what we perceive to be poor decisions. Perhaps a known gp or nurse from the practice tomorrow could help. They will have the words to ask the difficult questions about what she wants for her future and by involving a known professional you will have done your best. Often an intermediary is helpful. If you have to phone for an ambulance again, a different professional may be able to get a different response. Going into hospital and coming home with a care package would be a solution if you could persuade her of that. You both have my sympathy.

After a hospital stay an elderly acquaintance had 24 hour care provided through social services and delivered by Red Cross and Crossroads. This was to be for a 3 week assessment period. The conclusion was that she needed this level of care and a residential home was recommended. She refused to move.

The care period was extended and she paid the costs for a further few months. It was decided that one carer was not enough to provide the care needed. Her daughter stepped in, using her power of attorney, and she was moved to a lovely care home where she grumbles and refuses to mix.
If she hadn't been 'lacking competency' her daughter couldn't have overruled her and she would have stayed at home no matter what!

Incontinence pads or “nappies” or at best a commode is all she would get in hospital and probably have to wait longer for attention in a geriatric ward than at home.

Staying home won't get you assessed quicker.

There is also more to it than just providing pads/pans/comodes. they would also assess for pressure wound risk as a result of the incontinence and reduced mobility and if necessary prescribe preventative barrier products or build up suppliments or maybe district nurse referral to keep an eye etc.

It is her choice whether or not to go to hospital and understandable if she doesn't want to. But it is not the case that declining to go will speed up assessments for home care!

P.s. even "fast track" home carers for end of life care can take a few days to set up!

If she does want to let nature take its course then that can be supported and she can have "community treatment only" which means things like antibiotics etc but no hospital, and then if things deteriorate support can be in place, but the conversation has to be had then discussed with GP.

If she is acutely ill now and not going to hospital could kill her, she could be eligible for "fast tracked" care at home, but again the discussion needs to be had with her and her GP IF thats what she wants.

This might sound awful but sometimes some people have just had enough, and like an animal sometimes slinks off to end their days quietly on their own, she may have just given up with all the poking and prodding of hospitals and wants to be in her own home to end her days It’s nateural to always want to make it right but maybe it isn’t always what the person themselves need or want

If she doesn't want the medical treatment but does need personal care, that wont be a nurse. It will come under social care not nursing care.

Care agencies won't usually send someone in straight away, it can take days to weeks to get care started.

Might be worth going on your councils website and calling the adult social care number for advice