Strokes

My mum had a stroke just as I finished university. I remember organizing speech therapy n other physical therapies for her. To be honest we got her home and I moved back home and cared for her there. We did loads of speech and physical therapy every day all day.Her speech n physical well being returned really quickly with lots of effort. Her personality was changed forever, unfortunately.

Sorry should read today and not okay.

My BiL has Received a letter okay from the community OT in relation to my referral to the home support team saying they will get in touch with him within 4 Weeks. Why would they send that to his home when they know he's in Hospital duh!!

Thank you everyone it's so good to hear how others have experienced this sort of thing and listening to how best to manage a difficult situation. After a chat with Tricia Marwicks (MSP) office this morning I am determined to keep her in the loop as a back up in case all my manoeuvres fall down. Yes an assessment will now be carried out after the rehab feels BiL can go home but only with support.

On the whole I commend the nursing staff at the Victoria hospital Kirkcaldy as being second to none. Brill!!! So many negative words spoken about health care. but not in his case.

Elizabeth - I am glad that your BIL is going to a rehab unit - it is absoluitely the right thing.

They cannot discharge him from there without a full assessment of his needs when he returns home, and an assessment as to whether the NHS should pay for that care at home (Continuing Health Care funding).

They must not send him out until that care is in place. If he is in a rehab unit they will have a good grasp of this and know the systems to set in train to make sure he will be able to manage at home. There is far less chance that they will make a sudden discharge, so you can rest easy.

I am puzzled by what the social worker has said about needing to wait for an assessment for home care input - hospital discharges take priority in order to avoid blocking beds with people who could be at home.

If he will be funding this care himself (because he has savings) you can set this up yourself, although you might ,ike to ask your local Social Services Dept to give you some advice - they have to do this, even if he is paying for himself.

If he does not have savings and needs their financial input, they will need to make a full assessment.

I do hope that he makes a good recovery - he is in the best place.

Agree with Mishap above, in spades.

I am horrified that, so soon after a stroke, less than a week ago!! - discharge is even being thought of. I couldn't emphasise it more. He must go to rehab before return home is considered. He may get back a lot of function, but only if the people who know what they're doing get a chance to work with him, and that doesn't mean leaving him sitting on a ward all day, virtually unattended except for the very basics.

Some of us on here have been there, seen it, done it....

Had a very busy day talking to social work, nurses and local MSP regarding discharge planning.Pressure coming out of my ears at one point. Outcome after visit to hospital is that BiL going to local rehab unit after all. Only I believe after OT found he struggled to make toast and tea and the strength of my input into the concerns I had. It s found that BiL also hurt his back when he fell over last night so that gave further concern.
Was advised the social work have a waiting list for assessment into home care however after a very long chat with them was invited to phone back after hospital visit. I think in case he was sent home some individuals were becoming a little apprehensive. That was encouraging and I think all are now on alert. Applications are into supported living housing associations and the local authority, however, present home is all on the flat and with home care BiL may continue to be able to stay there safe and secure once the rehab have worked with him. (Here's hoping) now relaxing after an eventful day. Thank you all once again.

I have worked in this field - it is absolutely vital that you press for a referral to a specialist stroke rehabilitation unit - do not take no for an answer.

I have seen so many people make brilliant reoveries to functional life after a period in one of these units, but we always had to fight for the referral - local CCG will balk at the cost, but the units are there to be used. They work on physical recovery, functional skills speech therapy and cognitive rehab.

We have the skills to help stroke patients but they are only doled out to the lucky few.

Whererabouts are you/is he? - I may be able to suss out the nearest unit.

It is only after a full course of rehab that home care packages or residenbtial care should be on the agenda.

Is he having physio?

We have an excellent stroke unit at our local hospital (Southend-on-Sea) which has received all sorts of accolades since it was set up. Early diagnosis and brain scan is crucial - is it due to a clot, or a bleed, because the initial treatment will be different. Following the initial treatment, physio is crucial. Don't write him off as a lost cause yet because, with good care and, again, physio!! - people can recover a lot of function.

If his left arm is affected DO NOT allow it to hang down because this is painful and damages the shoulder-muscles. It must be propped on a pillow if he's in bed/in a chair.

There should be no excuse for someone being allowed to stay in nightwear all day with, as you said, all his lower end on show. No excuse at all.

HTH

Update - BiL's nurse was challenged when I asked why he was always in his pyjamas as previous nurses advised me to bring his clothes in to see if he would feel a little motivated. Must say she responded well as Bil was in his clothes next day looking better and no sign of his lower half being exposed to all and sundry if you know what i mean. I have referred BiL to Social work and set the ball rolling for a forward plan should he be considered for discharge in the near future. BiL unhappy now and wants to go home however he is continuing to be sick each day and he had a fall last night. Must say I saw this coming. BiL's name is down for very sheltered housing but until then he will need a care package in his own home should he be dis charged but I certainly will be unable to dedicate all my time to him. It's a blessing I have retired otherwise Dont know what would have happened. Things are uncertain at the moment and we are taking each day as it comes and I am hoping he will be transferred to the nearest rehab hospital as was suggested earlier. It's as well I have a background in social care so will have much input into any multi disciplinary meetings and be able to make my voice known.
Thank you for your comments and interests, I'll keep you informed of any further developments.

Elizabeth1, Your brother in law cannot be discharged from hospital until a full discharge assessment has taken place. This has to be done by Social Services. Just make sure you are not included in the report as providing any form of support. As * JessM* says resist all emotional blackmail to include you in the care package. Sound, to them as cold and indifferent as you can, when they ask you to help.

I was pressured very hard by a psychiatrist to take my uncle home with me on discharge. I lived 'out of area' and it meant they could wash their hands of him, no follow-up, no care, no assessment. He played (or tried to play) on my affection for my uncle, shown by the support I had given him in the crisis leading up to and during his hospital stay. He threatened to just load him into an ambulance and dump him outside his home. But I just said NO. In the end he went into a Care Home for convalescence and as he had enough money could afford to decide to stay, close to friends in the town he had lived in for 35 years.

However, once he is discharged home with a Care package monitor it, and do not hesitate to try to get your BiL into a Care home if you think he is in danger in his home on his own.

Sorry to hear this Elizabeth1. All I can say is that there are huge pressures on NHS staff to discharge patients. When my cousin, well into her 80s had a brother in hospital last year the staff were trying to get her to take responsibility for his discharge as this was easier than dealing with the son and daughter who were not visiting as frequently (lived at a distance). Fortunately she is a powerful woman (although not physically) and was able to "push back" when they tried this. So I guess you need to have a serious think about how much you are able to do and how much you are willing to do. Good luck.

I'm sure many people won't agree with me but it sounds as if he needs to consider going into residential care unless he can afford private care at home. Even if this is only on a temporary basis. It doesn't sound as if carers coming in for 20 minutes 3 times a day will provide enough support and if you are not careful you could find yourself tied down and trapped. My experience is that hospitals want people out and social workers aren't much help. They just want to tick a box and move on to the next case .( I understand they are overworked etc).
When my father had his first stroke he could not walk and lost the use of his hands but they wanted to send him home with a commode in his lounge even though my mother would not have been able to lift him onto it.
Can you call on his family for help and support?
This may all sound harsh. I appreciate that you want to be supportive and help this man but you have to think of yourself as well as what is best for him.
Let us know what happens.