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Care & carers

Social Services and Nurses

(29 Posts)
sunny123 Wed 01-Apr-20 17:30:27

I'm having ongoing problems with my Mum who is nearly 89. Recently she has been unable to get up from her chair and has been wearing an incontinence pad but unable to change it.

She does not want to go into a home but has been forced into it for "respite care". The nurses told her it would be free and for a week or two. Then a social services lady called me and the cost was revealed at about £500 per week plus it may be for up to 2 months. Mum objected to the cost and said she would rather go into hospital but the nurses / social services are dead set against this.

I spoke to the social services lady again and she suggested she told my Mum that I said she should go into a home but I objected as I thought she was tricking my Mum but saying something I hadn't actually said. She then told me that she was "concerned" that I was in the process of applying for LPA which to me hints at blackmail - push your Mum into a home or we will block the LPA.

I spoke to the nurse yet again and she said Mum could die tonight of Sepsis so we should get her into a home today but there was no need to go into hospital plus there is a risk of her catching Covid 19 in hospital.

The social services lady called me again later and said nothing would happen today as it is too late but hopefully tomorrow so I asked about the nurse telling me Mum could die tonight of sepsis? She called the nurse then called me back and said Mum has not got sepsis at the moment but it can happen very quickly.

I am trying to act in Mum's best interest and also respect her wishes at a difficult time. I am trying to base my decisions of what the "professionals" are telling us but I know the nurse has lied twice and the social services lady has implied she might object to the LPA if I don't do what SHE wants me to.

I'm not very happy about this whole situation. Should these professional people be acting in this way?

rosenoir Wed 01-Apr-20 18:03:37

If your mother can not change her pad then I would think sepsis is a possibility as she may be developing pressure sores too, surely a home would be the best and safest way for her at this time.

Staying alive and healthy take priority over money at the moment.

sunny123 Wed 01-Apr-20 19:17:11

@rosenoir I agree the best place is a home. I'm just not impressed that nurses have been telling lies and social services people hinting at blackmail to force her into a home.

welbeck Wed 01-Apr-20 20:23:06

what ought / ought not to be and what is are poles apart.
but practically, you cannot do anything about that, even at the best of times, in my experience, and these are certainly not the best of times.
forget about them.
what is best for your mother at this time.
she obviously needs help with personal care.
could you move in, or visit every day to do it.
or would/ could you /her pay for a careworker to come; may be difficult to find at the moment.
i can understand her wanting to stay at home.
but she needs care. so can you set it up so that she gets that care at home.
if she goes into a care home will you be allowed to visit.
i dont see how she can be forced into one.
does she lack mental capacity.

rosenoir Wed 01-Apr-20 20:25:15

Having just re read my reply I realised how un sympathetic I sounded, sorry I did not mean to be so abrupt.

Maybe the nurse was just trying anything possible to get your mum to agree to go into a home as it would be best for the stretched hospital services or maybe she was stressed about other things.

Social services are also in an awkward position when it comes to someone having LPA as it can be used by the person having it to get their needs met rather than that of their client and what they can realistically offer financially and what is available. Not that I am saying that is the case with you.

I do hope this is resolved quickly for your mothers well being and for your peace of mind.

trisher Wed 01-Apr-20 20:38:25

What a difficult time to have such a problem. I think one of the issues is that there has been a shortage of carers for some time and so there might be difficulty finding any to visit your mum. That said if that is what she wants the social worker should be doing her best to fulfill her wishes.Perhaps you could say that if you agree to a short period in a care home you will expect the social worker to keep working to find a team of carers so your mum can return to her own home. And set a time limit for this. I do hope your mum gets the help she needs.

Hetty58 Wed 01-Apr-20 20:52:35

sunny123, Your mum can't just choose to go into hospital if there is no medical need. You may have to persuade her to live in a care home as it seems to be in her best interests.

You could start with a respite period. She doesn't need to know how much it costs. We lied to our mother - as she would have been horrified at £1,250 a week!

sunny123 Thu 02-Apr-20 07:58:39

Thank you for all the replies. Mum has now agreed to go into a care home and it does seem the best option for her. She has mental capacity and did not originally want to go into care.

I am very unhappy with the way she and I have been bullied into making this decision. Some of these calls happened on hands free in my car and my children heard them as well. They got very upset when they heard that their Nan might die last night, alone, sat in her chair. This was hurriedly retracted when I asked why she couldn't go into hospital last night if she was on death's door and a care home place was unavailable.

This experience has eroded all trust I had in health care professionals and social services. Any time I am given any information by a doctor, nurse or social worker in future I will be wondering whether it is true or not and what their true intention might be by giving me false information. This is also going to tarnish the opinion my children have of doctors and nurses and they are only 13 & 15.

@rosenoir don't worry about sounding unsympathetic

@Hetty58 she is going in for a respite period. The nurse said this would be for a week or two to get better. When I questioned this with the social worker she said more like 8 weeks. I think Mum will go into care and end up trapped there though.

travelsafar Thu 02-Apr-20 08:13:28

Have you thought of seeing if local counil or housing association have flats in extra care schemes. They have teams of carers working on site and they could attend to your mum and her needs. Usually the person is given a tenancy so they pay rent and council tax but can apply for HB and CT rebate if income is low. They pay a care charge according to their personal needs, not a generic one. It will work out cheaper than a care home and mum can take her furniture and other things with her. Flats usually are one bedroom or a studio apartment. May be worth looking into.

Hetty58 Thu 02-Apr-20 08:25:42

sunny123, it's really tough, I know. The behaviour of social workers can come as a shock and make it far worse.

My poor old Mum was in hospital having the 6 weeks allowed for physiotherapy/recovery after a stroke. She was pretty confused and couldn't hear very well.

The 'discharge plan' meeting was arranged, with a senior nurse, doctor, social worker, and us. The 'lovely' social worker just barged in hurriedly and shouted, demanding to know the amount Mum had in the bank and whether she owned her home.

Mum was quite taken aback and scared, reluctant to answer - and further confused by it. We had all, quite rightly, assumed that the meeting was to determine the best arrangements for her care. (Silly us!).

Social worker then loudly stated that Mum would just have to sell her home and live in a care home. The other's said little - then off she went to her next job. Mum was in tears.

I was so angry at that point, marching outside was my only option. Luckily, I didn't see social worker again. Never in my life had I felt more inclined towards violence!

Hetty58 Thu 02-Apr-20 08:32:46

travelsafar, we did look into 'independent living' apartments with carers on site - only to discover that they don't accept people with mobility problems. Apparently, the carers are for any later decline!

sodapop Thu 02-Apr-20 09:12:10

It seems you are having a difficult time trying to support your Mum Sunny123. Your post indicates that you are at odds with the the professionals who are dealing with your Mum's problems. It's a shame when things break down like this and no one is happy with the outcome. I agree with Hetty you can't just decide that a person needs hospital care with out a medical need especially now. I hope your Mum settles in her new home and that you and the Social workers, care staff etc can rebuild relationships.

Missfoodlove Thu 02-Apr-20 09:25:20

Hi there, are you aware that you can apply for power of attorney online through the government website?
It’s simple and costs around £80.

I had to put my other in to a home, there was no LPA, I had to apply for deputyship.... it was a nightmare!

It is a difficult time as I guess you can’t go and look around the homes easily.

Before you commit make sure you are not being charged top up fees by the home, this is a hidden charge that the next of kin is liable for.

I hope this goes well for you, I understand what a difficult thing it is for a daughter to do.

Daisymae Thu 02-Apr-20 09:33:53

This is difficult and you have my sympathy. The elderly are not always treated with dignity and respect, my family have witnessed it first hand. My friends mother is bedridden and has carers come in 4 times a day. I don't know if that's an option in your area. She does have to contribute. Is your mum claiming attendance allowance? It does sound like she needs additional care and maybe a home is the best place at the moment. I would think that she needs to steer well clear of hospital.

Alexa Thu 02-Apr-20 09:41:05

Is this incontinence pad the best thing for your mother's incontinence?Is it fastened on in some way, or inside her knickers?

Could she instead sit on a large absorbent pad on her favourite chair , no knickers worn ,and simply pull it out from under her when it is wet and slide a clean one under herself? Much depends on how mobile she is. If she is incontinent she will need a supply of wet clean cloths for wiping and barrier cream on her skin placed where she can reach them. If she is abe to do miminal tasks such as those she is besides remaining independent, also getting some excercise.

I forsee the main problem may be she is too conventional to abandon her knickers for a bare bot.

I am 88 and so I well understand she does not want to spend your inheritance money if she can avoid doing so.

Alexa Thu 02-Apr-20 09:44:05

PS an experienced carer or home help sometimes has better practical solutions than the professional social workers and occupational therapists

Alexa Thu 02-Apr-20 09:49:14

PS I am not minimising the risk of sepsis from pressure sores and urine burns. It is very important she does not remain immobile for longer than two hours with pressure on her sitting bones and wet with urine.

Can the physiotherapist help to get her a little more mobile?

Iam64 Thu 02-Apr-20 10:51:21

These communication difficulties between health and social care are sadly all too common. It's rarely a case that people lie, more that they don't take the necessary time to establish what the individual and their family want and what its possible to provide. the other big issue is the fact social and nursing care haven't been amalgamated, neither do the two agencies often communicate effectively with each other. This leaves the family struggling to understand the process and feeling increasingly stressed.

Our GP persuaded mum to go into a nursing home for assessment. He sent the practice nurse out, she confirmed his assessment and found a place for mum (in the home she said she'd want for her own mum). The assessment period was paid for by the NHS, no social work involvement needed until the assessment was underway,

From your description it sounds nursing care is needed. Can mums GP help?

V3ra Thu 02-Apr-20 11:07:41

I don't think a social worker can block a power of attorney application.
We set it up online as previously suggested.

Would an electric riser chair enable your mum to get herself to the toilet?
Dad has one (bought on a "it'll come in handy one day" basis as he doesn't need it at the moment) and it virtually stands him upright!

sunny123 Thu 02-Apr-20 12:56:51

Thank you for all the replies. There is a lot of information there for me to take in.

Right now someone is trying to find out which homes have space and are willing to take Mum in. I think it is the social services lady. At the moment I only know her first name and every time she calls me the number is withheld. This all hit me unexpectedly yesterday so when she calls me today I will start by getting her full name, job title and a number I can contact her on. Right now I don't even know who she is which isn't right.

If Mum goes into a home temporarily as planned I have no idea what the process would be when she wants to come out. Mum has a single seater sofa type chair and a two seater and these will need to be dumped or incinerated before I can get a replacement of some sort. At the moment the tip is closed and unless I break up the furniture (which could danger my health if it has urine / faeces on it) I have no way to get rid of it anyway unless I can pay somebody to do it for me.

@V3ra I could get a riser chair with some kind of waterproof cover then hopefully she would be able to get up to go to the toilet - assuming she builds some strength back up after being looked after in the home. I can't shop for one at the moment as everywhere is shut and also I don't want to buy something that never gets used if she ends up not moving home again.

@Missfoodlove I have already applied for the 2 LPAs by post, I have 2 weeks more to wait then they will let me know within 2 weeks from that date so about 4 weeks to go. I believe they allow a period of weeks in which people can object if they want to.

@Daisymae I helped her apply for this several weeks ago (attendance allowance) but we are still waiting to hear back.

@Alexa Mum was using some disposable pants I bought from Boots. I am not sure if that is the best solution or not. She has been doubly incontinent so I will need to make sure she has plenty of wipes and cream and is able to sort herself out properly or get someone to come in help her do it. It is very hard as you know trying to contact shops and online retailers at the moment and those pants were the last packet on the shelf in Boots at the time as many products had sold out.

@sodapop I wasn't deciding she needed hospital care without a medical need. A nurse had just told me that Mum could die "tonight, alone in her chair from sepsis" so I assumed that being critically ill, hospital might be a better place to save her life than leaving her sat in a chair at home. BTW I don't have any medical knowledge so I had to look up what sepsis was after the phone calls. Healthcare professionals seem to assume you are as familiar as them with the language they use and many people are not.

MissAdventure Thu 02-Apr-20 13:16:28

So, really it's your mums mobility which is the problem, rather than incontinence?

If she wants to stay home, a care package can be put in place so that its possible; I apppreciate all the extra issues bought about by the virus.

What a pain for you both.

V3ra Thu 02-Apr-20 16:16:30

You can get incontinence supplies, free, through your GP practice. Don't feel you have to buy them forever. It may take a while to sort out a supply and delivery but do ring and ask.

sunny123 Thu 02-Apr-20 21:43:03

@MissAdventure I think it is a mixture of mobility and incontinence. She cannot get up to go to the toilet but she has also been having "accidents" of both types while walking around without realising it is happening.

@V3ra thank you I did not realise you can get these supplies through the GP.

As an update: Mum has now moved to a care home this afternoon for temporary respite care. I spoke to her on the phone earlier and she said that she was only staying for 2 weeks but we will see what pans out I guess. The social worker told me it was likely to be 1 or 2 months.

Hopefully she will regain some physical strength now as she will be fed regularly and given drinks etc. She will also benefit from being cared for, eg washed, dressed in fresh clothes, helped with the toilet and any skin damage dressed hygienically so it can heal up.

I told her if she was to move home again the 2 seater sofa and single seater would need to be disposed of and the best replacement would be some sort of vinyl armchair that rises to help her get up out of it.

She seems to be struggling to understand what needs doing. She suggested I advertise the chairs to get rid of them then said a second hand furniture shop would take them. They are soaked in urine and possibly contaminated with faeces so I think they need removing and destroying possibly by people with Personal Protection Equipment as they must be a health hazard to move? I know how hard it is moving a sofa around and you would not want to be breathing in germs trying to man handle a sofa down two flights of stairs.

I told her that the chairs have to go as they are soaking wet, stink and are a health hazard but she said they would dry out and the smell wouldn't bother her.

She objected to the suggestion of a new chair as she "isn't made of money" so I left it there for the time being.

Regardless of how I feel this whole process has been handled I need to work out how to best help her going forward. Who should I try and liaise with to discuss the options for her should she move back home? She had originally refused to pay for any carers to visit and help her but hopefully she will now realise she needs to do this if she wants to get back home again.

V3ra Thu 02-Apr-20 22:53:15

My Mum ended up in hospital following a fall at home. She had Alzheimer's and Dad was her sole carer. He desperately needed help.
The social worker insisted they agreed to a carer before she would sanction Mum's discharge. They'd always refused but she pointed out that with power of attorney I could overrule them. It didn't come to that thankfully.
Social services provided carers for an initial period, then as it was going to be necessary permanently a private company took over.
Once the carer started coming they were both delighted with the support.
Someone came and did a financial assessment to determine how much Mum had to pay.
An occupational therapist visited the house and arranged for an extra banister rail on the stairs plus hand grips in the shower and over a doorstep.
It all stemmed from the adult social worker so you need to work on building a good relationship with them.
Not always easy when you don't understand the system and are upset and stressed, plus trying to convince an intransigent parent it's all in their best interest!

MissAdventure Thu 02-Apr-20 23:33:59

I would get a note pad and pen, and start phoning round to ask about what the procedure is, should your mum still want to come home.

The care home will have procedures to follow in such a case, so they should be able to help and advise you.

No doubt it will lead to further calls, so make sure to ask each person's name, and make a note of the date.