Granpa: Discharged from Public Hospital - No One Able To Pick Him Up.

tempura on 30/07/2019 - 14:11
Last edited 30/07/2019 - 17:20 by 1 other user

My Granpa about to be discharged from the public hospital and I have two "perfect" situations here (please bear with me as I try to be as brief as I can).

  • I will be interstate on his discharge day and will be back just the day after; there's no one else able to pick him up.
    Q: Has anyone had this sort of circumstance? is it too much of an ask if I politely request if he can stay for another night in the ward?

  • Both lifts in his apartment are currently under maintenance and expected to be fixed mid next week and he is not fit to walk up 5 flight of stairs going to his unit.
    Q: Ambulance is not an option here from my understanding; is there any other option/s to get him up there to his unit?

Thanks!

Health & Beauty

Comments

    • MessyG on 01/08/2019 - 19:54

      Jcww I'm really sorry to hear about your grandma, that sounded horrible. The transport the hospital uses to take people home isn't the same as MICA or the 000 ambulance service though.

  • GordonD on 31/07/2019 - 10:15
    +1

    Every public hospital I've had anything to do with has had an attached volunteer organisation that would be happy to help by providing or organising transport.

    • BestofOZB on 31/07/2019 - 11:05

      They won't take someone 5 flights of stairs, too risky.

  • luffyex2010 on 31/07/2019 - 10:32

    sounds like you need a temporary carer.

  • fredz0r on 31/07/2019 - 10:36

    Cancel your interstate trip. Simple.

    • funnysht on 31/07/2019 - 11:06
      +1

      if it's not urgent i.e. holiday, seeing friends, work, eating then yes pure simple come back earlier.

  • ahly92 on 31/07/2019 - 10:51

    I feel for you OP. I once had to cancel my interstate work trip to help grandma in hospital, but thats because im the oldest in the family and i can handle the stressful situations better then the family… so more responsibility…but Unless theres a tragic storyline behind it, Surely there's other family members in the same state?

  • wkd on 31/07/2019 - 11:09

    he can stay another night. hospitals wont kick him out for staying an extra day

    • petry on 31/07/2019 - 11:14
      -1

      they do in England all the time - where do some of our hospital staff come from? that's right the same shithole- and people wonder why oz health services are being run down… they screwed over the nhs to sell it to trump for a dollar, and now they're here to do the same.

      • wkd on 31/07/2019 - 11:16

        this aint england. they dont kick people out in melbourne. talking from experience

        • MessyG on 31/07/2019 - 21:10

          Agree, we're not perfect but we're also not NHS-level dystopian.

  • gumbo45c on 31/07/2019 - 11:12

    He can refuse the discharge, and will have to pay a small fee to stay an extra night.

  • bs0 on 31/07/2019 - 11:52

    Regarding the stairs, if the hospital are about to discharge your grandpa then they should have checked his home situation for clearance.
    i.e. Allied health should've cleared him already/just about to clear him to mobilise up and down into his home.
    OR, no one's let the team know about his situation and so no one's checked, in which case someone should. This might take the same day of discharge to clear him, or an extra day, it varies.
    Once he has been cleared, then someone needs to pick him up.
    If no one can transport him, they will either wait the extra day or organise transport to home. Once he is home, that should be fine … since he has been cleared for stairs.

  • Klasglart on 31/07/2019 - 12:17

    Get a cabcharge from the ward, they will charge it back to you.

    Get the nurse to ask the ward clerk to book NEPT or your state equivalent.

    Has your grandpa explained his home situation to the Allied Health OT?

    And no- you can't just ask to stay another night in hospital.

    • thethinker on 31/07/2019 - 12:27

      you can TOTALLY ask to stay another night for the hospital.
      We respect the elderly and their families; let's not put this old man through an ordeal for no particular reason. Tax payers pay for far stupider things.

      • Klasglart on 31/07/2019 - 13:03

        If the clinician decides the patient is clinically ready for discharge, then that's it. There's other patients waiting to occupy the bed as well; what about those patients? If we could ask for extra days in the hospital that would be detrimental to patient flow and hospital funding as there's an efficiency target under the funding model for patients to be within a certain ALOS.

  • thethinker on 31/07/2019 - 12:26
    +9

    Ok, so I'm a doctor in a major public hospital in Victoria

    This sort of thing happens all the time.
    All my colleagues would keep this man in for an additional day or two. You really ought to talk to the resident on, I'm sure they'll be more than happy to help out.

    Priority is always patient safety. If he can't be home safely/functionally, then he can't leave the hospital.

    Talk to your medical team.

    • Skramit on 31/07/2019 - 13:00
      +2

      Yay for a person who knows!

      /thread

  • Roman Sandstorm on 31/07/2019 - 14:53
    +6

    I have encountered this over recent years, and other circumstances mentioned in this thread, when dealing with my elderly mother.

    First, it is simply inconceivable that any major public hospital would 'unsafely release' a patient in the circumstances described. There have been absolute statements in this thread from doctors and other staff to that effect. It is also my personal experience.

    Second, there is a vast range of services available to both the aged, and the unwell. The problem is actually finding out about them; many services are offered by differing departments, levels of government, private organisations, etc. And there is not really a central source with all the info that one would like.

    Let me give an example. My own. My mother is in her 80's. She has a chronic lung condition which makes breathing difficult from time-to-time, but mostly she gets by OK. She still drives, shops, lives alone, and has no mental impairments. But she is a bit frail, and does struggle to get around at times. She is a full pensioner, and owns no property. Rents public housing. I live in a different state. Over the last few years we have discovered so many support and assistance services, but the discovery has often been random and arbitrary.

    My Aged Care is the main federal government care and assistance system. After an ACAT assessment a person may be determined to be at one of several levels depending on their capabilities (or lack thereof). At first my mother had 1.5 hours per fortnight of help. A carer would come in, clean, vacuum, wash, etc. The heavy stuff. Following a recent slight deterioration in her condition this was reassessed. Now she has a visitor every day (er, well, except weekends - this is Queensland, after all, and no-one should get sick or have anything happen on a Sat or Sun…. sigh…), who will help around the house, sit by while she showers, go shopping with her, etc, etc. Apart from the heavy lifting so-to-speak, this provides my mother with confidence, a person to talk to if she is worried about things, etc.

    The My Aged Care services are provided by private companies; some vary in quality of service a little, but that's the system. My mother does have to make payments, but they are means-tested according to her pension, and really amount to fairly trivial amounts. Very fair.

    This keeps her out of taxpayer-funded residential care. A massive saving to the community.

    Other services include patient transport - to and from hospital - sometimes via ambulance, sometimes paramedic vehicles, sometimes taxi vouchers. There are also taxi vouchers for transport to and from regular doctor appointments (although mostly, my mother can drive herself. But if she is feeling crook, it's there for her.)

    There is also post-operative care, breathing care, occupational therapy, psychological counselling if desired, all visiting my mother if required.

    Councils offer some facilities and services (although that massive behemoth, the Brisbane City Council, is light on central info. But local branches, libraries, etc, offer various services and support.) Someone, I am not sure who it is (LOL), provides vouchers for lawn mowing which cover about half the cost.

    Addressing the 'discharge' question; I have had to go up to Q'ld a couple of times in recent years, as the hospitals (large public) would not release my mother to leave unless she had: a) someone to go home with her, and/or b) someone at home when she arrived. Yes, I'm sure if she made a stink, and carried on, she could have signed away a discharge, but seriously, life is not an American TV show. If that's what the hospital says, it's pretty reasonable to go along with their requests.

    Both nursing staff and doctors I have spoken to when discussing this have said that they would keep my mother in a ward unless there was someone to be with her.

    Most recently, the My Aged Care support person came and picked her up, brought her home, stayed with her for a few hours, and then made sure the neighbour was aware. (The previous two times I flew up and performed this function.)

    I'm sure there are other support facilities I have forgotten, or don't even know about! It's not the lack of support, it's the lack of knowing that is an issue.

    Overall, the system, such as it is, keeps my mother as well as can be expected, gives decent, personal and extensive service, keeps her out of a facility, enables her to live independently and happily, all at a very nominal cost.

    And the Medicare levy is what? 2.5% of my taxable income? Sounds reasonable.

    • tempura on 31/07/2019 - 15:01

      thanks for the lengthy comment; much appreciated. do you know if My Aged Care can do assessment whilst my Granpa is still in the hospital ward?

      • kolorijo on 31/07/2019 - 15:44

        The first step to access government-funded aged care services is to call My Aged Care on 1800 200 422.

        More helpful information: https://www.myagedcare.gov.au/assessment/what-happens-call

        • tempura on 31/07/2019 - 15:49
          +1

          thanks

          • kolorijo on 31/07/2019 - 16:00

            @tempura: might not be for your current situation, but could be really helpful for the future.

      • Roman Sandstorm on 31/07/2019 - 17:03
        +3

        Possible - yes. More likely - no.

        My Aged Care will allocate a provider in your geographical area. (That is, one of the private companies which gives support instead of the government.) They will then contact your grandfather. This may take from… a couple of hours to…. weeks. These companies are sometimes short on admin… They can be 'prompted' to respond quicker by: a) a call from the hospital social worker, b) a call from My Aged Care (but you have to get back to My Aged Care, and preferably the same person who started your grandfather's case… sigh… a complex process), c) a visit to the offices of the local provider by you, or someone who knows the situation.

        As I said, these private providers, while often (usually) giving good quality support and care to their actual clients, appear to be a little lacking in the admin areas. Last time, my mother and I had to call 7 times (as well as calls to My Aged Care) before a call was returned. They can be seriously busy, and then what with the shoestring admin staff, with leave, sickness, etc, etc…

        Anyway, once you have a provider (yay!) an ACAT assessment can be scheduled. This is only an hour or two - usually in the home, as they look at facilties, bathroom, stairs, etc), but it is a senior staff member who does it, and their first appointment offer may be weeks in the future. Be firm, insist that your grandfather needs help now… go halfway… say you can meet out-of-hours, etc. Whatever it takes.

        The assessement happens, and then….. days… weeks… forever… before they get back to you with 'official' status… and care package can commence. Again, they need to be hurried up.

        My experience with this is four times, once with elderly step-father, and then with my mother three times. In every case follow-up calls were necessary to push things along.

        There was never a problem, the staff (both My Aged Care, and the various providers) were uniformly excellent, decent, caring. It's just the workload, and the bureaucracy, and I'm sure they have to prioritise. If you don't nag them, and if your grandfather's situation does not appear critical, they they will obviously get on to other cases before yours.

        This is the nature of a system farmed out to private enterprise in the (possibly mistaken) belief that private works best with a profit incentive rather than something provided directly from the government. [High & Dry, my friend, I'm sure you will have some comment on this ideological/philosophical angle… :)]

        The ACAT assessment will come back as an earlier poster noted: four levels. From your description, the first (lowest) level probably seems right for your grandpa. He'll then be entitled to some help around home, maybe a few hours a week/fortnight, and have to contribute a few $$$. Depending on pension level, this may be $15 a fortnight, or more.

        The system seems to work, generally, from my experience. It can be slow. Maybe providers in your area will be faster. Maybe they won't have the common Queensland "she'll be right, we'll get onto it next week, mate" attitude, or maybe they just have more staff.

        I knew nothing about any of this until I encountered it.

        Oh, from my previous post I recalled more things: meal services, (eg Meals on Wheels, but others too) nursing services (Anglicare, Blue Nurses, etc); there's a whole world of stuff… but it seems so much of it is only found by accident, word-of-mouth, etc.

        I was hoping my experiences of recent years may be of some benefit, and I never quite knew who to tell, apart from work colleagues.

        (Again a wall of text/info, but it won't fit in 140 characters… LOL.)

        Ooh, yes, one more thing… obviously these services are available to those who may not have great English, but you can see from the pains one has to go through that it would be significantly harder to make all the calls, etc. That said, I understand there are language assistance services as well, perhaps even specific aged care/medical, which may help in your case.

        Good luck. There really is terrific support in Australia for the aged and sick, etc compared to most other countries. (Yes, some are better, but not many.) But it can be hard to find it. (Of course, one could make the conspiratorial observation that this is deliberate… but I'm not that cynical.)

      • moocher on 01/08/2019 - 16:42

        I believe the social workers in public hospitals can hook you up with My Aged Care and send someone from the ACAT team to see your grandpa at the hospital. They may still need to visit the home for a full assessment to be completed though.

        Not sure if you already have the info but this is the link for the patient transport service (which does not require ACAT assessment):
        https://www.health.nsw.gov.au/pts/Pages/default.aspx

        It can be booked for both ways to and from the hospital by a medical staff, but you need to give them a bit notice (unlike an ambulance). Patient transport service vehicles will have stretchers etc if your grandpa needs help up the stairs.

  • pformag on 31/07/2019 - 17:01

    You need agecare101. Ask Julie

  • prabig on 31/07/2019 - 17:15
    +1

    Speak to social worker and they should be able to sort out this easily. Hospital cannot discharge someone if they have nowhere to go. I have had few admissions for social reasons when i worked in wards. Your situtation is not unique so talk to them.

  • petry on 31/07/2019 - 19:01

    to many jackanorys being told here ….

  • Scot on 01/08/2019 - 00:55
    +2

    As another Hospital employee-There is an Ambulance system designed to transport patients right to their home that can be arranged by the hospital. Their job is to get the patient safely home and if there is a lift problem they have equipment to get them up the stairs!It is a Transport Ambulance, not an Emergency Ambulance. Talk to the Nurse Unit Manager of the ward or Social worker to help you to get him home safely!

  • DBBROS on 01/08/2019 - 01:15
    +1

    You need to get the discharge planner involved if your grandfather require services before he goes. For a TACP assessment, it is a requirement that the patient has to be at the hospital. Interpreter services are available at every hospital. Do look into urgent respite for short term if the current accommodation doesn't suite your grandparents. I've seen some really bad cases at some of the places if I've worked. If things doesn't work, get the guardianship. Most of the bigger public hospitals won't have any issues accommodating social admissions unless they have a bed block

  • oO0Dam0Oo on 01/08/2019 - 09:50
    +1

    Id take a different point of view. Typically non emergency ambulance would be a real option however they will not be able to lift him up the five flights of stairs. Ambos & health care workers are susceptible to back injuries just like anyone else. I don't think it would be reasonable to ask them to do it under the circumstances.

    Secondly a post surgical medical event is also a real possibility. Think about the consequences of him getting back to the fifth floor and requiring an emergency ambulance. Not an ideal situation at all. Think possibility of fire evacuation.

    I personally wouldn't be moving him back to an apartment complex without good access and egress. Speak to the patient advocate or social worker from the relevant hospital. They should be in a position to assist.

  • Tin man on 01/08/2019 - 13:03
    +2

    You can discuss these with the social worker. Phone the ward and tell the staff the concerns and request a social worker input. Many occasions they have kept patients due to similar social issues.

    • [Deactivated] on 01/08/2019 - 18:45

      Social workers can be great. Sorry to hear of your experience.
      Best of luck

  • centrelink on 02/08/2019 - 01:02
    -2

    Give grandma and grandpa a hotel for the night and who knows you might gets baby aunt the next year

    centrelink on 02/08/2019 - 01:02 (Collapsed - Offtopic. Show)
  • [Deactivated] on 02/08/2019 - 16:43

    How is Grandpa? Is he home now?

  • Eeples on 02/08/2019 - 18:47

    Typically they can stash your Grandpa somewhere at the hospital for a day/night without any problems; so he isn't taking up a bed in emergency or the ward. Usually with the patients awaiting transport by transport ambulances. These waits can be 4 hours plus depending on demand and patients are 'serviced' while they are waiting.

  • Starchick on 07/08/2019 - 00:35
    +1

    ACAT or Community Aged Care Assessments for services such as Home Help, In-home respite, Meals on Wheels, Personal Care Assistance which, get referred to a persons LGA and subcontracted to a support agency on behalf of the council. HCP (Home Care Packages) also require a community aged care assessment and cannot be done in hospital and an Aged Care Assessor from the ACAS/ACAT team needs to see how a client is in the community. The only way an ACAS ax can take place in hospital is for residential care, respite and transitional care. I assist with ACAS queries/referrals on a daily basis.

    An acute hospital bed costs over $1000 a day as they have to factor in costs such as nursing staff, Dr's and allied health and require more care a people who are on those wards have acute care needs requiring. Rehab beds cost less, approx $800 and do not require as much nursing staff, hence a lesser cost.

    In the public system in Victoria ED need to discharge patient into either SSU (Short stay units) or an acute bed depending on their medical diagnosis and if requiring more tests/assessments from med and allied health. If pt's are in ED longer than 4 hours they pay penalty rates. That's why there is pressure to discharge pt's out of ED quickly.

    If anyone has any concerns with patient care and discharge planning, please liaise with any staff involved in the patients care: Treating Dr, Intern, Med Reg/Registrar, Nurse/NUM, Allied Health and Ward Clerk. They will ask the Social Worker to come and review the patient and liaise with NOK to ensure that the pt is well supported and ensure if they require any increase supports are required they can assist with this.

    All public hospitals have social workers, where in private health they don't always have SW's. On my wards I receive plenty of referrals from concerned relatives and the Dr's/Nursing staff/Ward Clerks are quick to refer to me to assess urgently.

    Yes, the longer the patients are in hospital they are "bed Blockers". Social Workers are often seen as delaying discharges as often it takes time to organise supports. We try to ensure that people have access to a much support as possible to prevent readmissions into hospital, which, ends up costing more money. We get a lot of pressures to discharge patients quickly and get referral at the very last minute. So if anyone has concerns about patients, best to ask in the morning so that we have time to organise assistance.

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