Where do they send bed blockers?

Delayed hospital discharges or " bed blocking " is hot news. As hospitals desperately try to unblock their beds where do they send patients and what happens to them? I am an ex social worker and former Director of community services so I thought I knew the answer but it's different when it's your own mum.
 
Every day dozens maybe hundreds of older people lose their balance fall awkwardly and end up in hospital. Nearly two thirds of acute hospital beds are occupied by patients over 65. These make up the majority of the so called bed blockers , people medically fit for discharge but unable to return home due to the amount of personal care they require. 
 
No one wants to be in hospital if they don't need to be there but what happens to people who can't go home? Where do desperate hospitals send the bed blockers? 
 
My 88 year old mum lives alone and has always been independent. She has an active social life centred around the art appreciation group, the local jazz society, a book club and several women's groups. She relies on friends and taxies to get her to and from these groups. She has been happy to take her self to the theatre or cinema for a Saturday afternoon out. She has a private arrangement with the women across the road who comes in to clean and do thing like change the bedding and my brother is ever willing to pop in to change light bulbs, replace the batteries in the smoke detector and examine why the fridge is making a "strange noise".

Recently she twisted awkwardly getting ready for bed, fell and brook her leg above the knee. After many hours in A&E she was admitted to a ward where due to complications and more urgent cases she was bumped of the operating list for a week before her leg was pinned and strapped. After a couple of days she was told she would be transferred to a care home for six weeks until her leg was weight bearing. 
 
She was transferred to a local care home that had recently been awarded the NHS contract in her area. The transfer wasn't well organised, the ward were only given half an hours notice, every thing was rushed, clothes, toiletries, get well cards, books and magazines were hurriedly stuffer into black plastic bags. The paramedic point blank refused to take the Zimmer frame the OT department had provided and stipulated that the rules stated patients could take only one bag in the ambulance. A taxi had to be organised to take the Zimmer frame and excess baggage. 

Mum has been fortunate to have visitors most days and a friend was visiting whilst all this was happening. Seeing that mum was getting distressed she offered to follow the ambulance in her car and help mum get settled in. A very good thing as it happened because when she arrived at the home the staff were not expecting her and said they had no bed, literally no bed they had to go out and buy one! Mum was left in her night wear sitting in a large lounge populated by residents suffering from dementia. Her friend,  felt to uncomfortable to leave her so stayed all afternoon until my mum was settled into her first floor newly decorated bed room with new bed. 

An informal rota of family visits was organised. Before I visited my brother told me the access code to gain enter to the stairs and corridor where my mum's room is. I looked on the homes web site and was surprised and a little concerned to note the home specialised in caring for people with dementia. 

On my first visit it was clear that the access codes were to limit where the residents suffering from dementia could wander. Upstairs I was greeted by a women in her underwear, shouting that she was starving and hadn't had any breakfast. The only member of staff on the corridor was a cleaner who told the resident to go back to her room and get dressed. She didn't. When told that it was inappropriate to wander around in her underwear she replied, " well that's what I do at home". 

Having been in the home four weeks my mum has not left her room. There is a garden weather permitting she could access in a wheel chair with assistance but  the lift is too small as she can't bend her knee and her leg sticks out. She is isolated in her room, a virtual prisoner. So far she has had visitors every day but this is bound to tail off over the weeks and I wonder how this will affect her wellbeing.

 
She stops eating, drinking or taking her antibiotics and is readmitted to hospital. 
 
Blair McPherson former social worker and director of community services 
 

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