Help for a disabled relative?

mocmo

Hi there, I wonder if anyone here could advise me.

I have an elderly relative, wheelchair user and living in a nursing home. She has expressed a wish to be taken out for an afternoon but the home has vetoed it.

The reason being she is very overweight and they say it will take 2 staff members to move her (true), a wheelchair taxi (I don't see a problem booking this), plus extra insurance costs as she is under their care. The family would happily pay and we could rally our troops and have plenty of people on hand, but the home aren't going to release the staff etc. and are just really against the idea.

I am wondering if there are any charities / organisations that could help? She is getting on and all she wants to do it sit in her own garden (a few miles away) for an afternoon, I hate to see her denied such a simple request, even if it does take some planning we'd be willing, but will have to fully satisfy the nursing home admins. Does anyone have any ideas or advice?

AndrewJRenko

Could the family just do it and leave the staff out of it? In fairness, they may have a duty of care to ensure she is safe, even when she is with family.

mocmo

Hi there, thanks for the reply.

Yes we've had some discussion and some of the family are willing and able to manage the trip, but we are facing a serious row with the nursing home (they were very strongly against it), which we'd really like to avoid. We do understand their position and obviously we want to avoid any danger or issues of safety, but at the same time it's a nursing home not a prison and her request is simple. I hate the thought of her being denied the only thing she has asked for in years.

I suppose the ideal would be for us to find and pay for some professional help on the day to help alleviate the concerns, this I suppose is the crux of my question, are there services that might provide this? Maybe we can hire a carer for a day? I've done some googling but haven't found what I'm looking for, maybe I need to try again and maybe we will just have to stand up to the home, take her out and take the risk.

Thanks again for the reply.

looksee

Could you ask her gp whether the issue is her health or the need for care that is concerning the home?

mocmo

Thanks for the reply, the issue is moving her as she is very heavy. However we have enough muscle within the family and I have found a local taxi minibus with hydraulic lift so really we'd just need to wheel her on and off it, and then over a very short distance. We're only talking about an hour of an excursion as we likely couldn't manage a bathroom visit if one was needed.

Even just planning it out here makes me think we'll just have to make the plan and present it firmly but politely to the home, hopefully we can reach an amiable agreement with them!

Chat to the public health nurse in the area you want to take her to. They will either give you a few contacts if Carer's in the locality or an agency contact.

Taxi services who cater for the disabled have their own public liability insurance. Just ensure that either you or the driver has a head support as I think it's compulsory now.

Also talk to her old GP. I'm assuming she had to change to the GP for the nursing home. Actually, talk to both and discuss the positive effects a trip like this could have on her wellbeing.

Check the nursing homes charter too and refer to it when talking to them.

mocmo

Great ideas there, many thanks.

Melendez

This post has been deleted.

mocmo

Melendez I hear what you are saying but the family member who asked about it really got very short shrift from the Matron who essentially wouldn't countenance it at all. This was the first time it was brought up, so there was no plan in place, hopefully we'll have a good and safe plan devised soon and we can bring it up with her again. But she was formidable and really intimidated the individual who spoke to her! I absolutely agree with your sentiment and the relative who lives in the home, while being fully mentally capable, is quite disabled and definitely needs a strong advocate.

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mocmo wrote: »

Hi there, I wonder if anyone here could advise me.

I have an elderly relative, wheelchair user and living in a nursing home. She has expressed a wish to be taken out for an afternoon but the home has vetoed it.

The reason being she is very overweight and they say it will take 2 staff members to move her (true), a wheelchair taxi (I don't see a problem booking this), plus extra insurance costs as she is under their care. The family would happily pay and we could rally our troops and have plenty of people on hand, but the home aren't going to release the staff etc. and are just really against the idea.

I am wondering if there are any charities / organisations that could help? She is getting on and all she wants to do it sit in her own garden (a few miles away) for an afternoon, I hate to see her denied such a simple request, even if it does take some planning we'd be willing, but will have to fully satisfy the nursing home admins. Does anyone have any ideas or advice?

The nursing home has a duty of care to your elderly relative, but they've also a duty to abide by HIQA regulations which includes supporting her to engage in recreational activities of her own choosing that promote independence, health and well-being.

First your relative is in a wheelchair and she'll require the manual handling of at least two persons. Things to consider.

1. Transport to her home - wheelchair accessible taxi.
2. Accessibility of her home - is her home easily accessible using a wheelchair? Is there a ramp for instance, step, are the doors wide enough to accommodate a wheelchair?
3. Toilet needs - is there an accessible downstairs toilet? Are there handrails? Can your relative weight bear at all? Is she continent (urine/faecal)? Does she have a catheter for her urine? Do you have a commode if there's no accessible toilet?
4. Manual handling. Are any of you's trained in manual handling. There's one day courses which teaches you how to manual handle safely so to minimize the risk. Family carers Ireland use to run courses, or they might be able to point you in the right direction.
5. Is it possible to rent a hoist? You will require training for the use of equipment. http://www.assistireland.ie/eng/Information/Information_Sheets/Equipment_Hire.html
6. What does her nursing care plan say about engaging in meaningful activities which should be individualised and based on her own identified needs and preferences. What this means is that your relative should have a say in the activities that she wants to engage in which includes outside activities and maintaining links with her former community, friends, family and lifestyle. You need to stress the point that your relative has the right to a person centered individualised service.
7. What about the community Public Health Nurse who might be able to refer you's to the community OT who could advise on aids etc.
8. Risk assessment. If the nursing home is saying that the refusal is because of the risk, ask them for a copy of the risk assessment that was carried out on your relative.
9. Put a plan in place and then approach the nursing home again and don't take no for an answer. Your relative needs a strong advocate who is willing to stand-up for her rights to a person centered service based on her needs and wants, not the rights that the nursing home wants to bestow on her.
10. If you really want to be difficult, you could argue that the insistence of the nursing home that your relative remains on the premises breaches her Constitutional rights to liberty and freedom under article 40 and her right to personal autonomy.
11. I presume that your relative is compos mentis and that she has the capacity to make decisions.
12. Does she have any special health needs that might require the administration of medication etc. You will need to be made up-to-speed so that you're able to meet those needs during the outing.
13. Plan for any potential emergency....so you know what has to be implemented and who does what and when.
14. Age Action might be able to help. They have an advocacy service.

OP, I've never heard of a situation where a nursing home insisted that members of staff must accompany a resident on a social outing with their family if they agree to take on the responsibility for care.

It might be wise to familiarize yourselves with the HIQA national standards.

https://www.hiqa.ie/reports-and-publications/standards/current-national-standards-residential-care-settings-older