How to get an ailing elderly relative into a home

*a place

Currently in hospital. Owns no property. Lives alone.

Raise concerns over living situation with doctor in hospital. There needs to be a care package in place for her leaving the hospital. If she has advance stage cancer, then a hospice may be the better option. Depending on her mental state and willingness to go to a home/hospice, there may have to be intervention from social services. First step is to make the doctors/nurses currently caring for her in hospital that her living situation isn’t safe any longer. Following that (depending on council area - assuming U.K. here) a list of availability is generally drawn up and if she has any friends/family who can visit those places in advance to weigh in then she could specify a preference for one over another.
This was the process we went through for my gran, was about 4/5 years ago though so I’m not sure if Covid will have changed anything. Speaking to hospital staff is definitely the first step regardless.

If relative is in hospital there should be a social worker who will be in attendance. The relative will be assessed for leaving hospital with palliative care etc.
I have been in this situation with three elderly close family members all terminally ill. I know how stressful it can be if it's all on your shoulders.
You will have to pester the staff to make sure the social worker attends the patient while you are there. So you can be part of the team making decisions.
It will have to be palliative care not just a nursing home. It will be you I assume a relative who will have to seek out a suitable home if social worker has no suggestions.

The problem is I'm not doing it. I'd be very happy to do it, but I live too far away. I just need to understand the process. Is it OK to locate a nursing home if it is to be state funded? Relative has no money.

The ward nursing staff will put in a referral for a social work assessment if you raise your concerns with them GagaJo. Social Worker will do an assessment, including finances, and the next of kin is asked at that stage to find a suitable nursing home. They will provide a list of approved homes which are within the price band they will pay - many homes charge top-up fees. For terminally ill patients who need full nursing care, the NHS will pay through the Continuing Healthcare route if the patient is on an end of life pathway, but if the needs are not yet full nursing care (bed bound, unable to do anything for themselves), Social Services will pay, they tend to argue it out between themselves on an individual case basis.

First and foremost question. Does she want to go into a home or not.

Thanks Casdon. That is super helpful.

Kali2

First and foremost question. Does she want to go into a home or not.

Definitely. HATED being alone and ill at home. Found it very frightening.

If it is her wish, then that is good. I have known many cases in the past where the ailing person did not want to leave their home, despite problems and a lot of pressure from relatives.

So as Casdon says above.

She should not be accepted by who ever might be expected to look after her.

You're describing my granny Kali2. Didn't want to go into a home. DID go into one briefly but was so cantankerous she refused to settle and demanded to go home again.

If the hospital has said that they are unable to go home, then someone has to find somewhere for them to go.
Liaising with the local authority if they have no money.

But, if she has Cancer is she well enough to be moved from the Hospital? Probably a Hospice would be best, the Hospital/ social services will help.

Not sure the stage/severity yet. Waiting for results.

Social Services must do a an assessment before she is discharge, although they will sometimes, try and get away without doing it, or without visiting client or their home (they caught me out on that one).

Then suitable accommodation must be found. If she has assets to be self-funding, then she has a lot of freedom about what she does and where she goes. If she doesn't he iss at the mercy of Social Services.

I believe the key words for getting social services to act, are ‘vulnerable’ and ‘at risk’.

Plus of course making it crystal clear to them, that no relative can undertake the virtually full time care/presence that’s now needed.

I did once hear of someone who got so desperate, she told SS that if they didn’t find her parent a residential placement NOW, she was going to take him/her to A&E, and leave him/her there.
This was a case of pretty bad dementia, though, and although I gather that it worked, I wouldn’t recommend it!

Whoever lives nearest should insist on attending the hospital discharge meeting (where the social worker and doctor can answer questions) and the continuing care assessment too!

It's not as simple as 'finding a place' - as nursing homes have criteria on who they'll accept. A hospice, if available, is a better option.

I have no advice to offer Gaga but couldn’t pass by without saying what a dreadful position to be in, and I hope a place with suitable care will be found. I can’t imagine how awful it must be to be alone and very ill. ?

GagaJo, I just know I'd be exactly like your granny:

'was so cantankerous she refused to settle'

(so expect to end up on a locked ward).

It must be very frightening living on your own and being seriously ill, sadly it must happen a lot. Even if she has a continuing care package with carer’s up to four times a day they would only be with her for a very short time so she would still be alone for most of the day and night. Hope you find somewhere suitable and she is happy & settles there. If her results show she now needs end of life care a hospice would be the better option.

Hospice places are as rare as hens teeth unfortunately though Hetty58. Most nursing homes will accept terminally ill patients who are on the end of life pathway, but if your relative is not at that stage yet but is eligible for CHC and has complex care needs which some nursing homes can’t meet, the Continuing Healthcare team at the hospital will be able to advise GagaJo. It all hinges on the eligibility criteria being met, so I agree that if somebody is able to attend, or dial in via Zoom or whatever format the team use to the discharge planning you will be fully in the picture about what the options are.

We had the same problem with an Aunts care. She was living in a sheltered flat, fell, hospitalised, not fit enough to live alone anymore. She had a little money so we found a mid price home for her. When her money ran out within 2 years, Social services told us she’d have to move to a cheaper home for their funding, or we’d have to pay the difference (Aunt was 90+ & thought she’d lived in the home 40 years by then). Pressure on us was awful from SS. Numerous bullying phone calls to move her. We looked at the ‘council home’ where a room was free- not nice. Refused to move Aunt. Found out some residents were funded where she was, so then wrote to her local MP( who later became PM!) Reply was it would be dealt with! It was - immediately! . Aunt allowed to stay where she was. No more pressure on us as family to pay anything. All in all very stressful for us - Aunt not aware.

Are you able to take a few days off work so that you can attend meetings, see people face to face, and spend hours waiting on the phone? If you are physically there it is more difficult for them to put your relative at the bottom of the pile, although I do appreciate the difficulties SS are under.
It took me a week of pressurising in person to get a place for my father in a care home, after months of him not coping at home, and he was able to pay.

Not really, because as well as work, I'm full-time childcare for my GS.

She does have a relative close by. I just hope they can be realistic about her actual sitution. I suspect they're still hoping for the best, but I've been here before and what they're hoping for is unrealistic, in my experience.