92 year old mum rapid decline

M0nica

What a difficult time you have a head of you. Here is a link to an Age UK fact sheet that might help www.ageuk.org.uk/siteassets/documents/factsheets/fs37_hospital_discharge_fcs.pdf

I have been in the situation you have been in. You must stand strong and refuse to let them discharge your mother home. You must insist, that she cannot manage at home and must go into care, at leasttemporarilly. Or you could let them discharge her, wait for something to go wrong and then read them the riot act.

What I did was write a letter in advance (or send an email) listing the things that can go wrong: incontinence, immobility, choking, unable to help herself if she were to get out of bed and fall and send it to social services before she is discharged. Then, when things go wrong you can wave it at them and say 'I told you so,' as you take them through the complaint system. - end of cyncal rant.

Contact PALS at the hospital. I have found them very helpful. Do not let any doctor or nurse browbeat you.

Good advice.
There aren’t the convalescence homes around like there used to be unfortunately, but there are nursing home type hubs that frail elderly patients are often sent to.

Only part of my post was delivered !
hospital and the hospital wanted to send him home .
He wanted to come home .
I found the social worker impossible.
I also didn't like the carers and my father was frightened of them.
Eventually I asked the second lot to go and made my own arrangements using an old friend/neighbour to pop in when I needed to shop .
He wanted tea and chats with her.
I did everything else myself.
Food was a problem.
I made mini meals and left little bowls of treats such as cheese ,chocolate and grapes which he'd pick at .
He craved an enormous variety.
We tried meal supplements but they gave him diarrhoea and stomach cramps.
After some trial and error we were both happy .

Michelle825 - Sorry to say this as most contributors seem to want to keep very old people in hospital, but I personally believe that's wrong and as a psychotherapist with lots of experience with bereaved people I know that hospital is never the best place for a person who is medically OK but can't feed themselves, brush their hair, do their own toileting.

People in this position die of neglect, they are not fed because there's no resources available to sit for half an hour and try to coax someone to eat sloppy food, and nobody thinks of combing or washing their hair or massaging their hands. They lie in bed without attention and without being turned, and often this leads to compression sores which can arise very quickly and just as quickly can become ulcerated leading to infection. And of course, pneumonia is rife in such places.

As others have said, social services will arrange for six weeks in a care home on discharge from hospital and during that time a proper care plan can be devised. Your mother might actually like it there so there's a possibility she might be persuaded to stay.

There is another question which you need to contemplate which is if your mother really can't do the things you say, what do you think her life expectancy is? If you can honestly say that it's not more than a few months then is there any way you can keep her at home as a family for that time. Use carers coming in four times a day to do the personal care and lifting, but have a rota among the family so that someone spends one night a week with her (sleeping). I know from experience that many people come for bereavement therapy full of guilt because they feel they deserted their elderly parent at the last hurdle. I know this is a very difficult thing to consider but some people can do it and are pleased that they did when their parent has gone.

Thank you all so much with helpful advice. Seems many of you have been in the same position. I understand the need for the hospital to make room for other people with urgent medical needs. It’s a catch 21 situation. If she goes home we will only end up back in hospital. I’ve looked at 2 homes now and have a preferred choice. It’s just whether that one can meet her needs. We have POA for finance but not health. She will be self funding for the home if she agrees. I just have to say to her it’s a rehabilitation place until she’s fit enough to go home. She likes it in hospital and is holding her bell close to her in case she needs help. At home she has lifeline but that takes a while to get to me and then I have to drive to her house. It looks like she is only eating less than 300 calories a day at the moment. No sign of the Fortisips we asked for. I like the idea of writing a letter in advance to SS saying a discharge is unsafe.

We cannot expect hospitals to keep elderly infirm if they are not ill, it is just bed blocking, we have to make our own care arrangements and yes I totally understand, having had my mum and Dad and Nan all in this position.
You are right Michelle it’s a horrible catch 22, the gov closed down the cottage hospitals and the recuperation wards and now the poor old NHS gets the blame when it can’t house people with no actual medical needs.
I think getting 6 weeks free care in the home is wonderful (think America) my friend has had it three times after hip /knee replacement and a heavy bleed needing a number of transfusions (another problem using precious blood on a dying body )She has now decided to stay home and no more ‘saving’ her life when it next happens ( which it will) she is 90 but totally compus mentus and has decided to ‘go’ whilst in her own home with obviously care but no more treatment.

You re mum is winding down Michelle get the family to help if you can I was in my own, no siblings and it’s very, very hard.
Good luck

I can sympathise. We’re going through the same thing with our 96 yr old FIL. He’s gone downhill a lot and has just been transferred from hospital to rehab as they’re sure he’ll eventually be able to manage at home on his own with carers popping in. For the moment we’re just glad he’s in a safe place. He just wants to die - he’s had enough and tells us every day. It’s very upsetting to see him crying. All we can do is love him, be with him and then see what happens when rehab has finished. But it’s a very painful time - for us as well as him 💐 x

Michelle we were in the same position as you eighteen months ago although we were told it had to be a care home as no package of care would be enough.

Mum was 92 and very resistant.We looked at several care homes and had a wait as our preferred home was being refurbished and all new en-suite rooms.It took mum a while to settle but she is as happy as she can be, safe and very well looked after.It is a hard decision and I felt guilty for a while but knowing she is safe and cared for was a massive relief.She has formed a strong bond with some of the carers.We have been given a diagnosis of her slowly dying but I feel she is in a lovely place surrounded by lovely people and although it was such a tough time it has worked out really well, not perfect but she is content.

I hope your mum settles.Give it time💐

Oh dear this problem gets repeated time after time. Your poor mum, and many others like her including my own mum many times.
Have you enquired about a rehabilitation bed ? Where I live there are quite a few purpose built hubs, and hospitals with rehabilitation wards especially for patients like your mum. Even if it’s not that close it could be the best option.
My mum spent many months in four different places until she was well enough to come home with carers.
I do sympathise it’s a terrible situation I was once told to hurry up and pick her up from hospital because she was bed blocking The hospital had sent her home in an ambulance to an empty house, luckily the physio had just arrived to see her, saw what state she was in and sent her straight back to hospital ! Absolutely disgraceful.
Another time they sent her home from hospital at 3am without telling me. She was unable to walk, I went to visit her in hospital the next day only to be casually told, oh we sent her home yesterday. I found her at home cold and hungry poor luv.
I do sincerely hope they don’t send her home. I would get in touch with Pals and at least register your worries this happens far too often. Good luck

Carers that come into the home, three, four times a day, tot that up & it’s probably as much as a care home.
Bring that person to live with you, whether you have carers 3/4 times a day, you are still to a point house bound also if that person can’t be left alone.
A lot to think about.
Social service do a card which is loaded with a certain amount which you can put towards carers or day care- you would have to look at what the criteria is to get one.
I personally think when a person becomes so ill & infirm, it would be best just to slip away, but of course it doesn’t always work out like that, as it can go on for years.

Also is she on a DNR?

Mum is self funding and it is a lot🤦🏼‍♀️but she gets excellent care, is safe with trained nurses on the unit 24 hours and the dr a phone call away.The GP and advanced nurse practitioner visit twice a week.A care home wasn’t where we thought she would end her days but it is so much better than we could have hoped.She would love to slip away, she has had enough💔

We had a similar with an elderly relative. She refused to go into hospital because she thought she would end up as a "bed blocker" and kept in until a care home could be found, so I promised her we would support her wish to come home ( she really hated hospital stays).
She came home after a couple of nights, she already had 2 care visits in the daytime so we increased that to 3 and one of the family stayed overnight to help with the commode at night.
It was only for a week, as the diagnosis showed that she was unlikely to live for long so she decided to go into the local nursing home for the last few weeks.
Financially we would have been better off leaving it to the hospital to arrange safe discharge, but I am always pleased we acted as we did as she died 5 weeks after her hospital stay, & the decision to go into care was her own, she had visits from the neighbours, the family dogs during that last week at home & said goodbye to her beloved little house. If she'd waited in hospital for a care place I think she would have died there.

It is physically very tiring supporting a family member at home straight out of hospital, even when they are able to manage toileting by themselves. After his heart attack and 3 weeks in hospital DH needed help with everything else to begin with. I was exhausted, even though each day saw a slight improvement ( until it didn’t ). I’m not complaining, I wouldn’t have done it differently, but just saying how hard it is.
My dear mum had told me that if Dad died first she wanted to go into a Home. She didn’t need a lot of care, just help and support, but she had a new lease of life. Best decision she made, for her and for me.

Yes it’s in place

The DNR

Michelle825

The DNR

Good.
When dad passed away I was told to pull him off the bed & start cpr. I said there was not a chance I was doing that. He had been dead twenty minutes by then & on a DNR.
She then told me to step away from the body, told her there was no chance of doing that either.
We held & hugged him until the police arrived.
Why on earth would you want to crack open your loved ones ribs.
Dad just closed his eyes & that was it. The best way to go in my opinion.

Sadly mum died yesterday. In a way it’s a relief as she would never have wanted to go in a home and the loss of all dignity would have broken her . Thank you for all your suppor and ideas. For everyone in a similar situation my heart goes out to you all.

Michelle I am so sorry that your precious mum died yesterday, but she was at her end wasn't she and thank goodness no more suffering, and as you said she would have hated going in a care home.
She is at peace now and given time you will see that nature did the right thing for her and you
You will miss her so much but no more pain
Sending a hug your way

Michelle I am very sorry for the loss of your mum and the traumatic time you have been through. I am glad you have some relief in knowing your mum is at peace. May you have fond memories and love surrouding you. Take good care of yourself. My thoughts are with you.

Condolences Michelle, but your mum is at peace, no more struggling.

My condolences Michelle. Having been there I know it is a mixture of relief and sadness.

Very sorry for your loss , Michelle flowers

So sorry Michelle.Not too long ago since my mum passed. The feeling of relief is a strange one, but totally normal.May she be at peace now. Take care.

We have my DM living in our annex, she’s 97 and in pretty good health.
I just hope that one morning I go in and she is dead. That’s what she wants too. So many people seem to have to suffer such awful things before they die.
Your mum, Michelle, was lucky she was loved and cared about by you.

Oh so sorry to hear that Michelle.
My heart goes out to you 😞