Elderly man discharged from hospital found in a 'bad state'

An elderly man who was discharged from a public hospital recently without family support or respite services was found in a "bad state" that night by a home help.

Fianna Fail councillor Mary Hoade highlighted the case at a recent meeting of the HSE West's regional health forum held at Merlin Park Hospital.

She inquired what level of respite was being provided for patients with no home supports who were being discharged from hospital. She also asked if the health authority was contracting beds from private nursing homes when beds were not available in public nursing homes.

In a written reply Tony Canavan, the chief officer of Community Healthcare West, explained that respite involves clients who are cared for in the community being provided with one to four weeks annually in an HSE community nursing unit. This respite supports carers help older people remain at home.

He outlined that convalescence is provided to free up acute hospital beds in cases where patients are medically discharged but as part of their care plan, a period of recuperation is clinically indicated. The convalescence is requested by the HSE acute hospital and is administered by the local older person's service in liaison with the National Older Persons' Service Office.

"Generally the hospital requests a period of one to two weeks but there is provision to apply for up to a maximum of four weeks where the patient has been seen by a GP and a written request is made by the GP outlining that the additional convalescence period is required. In certain situations, eg, non-weight bearing patients, the national office may make an exception and approve up to six weeks.

"In all cases the protocol is that available step-down/short stay beds in HSE community nursing units are filled in the first instance. Where there are no HSE step-down beds available the patient is funded in a private nursing home. The identification of a private nursing home is done in the acute hospital. The protocol for choosing a private nursing home should be patient choice."

He added that Community Healthcare West had no convalescence beds contracted with private nursing homes.

Chris Kane, the general manager of Galway University Hospitals (University Hospital Galway and Merlin Park Hospital ), told the meeting it was usually identified when patients were admitted if they lived alone and required specific support. She added that it was "not automatic" that everybody got respite care.

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