Seems to me to be a total disconnect between in-patient care and so called "community". I wonder if hospitals actually know the reality of what terminally ill people face on discharge home?
My wife (see other Posts) was discharged one week ago. The Report and Letter to GP made assumptions such as "social care to be intensively involved for safe discharge", "community referral sent by palliative care team" and "3/day package of care for home". Needless to say, what little of this has happened has been less than helpful. I cannot see that it will improve. One community nurse visit - focussed on incontinence pads. One GP visit - seemed to want to ask mainly about resuscitation wishes - and no-one has yet managed to get her openly to acknowledge the terminal nature of her condition - at a terribly inconvenient time. She is on the MacMillan Community Nurse waiting list, but apparently GP doesn't want this until she is "receptive" - of what I'm not sure. And home care nil.
The GP stronly hinted "weeks", but I do not know what the downward stages might be, how to recognise them nor what my responses should be. Brutally, I assume that once she is screaming in pain I phone 999.
Simple cost pressures to free up beds I guess.