Question about hse home support package

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Ollie11

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my father has been in hospital for several weeks and has applied for the hse home support package.
We his family are not supportive of his coming home for reasons I do not wish to discuss. His medical team know the reasons why. They are now saying that we need to agree his home care package before they discharge him.

We are not in a position to offer any care which they know and they have previously said that they would be sending him home even if he lived alone as it is his wish and right to be at home.

Are there any reasons why we should not agree to the package?
We feel we are holding up his discharge by not agreeing but are slow to sign anything as we do not in actual fact agree with him coming home

Can they keep him in hospital until we agree?
 
Im not clear what your question is, do you mean can the hospital discharge him without your consent? Possibly, but probably not from what you have said.
Ideally what would you like to happen bearing in mind staying in hospital is not an option.
People go downhill quickly in hospitals for a number of reasons so the priority should be to get him out asap.
 
You have obviously given his medical team a lot more information than you've given here and they have told you what should be done based on that, along with their views on your fathers condition. Not being judgemental, but they are the experts and they also know the situation unlike us here. If they feel he can go home then that's good and if that's what he wants then it will be good for his state of mind as well. Along with all that, the bed he is in can be given to another patient who needs it more.
 
Obviously from what you write your father is in a position to come home from hospital with a homecare package in place - if as you say it is his wish to come home then let him do so. He would be much better off in his own home. They wouldn't discharge him unless they felt he would be able. At least with a homecare package someone will be looking in on him and helping out regularly for a few hours. I'm assuming you are either living too far away to look in on him now and again or don't feel able to take on the responsibility - either way I think give him the chance to try living at home and if it doesn't work out look into other options then.
 
If your father is in an acute hospital they are quite entitled to either send him home if they deem him fit or send him to a step down facility. If he wants to come home you should agree to give it a try with the homecare package , alternatively a nursing home may be on the cards which will cost.
 
Ollie11 said:
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Can they keep him in hospital until we agree?
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They can just decide that he's able to manage in his own and send him home. Lots of stories about that in the media. After that he's someone else's problem.

If hes unable to manage in his own, they can't discharge him if nothing is in place at home. He then becomes a bed blocker .

Some regions have units where people can stay while their care needs are assessed and home supports are or in place or a nursing home comes up. We had to manage for about 6 weeks still this came up.

Had a cycle of home hospital, home, respite home, Hospital, for a while until managed to get a place in a nursing home.

Also had the experience of being unable to contact the right people in the hospital until we broke contact and basically ignored the hospital calls for discharge .

But be aware that respite or nursing homes are 1000~1400 ish a week and not all are covered by insurance. So the hospital might transfer to one not covered by insurance.

My experience is older people and some of their kids leave it to late to seek help, or accept changes until it becomes a crisis and then it's fire fighting.
 
Feemar5 said:
If your father is in an acute hospital they are quite entitled to either send him home if they deem him fit or send him to a step down facility. If he wants to come home you should agree to give it a try with the homecare package , alternatively a nursing home may be on the cards which will cost.
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The issue usually is home care isn't enough to fill the gap and it falls to family who maybe be unable to fill the gap either.
 
Getting the right home carers is no picnic either. Lots of difficulties with that.

Also siblings might not all pull together. Those that are left might be unable to cope with demands placed on them.
 
Thanks for the replies so far.

They have funding approved for 27 hours a week and the house has been assessed and some changes need to be made.
The family are not able to fill any gaps.


He has a history of non compliance with health care professionals and we are terrified that he will have a fall at home and die as a result of this.

He applied for the home support package himself with the help of the discharge nurse.


We are now being told that they will not discharge him until we, the family agree to the package.

None of us want to do this as we effectively believe this is signing his death warrant. Dramatic I know but we have been through terrible times with him health wise and we are heartbroken that this is the way it might end.

He has been deemed to have capacity to make his own decisions and doctors agree that coming home is him making a bad decision but one it is his right to make.

MY main question is: Can they delay his discharge if we do not agree the package? Are we taking responsibility to fill in any gaps if we agree to package, even though he applied for it on his own?



He is going down hill the last few days and we know it is not the best environment for him to be in but at least he is safe.
 
27 hours is a massive amount of support to be getting. My father can only walk from bedroom to bathroom/kitchen for example with difficulty even with a frame and cannot prepare any of his own meals gets less than 5 hours spread over 5 days. He has home help every morning to help him get up and have breakfast and a longer time one day a week for a shower. We then have to arrange for his other two meals. He has other health issues too and we have applied for an extra home help visit per day but are still waiting to hear and I am fairly confident the answer will be no.

As for the risk at home v safe in a nursing home side of things we all know my father would prefer to take the chance of falling and dying earlier as a result of being at home than having a longer life sitting safely away from his home and garden in a nursing home. Maybe your father is the same.

My father has regular trips to hospital and once perked up again we try to get him out asap as there is no doubt he deteriorates in there, from a mobility point of view especially.

I assume your father is worse though based on the amount of support you are being sanctioned.
 
We had the opposite experience, got better in hospital, got worse at home. I guess everyone is different. In hindsight I think paying for private care at home might have been a better option
 
I think why he deteriorates is because they make no attempt to make sure he gets out of bed and walks a bit each day to try and retain the little mobility he has (short staffing or whatever reason). He can't be allowed do it himself as he has difficulty getting in and out of bed to start with, he's used to his own and has systems in place, he's had two falls in hospital previously so is very cautious about moving around anywhere there where it's unfamiliar territory.

His overall health may be better coming out of hospital but his mobility will be worse.
 
Just a quick update on this issue.

My father's funding was approved and his discharge processed.

The family expressed concerns and wished it to be noted that we were not in support of him coming home.
We were told that we could block his access to the house but that his SAGE patient advocate would organize a solicitor on my father's behalf and sue us.

He came home Wednesday last week via ambulance and was stretchered into the house and settled in bed.

His first home help call came at 7:30 that evening and he refused to be toileted/changed.

Home help left at 8:10 and he then tried to get out of bed at some stage to access commode and fell and was not found until his next home help call the next morning at 8am.

He is now back in the hospital with a broken hip and his condition is deteriorating rapidly.
 
I'm really sorry to hear that. I have sympathy with you all ( The family and your father).
It's a very difficult thing to witness when you feel that you should be able to help and fix things and you can't always do that.
He clearly hates the thought of being in hospital for an extended length of time ( I think the same will happen with my father)

This is easy advice to give ( and hard to follow, because you love him and you are heartbroken) but remember that you have done your best.

I wish you the best with the next few weeks.
 
There is a company my aunt used and they were very good at that time.
I think they only cover Dublin but they may be able to offer you some advice
There name is HomeCarer trusted independent living and you can see their contact details on their website www.homecarer.ie
It is a difficult time so good luck
 
jimbojone said:
There is a company my aunt used and they were very good at that time.
I think they only cover Dublin but they may be able to offer you some advice
There name is HomeCarer trusted independent living and you can see their contact details on their website www.homecarer.ie
It is a difficult time so good luck
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Any connection? Always looks suspicious when someone recommends a service to a question posed 4 years earlier.
 
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