"Pressure on beds versus adequate care."

My 87yr old father who has Alzheimers was admitted after a choking incident where he collapsed. My 87yr old mother was told he would be kept in a couple of days on 2 antibiotics as he had developed fluid in the lungs. Next morning we were told to visit to get information as it was too difficult to get someone to speak to us on the telephone. As soon as we arrived it was obvious they were pushing to get him discharged home. (We observed beds being emptied and filled giving staff only enough time to clean and remake beds.)

When we saw dad, he was more confused than his usual and looked visibly shaky when eating and drinking. A physiotherapist arrived assisted dad to stand and walked him a few steps to the room door and back and stated she was happy for him to go home. I advised her that I didn't agree as he was less mobile than he had been before. I also advised her that he lives at home with 87yr old wife only and that he had 7 stairs to climb outside his house and 15 stairs inside his house to get to bed and toilet which he would normally do independently using two handrails, but that by the way he was moving I felt he would really struggle. The physiotherapist made no comment on that and said she was happy to recommend discharge.

On arrival home dad almost fell back down the first set of outside stairs had I not been behind him. It was an absolute nightmare trying to get him safely into the house as his legs were shaking. Immediately in he said he needed the toilet. It was an absolute nightmare to get him upstairs once inside the house. He remained upstairs for the remainder of the day ( he got home at 3.30pm) and my 87yr old mother had to do the running up and downstairs with hot meals, drinks and medication for the rest of the day. She struggled, hurting her back, trying to get him up out of the armchair in the bedroom when he needed to go to the toilet, a thing he would normally be able to do independently. 

To make matters worse, when dad's carers arrived at 7.30pm to get him washed, changed and into bed, the carer noticed that dad had been sent home with a cannula in his arm. The nurse discharging dad had asked dad if he had a cannula in but obviously having Alzheimer's Dementia he wasn't aware he had, and she just lightly felt about on his sleeves of his sweater and said he was fine. Dad is prescribed Warfarin which means any bleed take a long time to clot.  We tried telephoning NHS24 for advice but they had a wait time of more than half an hour and dad was tired and wanted to go to sleep. Dad jokingly said he would just take it out himself and the worry was that he would do just that if we had left him alone in bed. Therefore I removed it and kept pressure on it for 5mins. However this did not stop the bleeding and this worried and upset my mum. I elevated his arm and reapplied pressure for another 10 to 15mins before checking it again. This time it had stopped and I covered the area with a clean cotton wool ball and an Elastoplast. However mum said she wouldn't sleep all night for fear that it would start bleeding again. Therefore my younger brother agreed to stay overnight to put her mind at rest. 

I just feel had they kept dad in hospital an extra day as they had originally told mum that they would, to allow the antibiotics to take effect, these upsets could have been avoided. My dad had a failed discharge at Wishaw General earlier this year and had it not been for the availability of my brother and myself, this could have been another failed discharge.