Carers Group: 8/6/20

Covid-19 discharge

The meeting started with a tale of a member’s mum being discharged from hospital to a care home 35 miles away from the daughter. We have been told of 3 stories of people being discharged from hospital to a temporary placement in a care home. Tatiana informed the group there is currently in force, in hospitals, a Covid-19 discharge plan. This paper sets out NHS policy on hospital discharge. The summary states: “Unless required to be in hospital, patients must not remain in an NHS bed. Based on these criteria, acute and community hospitals must discharge all patients as soon as they are clinically safe to do so. Transfer from the ward should happen within one hour of that decision being made to a designated discharge area. Discharge from hospital should happen as soon after that as possible, normally within 2 hours.“

The carer thought mum’s home was probable quite good. It has a cinema and a hairdresser, amongst other features. But there had been only 3 hours notice of discharge and no opportunity to choose a care home (the daughter had identified 3 local to her). Tatiana gave some general advice about contacting the key decision makers and highlighted that there would be several key people who each have part of the responsibility for the next stage of mum’s care. The current placement would be temporary, to give all those involved the chance to agree the next move.

Caring – at a distance

Several of our carers do not (usually) live with the person they care for. The current situation had added additional layers of complexity to their caring role.

One carer was trying to resolve he mum’s car home placement. Mum’s care home costs were being paid by the council on a “non-prejudicial basis” while a financial assessment was being completed. The home seemed good for mum, however, the ‘top-up” cost would be high; mum’s saving were near the £23,000 threshold; the care home had been rated “inadequate” by the Care Quality Commission (CQC); and all the care home and council contacts had stopped giving advice or guidance. Tatiana advised that the carer should be consulted at every stage of the decision making process, as she had powers of attorney. As usual the carer needed to be proactive and assertive to ensure mum got the best deal and the right home for her.

Two stories of confused mums

The first mum’s issues had become clearer when her husband had recently died. She had stayed with the daughter, which proved stressful. The grandchildren had taken mum home to see if she would settle. Out of her home situation she had not been focused on the absence of her husband, but back at home she repeatedly asked where he was. Moving her was unsettling and surfaced new issues.

The second mum was a bit further along her journey. Three months with the daughter led to the need for a break and she returned home. Now she is very happy and well cared for. The change is due to two factors. The carer spoke to Sharon, from the Carers Centre, who suggested mum might be depressed. The GP had agreed, and prescribed some anti-depressants. The results were rapid and very positive. Mum had also benefitted for some paid cares being found. There seemed extremely helpful and… caring. The mum was happy and the daughter was happy. This carer offered to speak privately to the first carer about their situations and options.

Janet noted that depression is common in people with dementia (and not necessarily a result of the dementia). And, depression can be cured. Talking to your GP, as circumstance change, can produce positive results.

Pills

We welcomed a regular couple from our Friendship Group. They are trying to support his sister, who lives alone. She had been engaged with the outside world prior to lock-down, accessing websites and being very chatty to family and friends. Now she has become less communicative and wary of making contact with people. The brother thought she was probably depressed. The relatives are concerned that she takes her correct dosage of pills. It appeared that sometimes pills would be taken, sometimes not, sometimes they would be put in an egg cup and tidied away in a cupboard. Group members were very familiar with this problem (not the egg cup!) and, from their experiences, thought she needed paid carers to support her. On a positive note, the brother had been in contact recently with the memory clinic and they had called his sister to discuss her current issues.

All fine here

A couple of carers said they were ok. They did qualify the comment with some issues, but they thought these were relatively minor.

Peter’s post-meeting piece: Stay well & look after yourself

The University of Exeter have produced two brief booklets aimed at helping carers and people with dementia during the lockdown. They present key messages to help us keep well during the current period of isolation.