Advice wanted - help for elderly aunt

[Carrie]

I was not really sure which section to put this in but hope some of the medical/social work types on the forum may pick this up and may be able to give some advice.

I am at my wits end as to how to get help for my elderly aunt (82 years old). She broke her arm 12 days ago and due to the position of the break it was not possible to set the fracture so her arm is just in a sling. She lives on her own and is in desparate need of assistance as she obviously can only use one hand, she has only managed to change her clothes once since it happened and that took her 3 hours and she is in so much pain that she cannot lie down so is really confined to her chair.

When she was released from hospital (Kingston Hospital as she lives in Raynes PArk) they told her if she needed any help then she needed to phone her doctor. When she phoned the doctor she was told they could not help her and she had to phone the council. The council have told her they cannot help her as she is not permanently disabled and told her to phone the hospital. She was supposed to be going back to the fracture clinic today but that has now been cancelled.

When I went over to see her the other day and saw that her legs had become really swollen as a result of her not being able to lie down I said she had to get in contact with the doctor immediately. As a result a district nurse came out to see her yesterday but would only look at her legs and would not listen to her when she was asking for help with day to day living and said she wasn't there to deal with that.

Does anyone one know who we can contact to try and get some help for her - even simple things like a long handled grabber so she can pick up her post off the floor as she can't bend down due to the pain.

Sorry for the long rant but I just can't believe in this day and age that an 82 year old who lives on her own has just been sent home to fend for herself and no-one will accept responsiblity for providing assistance.

[Mogs]

My mother in law is 80 and had a fall a couple of years ago, finally through social services we got lots of things in place to help with day to day living.

- 2 Visits a day from coucil social services carer

- 3 times week 2 hours a day Share & Care - private company

- Toe Nail Clipping service as she has diabetes

- District Nurse home visits

It does take time and effort to get these services in place, and I'm sure each council services will differ from others.

I'd be happy to meet up and discuss further.

[giggirl]

Carrie - I'm so sorry - what a nightmare for your aunt. I don't have any answers but I just wanted to say that you are a star and I hope for your aunt's sake that she gets help quickly.

[Keef]

The council have a duty of care, and if they don't respond, then she could well end up with a permanent disability, try reminding them of that. I know you shouldn't need to do this, but lie on the phone if you have to!

[ratty]

What borough is this? Need to contact the older adults or older people team in that Borough and do not take No for an answer.

[annaj]

Carrie, this story makes me furious on your behalf. The emergency department should never have discharged your aunt without services in place or a follow-up so see what services she needed. Older people injuring themselves in a way that renders them unable to cope at home is a common problem and every emergency department should have the links and services to deal with it. Her GPs response is also completely unacceptable.

My advice would be first to try again with the council as it is them who are responsible for provide care at home. If that fails, or if at any point you think your aunt's health is suffering or she is in danger of hurting herself trying manage at home, take her back to the emergency department. I should make it very clear that going back to the ED with what is essentially a community problem is not something I advocate lightly, but in this case the department who discharged her also have a duty of care and carry some responsibility.

If you (or another family member or friend) do take her to the ED, to get the best response go in the morning (not because it's less busy, but because it gives a whole working day for something to get sorted out) and be polite and calm at all times. Explain that your aunt was discharged with an injury that leaves her unable to perform her basic activities of daily living, with no social services support or follow-up, and has been unable to cope at home. If at any point you meet resistance or an unhelpful attitude ask, still smiling politely, for the nurse in charge or the duty consultant and explain the situation to them.

Once all of this is sorted out for your aunt I would also recommend that she, or you on her behalf with her consent, write a letter of complaint. Not out of spite or revenge, but to improve the services. Winter, the season of falls and fractures, is fast approaching and this department needs to know that it's services are failing.

Good luck.

[Carrie]

Thanks for the advice - it is Merton Council - my sister will get onto the older persons team there and do her rottweiler impersonation until she gets somewhere!

[Mogs]

Help the Aged maybe able to give advice too

[Peckhamgatecrasher]

To help with the other part of your question (as a short term solution), Boots online have a range of aids:

Aids

[Carrie]

Wow - so many things you can buy for one-handed living - who would have thought it - thanks PGC. Good suggestion about Help the Aged as well Mogs - I did have a brainwave and phoned Age Concern in Merton this morning and they have given me the numbers for the right people to phone at Merton Council so at least we don't have to waste time trying to get the switchboard to understand what we want.

[Mogs]

Through Help the Aged or Age Concern my brother in law was able to put my mother in law on the list for the befriending scheme which was also helpful when my mother in law was lonely in the evenings.

[LuLu Too]

Carrie,

How did you get on in dealing with Merton Older Peoples service?

Read up on the NHS/Community Care Act 1990 and Fair Access to Care Services (FACS).

Your aunt is entitled to an assessment of her needs (Community Care Assessment).

However often level of need must be deemed critical or substantial.

It might be useful for your aunt to have you or another family member there to help advocate for her during an assessment.

Age Concern will provide good advice.

I hope you get a helpful & prompt response from local services in Merton.

[Keef]

I'd say she'd meet the Substantial need criteria. And even if they said she was moderate, you could easily argue that by not acting, she is likely to become substantial. Early intervention is a buzz word they like, suggest to them that they act on it. It'll save them money in the long run, that shoul help convince them.

[Curly]

Have you tried to get her to claim Attendance Allowance? This may be your passport to getting other help and will provide some money to pay for someone to come in and help with personal care.

Each hospital has a social services team which should have assessed her on discharge and referred her to the appropriate support teams - but in my experience you have to jump up and down to get the right contacts.

[BARA]

If your aunt was an in patient at the hospital, the ward, knowing that she lived alone should have asked her if she wanted a referral to the Hospital Social Work Team. They would need to submit a Section 2 ( which is a referral to SSD) and it would be either the Kingston Team who would have assessed on Merton's behalf, or the referral sent to Merton who should have sent a social worker to the hospital. A Section 5 is sent by the ward to SSD to give a discharge date. It is far quicker to ask whilst in hospital for an assessment of need than to wait until after discharge as local teams go on priority status to assess people.

Some boroughs have specialist teams which can provide care for upto 6 weeks. Lewishan have a 'Home from Hospital Team'

If there is a need for rehabilitation i.e. exercises to strengthen arm once plaster is off - there are intermediate care teams.

It is perfectly reasonable for a Hospital Social Work Team to do an assessment of need to provide a care package for a limited period ( usually whilst people are in plaster and just beyond) this would give personal care twice daily, help with domestic tasks and either meal prep or meals on wheels. There are a number of firms which provide frozen meals -

Wiltshire Farm Foods and Oakhouse Foods ( they deliver on a specific day and many people prefer these meals to the MOW.)

All SSD have to charge for services and this is means tested. If you have only a state retirement pension and no private pension or savings, it is unlikely that you will have to pay much - most people would be a nil charge.

Attendance Allowance is only payable if you have a permanent impairment and need help with personal care. If you have a terminal illness - special rules apply.

Some Age Concern Branches have their own carers but obvioulsy these are more expensive per hour. Age Concern should also give you a list of Care Agencies in the area who you can contact directly.

Also your aunt should have been seen by an Occupational Therapist who may have been able to provide ( or advise) on equipment/aids. In Kings there is a team of therapists who cover A & E.

You should make a formal complaint to the PALS office ( Patient Liasion and Advice) at Kingston (copy to Merton SSD) as your aunt was the subject of a poor discharge, with no assessemnt of her needs etc. Unless the public report 'unsafe/poor discharges' this form of practice will continue. Hope this helps.