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Borsetshire Blues

Do you follow The Archers on Radio 4? If you read my last post, you’ll know that I do, and also that there is a storyline which has piqued my interest. (I have since found out that a number of my esteemed colleagues in this sector are also quietly excited by it.)

Poor Auntie Chris. At the time of writing, the last we heard of her was that she’s languishing in a hospital bed awaiting discharge. According to her consultant, save for her hip, she’s in good health. I think we can therefore assume imminent ejection from hospital (hopefully not literally) and rehab back in the wider world.

I noticed a few things though:–

  • Chris is finding it difficult remembering what to ask and what she’s been told by her consultant – hospital and injury is incredibly disorientating;
  • She’s guilty at the trouble she’s causing;
  • She is unsure about what happens next and where she might go – home may no longer be an option; and
  • She knows she likely has months of rehab ahead

Do you know what happens when you’re no longer ‘ill enough’ to stay in hospital? What’s supposed to happen is a result of careful, multidisciplinary, discharge planning. Ideally, this will culminate in a discharge planning meeting where everyone involved in your current and future care get together and build an achievable and appropriate plan to get you well again. Then off you go, everyone does their jobs and you’re hopefully as good as new.

Sometimes this discharge planning works wonderfully well. However, on other occasions, resources, targets, absences, admin and a whole host of other things get in the way of the right decision for the person who should be at the centre of the decision making (and who incidentally may even be absent from the process). It’s really easy to blame the health and social care professionals for this, but we have to be realistic – the pressures they are under are huge and it can be a series of little, multi-faceted failings which ultimately come together in the ‘perfect storm’ for someone like Chris.

Peggy wants to ride to the rescue and has even had an Occupational Therapist round to The Lodge to ensure it’s up to scratch for Chris’ return. Fantastic, but is she equipped to be a carer at 94 years of age? What about the emotional toll on her and also on Chris, who’s already feeling guilty.

What if Peggy can’t cope and then both she and Chris need to fall on the support of the NHS? Hopefully, the discharge planning process will help put a plan in action that will provide Chris and Peggy with the support they need.

Or maybe Chris will end up going into temporary accommodation for her rehab? I have a very good friend who spends a considerable amount of professional time working with the NHS trying to discharge patients appropriately so that the chance of readmittance (and therefore overall cost) is reduced. Although a bed at a local home is a quick and easy fix, what if Chris doesn’t get the support, physio and other stimulation she needs, loses muscle condition which interferes with her mobility so that she becomes an even greater falls risk? Will she end up with another broken hip? Or worse?

So, it would seem that two things are so important here – (1) planning in advance on how you wish to be treated in a health crisis and (2) accessing help so that your discharge is safe, appropriate and suitable for your needs.

If you haven’t had to deal with this before, I suggest you speak to a member of Solicitors for the Elderly, of which I am a member, so you can find a lawyer who can advise you on how best to advocate your wishes. He or she (or a trusted partner) can also be on-hand to ensure that the discharge planning process is undertaken properly. Sometimes you need someone to vigorously and noisily stick up for you, especially when you need to focus on recovering from illness or injury.

Plus, try to find someone empathetic – I think Chris is going to need someone kind to help her and help protect her dignity in the weeks & months ahead.

By Richard Bates