Advice for mum coming out of hospital please

Hi - I’m new here and relatively new to having any kind of significant caring role. My mum (85) has always been independent but recently I have had to start doing much more to support her since she has lost central vision (registered blind but able to manage getting around ok, just not read, identify small objects etc). Recently she had a fall which left her with a painful hairline pelvic fracture. She’s currently recovering in a small community hospital with great physios and OTs who are slowly getting her mobile again and I know they want to discharge her back to her own house as soon as possible. They have promised that this won’t happen till the required care is in place (probably carer visits morning and evening) but I am concerned that mum has lost confidence and seems to feel very insecure unless someone else is around most of the time and especially at night. I’m wondering what alternatives there might be to her returning to her own home - at least until she is feeling more confident again. Mum has no money of her own but receives housing benefit and pension credit guarantee, and is waiting to hear about attendance allowance. Are there short-term options eg care homes or supported living facilities she could stay in temporarily and would she have to finance that herself or is there some kind of provision for this situation where a person is too well for hospital but not well or confident enough to be alone at home? Thanks so much - any advice or experiences of similar situations would be terrifically welcome!

Hi Justine … welcome to the canteen.

A problem not unknown on the forum … potentially an unsafe hospital discharge … a regular and recurring problem.

First step … the BIBLE on hospital discharges … who does what :

Being discharged from hospital - NHS

In short , ANY deviation , NO discharge !

Anyone mention CHC / NHS Continuing Healthcare … or even offered same ?

Main thread :

Time for a little homework as to the options available as spelt out in the bible … and then return to us here on this forum.

Thank you Chris! I shall study the Bible and then return. Much appreciated!

Your welcome.

Not exactly light reading but … almost all the problems reported are simply down to the staff involved not following their own guidelines as laid down in that bible !

Justine hi -

Bluntly, the rules on ‘who pays’ are pretty clear. If someone has £23,500 in cash/savings etc (ie, not property), then they will (most likely) have to pay for all their own care, including home visits by care workers.

If you are below that threshold, then ‘funded care’ starts to kick in.

However, if you own property, ie, your house or flat, then if you want to live in a residential care home, the value of the property has to be used to pay for it. So either it has to be sold, and then you pay the fees out of the sale proceeds, or the council put a charge on it, like a mortgage, and when you die, they ‘collect’ whatever amount they’ve paid out in care home fees on your behalf.

(This happened to my late MIL - ALL the money from the sale of her flat went to pay her care home fees for the last four years)

However, once the sale proceeds are down to that £23,500 level (and asusmign there are no savings piggy-banked away), again, the council start paying your care home fees on a ‘sliding scale’ (ie, they co-pay with you) until you have nothing left except £14, 500 in all the world. At that point you pay nothing and the council pays everything!

(Family shouldn’t count on inheriting that £14, 500 by the way - the funeral expenses have to come out of it!).

BUT, if your mum doesn’t own her flat or house, she ‘should’ be entitled to free residential care, paid for by her council/local authority.

However, because, of course, residential care is more expensive than home-care, most councils will do their best to keep folk ‘limping along at home’ for as long as they can. This is fine if it’s what the person wants, and the at-home-care is adequate for their needs, but sometimes a point is reached where residential care really is the only option, and then you may have to fight for it!

Thank you, Jenny! That’s very clearly put and helps me understand the situation better. My mum would be below the threshold for paying towards her own care whether in her own home or in a care home. At this stage we are still hoping she will be able to come back to her own home but I’m just not sure that she will be well enough to do it immediately. I guess we will just need to wait and see how she progresses. Thanks for your help!

Justine, given mum’s age and disability, do YOU think it is realistic for mum to ever go home again, or is it now time to find a pleasant care home near you, so that you both know someone can be there for here 24/7?
Is it fair for her to go home, then fail again, then hospital again?
Only you can answer this. One day, after many years of supporting my own mum, I just felt I couldn’t do it any more.

I definitely agree it would be prudent ‘just in case’ this hospital stay marks a ‘new stage’ in your mum’s continual decline (which, in the elderly, does often ‘jerk down’ in stages, so to speak, and they can never ‘get back’ to the previous level), to start making a recce of the potential care homes in your area.

The Internet is your starting place - that’s what I did for my MIL a few years ago. The listings are not very revealing, but they are a start, and give you a rough idea (they do NOT put fees up!). However, one thing if your mum is not to be self-funding, as it sounds she isn’t, is to check with every home whether they take council-funded residents. Some do, some don’t.

Your choice will be limited to the former. Then you’ll want to go and visit them yourself, as it really takes a ‘site visit’ to get the feel of a place. The ‘good’ homes are pretty obvious straight off - you get ‘good vibes’ etc etc.

Be aware of the number of EMI patients (Elderly Mentally Infirm - ie, dementia) at any place, as, if your mum does NOT have dementia, it can be a bit gloomy for her if nearly everyone else has dementia, and she can see that all around her. You want her to have some ‘real companionship’ with other residents, which is impossible when everyone else has dementia alas!

Finally, be aware that your particular council may well have preferred homes that YOU do NOT prefer! In the end, for the council it’s only and always about money, so a ‘bad cheap home’ is better for them than a ‘good but more expensive one’. You want to know beforehand if the (permanent) home they are planning on funding for her is somewhere you want her to be!

(By the way, one ‘sneaky’ way of managing this - IF you can afford it - is to find a ‘mixed’ home, that takes both private and council funded residents. Book her in as a ‘private’ patient (it will be at least £3k a month, be warned - self-funders pay at least £100 a DAY!), but the sneaky bit is that IF she is ‘already there’ when her money runs out, she has a MUCH ‘stronger right’ to go on staying there. (Not guaranteed, but it should help her stay in a better home, even if council-paid by then).

Care homes ?

AGE UK … guide … probably the best there is out there :

Care homes | Information and Advice | Age UK

Help with finding a Care Home | Age UK

… and a 32 page guide in .pdf format … includes that kitchen sink !

Just to say, for the time being, if the hospital just want to move her into an interim care home while they sort out home care, and free up the hospital bed for the ‘Xmas rush’ (!), that obviously it matters far less where she goes, as she won’t be there permanently.

She may even, you know, be sent to a ‘luxury private’ home! This happened to the 95 y/o mother of a relative who was discharged from hospital to such a place (much to her initial reluctance!), and found it ‘wonderful’! She lived in the lap of luxury, being waited on hand and foot, and had a truly lovely time for a week…then came home again after her ‘holiday’.

So, do bear that in mind!!!

What you really need to know at this stage is WHICH CARE HOME they are thinking of moving her to! Then YOU can check it out NOW, and if you really think it is unsuitable, kick up a fuss. While your mum is in a hospital bed they are trying to empty, YOU have ‘power’…it is your strongest card, so be ruthless about not letting her be ‘dumped’ in the most convenient for them and cheapest place they can eject her too!

(Be aware, too, that they may try and call your bluff, and say ‘Well, can’t she come and stay with you, or you move in with her, while we sort out the home care? DO NOT ACCEPT - or you’ll find the’ home care NEVER gets sorted as they have successfully now got YOU to solve the problem entirely!!!)