Apologies if this isn’t in the correct place I’m not sure where to post this but I do need some guidance.
We have just found out last night my grandad (who lives 5hours from us) has dementia. No one knew this, he is 80 and everyone thought he was a little confused but no more than your average fit and well 80 year old. He has taken a sudden turn for the worse and went missing, the police found him, he is now in hospital. He needs residential care full time. Due to being so far away from us how can we start the ball rolling? We will need to do a care needs assessment and CHC funding. We will be going to visit him this weekend. Ideally we would have gone sooner but my mother is not in the country and has booked the next flight home she could, she arrives tomorrow evening.
We do not see him as often as we’d like due to the distance between us, he does have other family closer to him who do see him. We speak to him on a pretty much everyday basis. It is true that no one knew about the dementia and it did take such a drastic and sudden turn. We only saw him a month ago, he recognised and remembered us all. He could tell me about the time he took me to the beach when I was 7 and there was no sign of this prior. He is otherwise fit and well.
If there is a more appropriate place to put this please let me know. But I have so many questions and I just need clear and concise answers so I can make this as easy as possible for him.
9 comments
Contact the local Social Services. They will assign a Social Worker who will help sort out what he needs.
The hospital should have a team who work with social services, but best if you can contact them too.
You need Adult Social Services and an urgent ‘care needs assessment’.
Note – if dementia has come on that quickly, is it possible it’s a side effect of a UTI or similar? That happens in elderly people. Worth asking.
Speak to the hospital. They can point you in the right direction and perhaps help you set it up.
They may also have a team that facilitates this kind of hospital discharge
Ask someone on the ward if your grandad has had a care needs assessment arranged for him. It is the hospital’s responsibility to make sure this occurs and that it is safe for him to be discharged before discharging him. That said, hospitals are overstretched and will often just discharge if they feel they can get away with it. If that happens, you would need to call adult social care at your local county council, who would arrange a care needs assessment at home, but the wait times are very variable, so try to get one in hospital if you can. The hospital should have their own social work team who will carry out the CNA and then source care. If it looks like they want to discharge, you can say you believe they’re carrying out an unsafe discharge and will report it to PALS, which may get them to reassess.
source: used to work in ASC for an English county council
You need to speak to the local authority, they have a responsibility to do assessments and provide you with advice whether you grandad is funding his own care or not, they can give you some advice. Age UK or your local Carers charity can also help, you may be in an area with a Care Association who can also provide advice.
If he’s funded they’ll try and push you towards a low cost home so make sure you do your homework, check CQC reports and visit anywhere they want to place him. The incentives in the system are for quick discharge, not necessarily what in his best interest so insist on this.
I run a group of care homes, DM me if you like/have any specific questions.
Has the hospital checked for any underlying conditions? Things like water infections can make elderly people act more senile
I’m sorry to hear about your grandad. It is fairly common for people with dementia to take sudden turns when they seemed absolutely fine even a few days ago.
It can honestly be anything that triggers it. Some weeks are worse than others and you shouldn’t feel bad about not catching it or anything.
As for care home process. The hospital ward will have on site physiotherapy that will assess your grandad on a daily basis. To see how much care he requires.
During this time the doctors/nurses will update you on his progress and give you their medical opinion on discharge timeframes and arranging for care/care homes.
After this point I’m fairly unfamiliar as it is handled by adult social services.
I used to be a hospital social worker.
As many people are saying, most hospitals will have a social work team. They will help your grandad and his family concider the different options.
CHC isn’t routinely assessed in hospital. And it would be fairly unusual to go from not requiring any care to requiring continuing health care without a major event like a huge stroke. Not impossible – but CHC is broadly for people whose needs are more than the local authority can legally provide. It’s a complex assessment that requires input from a range of professionals. It’s likely your grandad would be discharged on something called a “D2A” (or discharge to assess) pathway. This may be to a care home temporarily while longer term decisions are made. But could also be to his own home. CHC would typically be assessed for at this point. But it’s worth knowing that the “checklist” will screen in far more people than will be eligible once the DST (full assessment) is completed. Nationally the conversion is about 1 in 5 that are screened in at checklist that are actually eligible.
Similarly there’s lots of options between having no care and requiring 24 hour care away from his home.(reablement carers and or social care carers visiting at home, assistive technology like GPS trackers or door exit monitors that alert responders if someone tries to go out at a time that would be unexpected.) Many people live for years in their own home with dementia. And for those whose needs can be met at home the outcomes are often better.
You can have dementia and still have “capacity” to make decisions about your care. Particularly if something temporary lead to his confusion (dehydration, infection, medication). This can be in addition to having dementia. This can be very hard for families to come to terms with. If someone has capacity they can not be made to have care or go into a care home. Even if everyone thinks it would be ‘best’
If his dementia is such that he no longer has “capacity” regarding his care then some formal “best interest” processes (often but not always a best interest meeting) may need to occur. These assessments would take place after any temporary condition (like confusion due to infection) was resolved.
But in short – ask the ward staff (usually nurses) for a refferal to social services/ adult social care
This happened with my dad after he had a fall and was admitted to hospital. My mum couldn’t care for him anymore due to his regular falling due to a stroke he had a few years ago (she was too small to pick him up). The hospital will arrange a meeting with you, with lots of documents to sign including ones to sort out the financing, and then you go get a list of care homes. Go out and visit them and see which ones you like, and then they will get you on the waiting list. If you are getting council to help the payments, there will be restrictions on the choice. Don’t just pick the prettiest looking one, talk to the staff, and see how they’re treating the residents, look at the activities available, and also how close you live to the care home for visits.