# Elderly Parent Care



## Clohass (17 Sep 2009)

Looking for some advise/suggestions. My mother has lived independently up to recently (almost 79 years old) despite being quite frail and suffering from arthritis. She was admitted to hospital last week and is now due for discharge having had a minor procedure. 
However I/we have a concern that my mothers mobility has detioriated over the last while and are concerned about her ability to live independently going forward. We have several supports in place, stairlift, carer and home help each weekday mornings but I'm concerned these are no longer sufficient. My mother will never accept that she is unable to continue living independently and I am wondering how should I be approaching this with hospital as they seem keen to discharge her as soon as possible. Should I be insisting on an assessment/report from an occoupational therapist prior to discharge or what should I do. I'm unclear where the responsibility lies within the system but am in regular contact with Disctrict nurse etc.

Any suggestions/advice welcome. Thanks you


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## Threadser (17 Sep 2009)

Anyone over 70 is entitled to a report from an occupational therapist before being discharged from Hospital.  I would insist that your mother has an assesment done. If she lives on her own then she may well need further supports put in place at home if she is to continue living there. The financial situtation is so dire that the hospital will try to renege on it's responsibility here, but you are in a strong negotiating position while your mother is still in hospital. Once she is discharged you won't be entitled to anything.


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## Clohass (17 Sep 2009)

Thank you so much for this information, its exactly what I need to know on a practical basis. Would I have the right to view and discuss this assessment?


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## Threadser (17 Sep 2009)

Yes, as the next of kin, you will be invited to discuss the assessment and care options for your mother with the occupational therapist.


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## declanja (17 Sep 2009)

The HSE can increase home help hours if deemed necessary by the discharging hospital team. There is also a Home Care Package available. This would give a grant of up to €200 per week to buy in home help. There are some restrictions, i.e. the payment cannot be made to a relative etc. There are Home help agencies here in the west that can provide this service at good rates. Your PHN or Hospital OT should be able to advise.


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## annet (17 Sep 2009)

You have a number of options.  Contact the nursing staff on the ward - ask them the day of the ward rounds of the consultant.... and be there on that day and  at that time.... you may be hanging around but I'd stick put on that ward till you get to speak to the consultant or specialist registrar.  At ward rounds you will get the whole team together - including the consultant, social workers, OT, Physio, nurse.  Ask the team what plans they are making and putting in place as part of your mums discharge planning.  Make it known to them that there is a deterioration in your mums physical condition and that you feel for reasons of safety, health and wellbeing you believe independent living in no longer feasible and its important that a home assessment by the team be conducted to ascertain her health and welfare needs to support independent living, including adaptions to the physical environment and support systems that need to be put in place like meals on wheels or home help etc.  

You can also ask to speak to the social worker in the hospital that would come under your mums clinical team.  The public health nurse should be able to put in place supports like meals on wheels for your mum also.


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## Clohass (17 Sep 2009)

Thank you most sincerly for taking the time to post. I will insist on an assessment and the opportunity to discuss that assessment prior to any discharge. At that point I hope that it will be clear whether my mam can continue to life independently (with appropriate supports) or whether the time has come when she needs full time care. She won't discuss this at all and therefore this will be very difficult but at least this way I'm being guided by professionals and doing my best to access an apporpriate form of care going forward.


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## Emiso (17 Sep 2009)

Hi ,
My advice to you would be to give your mum every opportunity to stay in her own home as long as possible if thats what she wants.
An OT assessment should involve a home visit with your mother to assess her ability to cope with her activities of daily living.Make sure that you are present at that assessment.
Also request a meeting with the social worker to discuss her care options such as an increase in her carer/home help hours or perhaps long term residential care if appropriate.

Don't take your mother home until you are happy with the supports put in place. It is much easier to get these things approved whilst your mother is an in patient as they will be anxious to get her discharged in order to free up the bed. In some HSE areas, it is very difficult to get home helps and care packages for people once they have been discharged.


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## KerryG (17 Sep 2009)

Sorry for butting in on your question but I have a similar query, 78 yr old father presently in hospital, definetly coming home to his own house.  I have the form for home help but this is means tested, does anyone know what the threshold is?   His main income is state old age pension but I have deed of covenant set up for approx 4.5k p.a. which helps pay bills.   If this would put him whatever the limit is I would be better off cancelling it as the gain is about €900 p.a.  The home help would be much better.   Would appreciate any advice.


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## Clohass (18 Sep 2009)

Threadser said:


> Anyone over 70 is entitled to a report from an occupational therapist before being discharged from Hospital. I would insist that your mother has an assesment done. If she lives on her own then she may well need further supports put in place at home if she is to continue living there. The financial situtation is so dire that the hospital will try to renege on it's responsibility here, but you are in a strong negotiating position while your mother is still in hospital. Once she is discharged you won't be entitled to anything.


 

Threadser would you have a link to where I could view this entitlement in case the Hospital dispute this (no reason to think they will but I like to have my backround info in place). Thanks again


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## annet (18 Sep 2009)

Clohass & Kerry G

The Carer's Association offers an telephone service that can provide practical advice on the issues that you are enquiring about and their contact details is 1800240724 Mon-Fri 9-5.30pm*.  *The Carers Association, National Office, Market Square, Tullamore, Co. Offaly.  Tel:  057 9322920.  Fax:  057 9323623  www.carersireland.ie.  

Age Action Ireland would also be able to give advice on rights and entitlements and this organisation would have and advocacy worker attached.


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## KerryG (19 Sep 2009)

Thanks


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## Threadser (20 Sep 2009)

Clohass said:


> Threadser would you have a link to where I could view this entitlement in case the Hospital dispute this (no reason to think they will but I like to have my backround info in place). Thanks again



Don't have a link for this I'm afraid.  Sorry about that.  A friend of mine who is a senior HSE employee told me of this entitlement and also told me to ask to see the discharge plan for my mother.  Basically if you feel that your mother will be unable to live independently at home with her current level of support then now is the time to get professional advice. Be firm and insist that this assessment is carried out.

If she lives alone, she can't be discharged until the supports are in place so you have a strong negotiating position now.


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## Clohass (24 Sep 2009)

Thanks once again to everyone for there practical advice and for sharing their own experiences. 

We are meeting with the Occupational Therapist tomorrow and whichever members of the medical team are available to discuss the current position and my mothers mobility and capabilities for independent living. 

I have done up comprehensive notes detailing everything I want to establish and say and I will ask that a copy of these be placed on my mothers file. I also intend asking for a copy of the Report of the OT so I can read and understand the assessment.

I will post again on progress. Thanks everyone for you assistance this far.


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## Cligereen (25 Sep 2009)

Clohass, whilst I fully understand your concerns and whilst I agree with the advice everybody else has given, it is important to point out that that if your mother is fully compus mentis then she has the right to self-determination ie she can make her own decisions about her future. 

If she is compus mentis and wants to go home then the hospital cannot prevent this, it is not a prison. It will be up to your mother which services she is willing to accept when she gets home.

Obviously you are trying to the very best for your mother and services may well be available to her - but only if she is willing to accept them.

If your mother is compus mentis then she has the right to confidentiality and you may not be given any part of her medical record without her consent.

You just need to be aware of these points.


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## Clohass (25 Sep 2009)

Thanks Cligereen

I understand the points you are making, I feel it is my responsibility to do our best to establish and access the appropriate type of care for my mam going forward. All I wish to do is ensure that the hospital have regard to my mams ability to cope and highlight that I feel she may be at an unacceptable level of risk if expected to live independently. 

It is now over a week since the hospital first contacted us to facilitate a discharge and at that point I don't think an OT had even seen her. Because of our concerns she is still in hospital, receiving an assessment from a geriatitian, an OP and access to a Physio. This is all positive and in my mams best interest but would not have happened had we not voiced our concerns.


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## Cligereen (25 Sep 2009)

Hopefully things will all work out for your mother and she'll get good support at home. I know how difficult these situations are from personal experience from both sides of the fence. Best of luck.


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## cinders55 (8 Oct 2009)

declanja said:


> The HSE can increase home help hours if deemed necessary by the discharging hospital team. There is also a Home Care Package available. This would give a grant of up to €200 per week to buy in home help. There are some restrictions, i.e.* the payment cannot be made to a relative* etc. There are Home help agencies here in the west that can provide this service at good rates. Your PHN or Hospital OT should be able to advise.



Sorry for butting in here, and I do hope that everything is working out well for the OP's mother, but I have to smile at the "restriction" mentioned above, it's as if paying a relative is akin to squandering the money!   There are a lot of us out here who are doing it all anyway, and doing it for nothing but the love we have for our parents.   

In my case, I live with my elderly parent, and work full-time from home and while it's great that I don't waste time commuting, it's turned my life inside out and then some.   It's a long story and it's been going on for a lot of years, but sometimes the almost daily loads of laundry, together with shopping, cooking, cleaning, ironing, hospital and doctors appointments, etc., really take a toll, and I'm doing it pretty much on my own.   As for days off or holidays, well I just don't let myself think about it anymore but I do get impatient with the do-gooders who constantly go on at me about taking a break and looking after myself, without stopping to think it through.   If I DO try to take a break, then some of them have to pick up the slack instead and it's not easy when they have jobs and kids and things going on.   

Financially, it's becoming a bit of a nightmare as I worry about my job these days too, and while I don't pay the utility bills, I do pay for most other things and the small sum my parent pays towards the housekeeping, about €150 every three weeks or so, doesn't go very far.   I guess my point is, that because I work fulltime, albeit flexitime, I wouldn't qualify for carer's anything, despite what I have to do.   So here I am, busy living from paycheck to paycheck, pension fund probably not worth the price of a pint when it comes to my turn (not THAT far away either!) and home care can't be paid to a relative!   Give me strength.......................!!!!!


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## Clohass (8 Oct 2009)

Good afternoon
I just wanted to update as to the current position. My Mam was discharged home last Monday after 26 days in Hospital, she insisted she wanted to live independently and whilst ultimately I am unsure how this will work out I did my best to make sure that an OT did a report, visited the home and assessed needs etc. Essentially if we had not spoken out my mam was being discharged after 7 days and would I feel have not been long at home before another crisis would have occured. I now feel that we have accessed whatever supports are available and whilst I am unsure what the future holds I do feel that we will have done everything possible to maintain that independence for as long as practical. 

Thanks to everyone who took the time to post with information/advice.


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## annet (8 Oct 2009)

Clohass

So glad to hear your mum was d/c and she's living independently with community supports put in place.  Hope it goes well for you all.


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## Patrick2008 (27 Nov 2009)

Hi all. I am in a similar situation with my Father. Can anyone tell me where it states that a hospital is obliged to prepare a OT assessment for a patient?


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