Numerous Falls at home - how many before ACAT condsider it unsafe for my mum to return home

My mum has had numerous falls in the past 14 months some at her home and others. Her first big fall she broke her hip, two weeks later in rehab she slipped & rebroke it, now one leg is about 2.5- 3cm shorter. Since then she has fallen twice in the garden causing nasty bruising. Three times in one week causing a fractured T11, she was not found for some time after this fall (she had not taken tablets for two days). Then after release from rehab she fell within 12 hours in the bathroom, fracturing 3 ribs and reopening the T11 fracture. She was reassessed at hospital on Friday and sent home. I am concerned for her as she can not even pull up her trousers on her own, can you explain how these decisions are made is there a formula? can I read a protocol?
I understand that she may still fall in care, but someone would be there to check on her on a regular basis and help her with dressing & remembering to take her tablets. I know she wants to be at home but my siblings and I are all concerned and I am not sure if I should be making a complaint or if I am being overly protective.

Hi Mel D,

In order to become an authorized Representative for my aged care purposes, you will need a letter from a doctor that states that your mother can’t act on her own behalf regardless of what it says on the power of attorney, as I found out. In my experience with my aged care is that when a representative rang up, she had to have my husbands consent before she would even speak to me, because she had a bit of an accent, he couldn’t understand her and he handed the phone back to me and she said he needed to consent for me to become his regular representative. I managed to get him to sign the representative form, and when the ACAT rep. came I thought I could handle things for my husband. He said to my husband "your doctor strongly recommends that you see a geriatrician " and I said can you just make the appointment and I’ll get him there, then he goes I need his consent. Well no way my husband wanted to see a geriatrician, so it took a bit of convincing for him to sign the consent form. So now I have to get him declared unable to act on his own behalf just so I can get to be his authorized Representative so I can get him into respite (for which he has approval) for when I have my surgery. Its absolutely ridiculous. I thought this is what these powers of attorneys were for. I need a letter from a doctor so in can use the power of attorney, but then to get him assessed by a geriatrician they need my husband’s consent, so if we didn’t manage to get him to consent and sign, I wouldn’t be able to get him assessed. So as far as I’m concerned my aged care have put me between a rock and a hard place. Who’s responsible if he stays home by himself and something happens to him?

Thank you for this post and the replies. This is obviously a common predicament that many of us find ourselves in with our loved ones. My Mum has had three falls and three visits to Emergency in the last 2 weeks and is currently in hospital until they deem her to be safe to leave . She has been fiercely independent 'til now and is resisting any suggestion of needing to be placed in an Aged Care facility (after all she is only 100 in 3 weeks!) still feels she can manage ‘by herself’ in her own home ( I visit daily, organise help, cook and do her bills etc, and she has a home care person assist each day for any tasks she feels need doing) , she has refused to allow me to become her ACAT representative until a week ago( I chose my moment to ring ACAT while she was in an agreeable mood and she could agree over the phone) Her cognitive abilities are now decreasing rapidly despite what she is imagining is normal, making reasoning with her for next move very upsetting for all. The hospital will not release her unfortunately until this is sorted. Note for all of us, DONT leave appointing an authorised ACAT Rep or Enduring Power of Attorney until the last minute despite how well you think you are, this process is fraught with stress!

Hi, it might best if you get My Aged Care to send out Representative forms, so you can then speak to My Aged Care on your mother’s behalf providing she agrees to you being her representative as she will have to sign the form. I had a bit of trouble with my husband, but I explained to him that it wasn’t just about him, that if something happened to me, he wouldn’t be able to stay home and look after himself. I was able to arrange for the assessor to come over, and got him at least approved for respite.

Hi Stella15,
Your poor mother. I cannot comment on the protocol of the hospital/rehab facility but having worked as a physio - the last 15 years in the aged care sector- I would assume, given your mothers history of falls, that prior to discharge from hospital that she would be assessed as “safe” to go home and a discussion about her home environment she was returning to? Does she have help? What falls risks can be eliminated? Does she require some modifications to her home to assist her with her mobility. Does she require a mobility aid etc. Does your mother have any home assistance outside the family? Without knowing about your mother’s ability and mobility I would suggest (if you have not already done so )that she has an ACAT assessment with the view to being assessed for a Home Care package. The ACAT assesses a person’s physical, medical, psychological, cultural and social needs. You can read about the ACAT at the link below. Your mother requires this to access part - government funded Home Care and Residential Aged Care. Aged Care Assessment (ACAT assessment) | agedcare101. To organise this she will need to register with My Aged Care on 1800 200 422. It can take up to 6 weeks but can be done sooner in an emergency situation. Once the assessment is co-assessor will clarify what level of help your mother needs. If a Home Care package ( levels 1 to 4) is recommended then your mother will have to submit an Income Assessment to the Department Human Services (DHS) to clarify how much government funding she is eligible for. You can read about Home Care packages on the Home Care section on our website. Home Care packages do not provide round the clock care (unless your mother supplements the government contribution) and my understanding is that there is a wait list across most of the package levels. The assessor will be able to advise on this. If your mother can not live safely at home (even with assistance) then perhaps you may have to consider residential aged care. Falls still occur in even the best run aged care homes due to the frailties of their residents but from my experience there should be systems in place to help minimise a residents falls risk. To clarify how much government funding your mother is eligible for she will need to submit an Income and assets form to DHS. If you decide that residential aged care is the best option for your mother then take the time to visit your “short list” of homes, spend time there speaking with care staff, residents and their families and particularly the Manager to decide if this is the right place for your mother. Ask about Falls Management programs and physiotherapy services. Regards Jill