Hip replacement & NHS after care

[Mascarponeandwine]

My one remaining parent is due to have a hip replacement next month. They live on their own in a bungalow. I am their only family so feel responsible for them to an extent, and they’re a good person.

I just wondered if anyone knew whether the nhs will try and get me to do after care when parent is discharged home alone. Are relatives coerced into this kind of care? I have younger kids, basically i do the school run alone in the morning, go straight to work, straight home at 6pm to take over while DH then goes to work for a couple of hours. No annual leave left to take and can’t afgird to risk my job. I would be willing to help care, but I don’t know when or how I could do this.

Parent is mid 70’s and in good health. Anyone got any advice as I have no idea what to expect. If parent discharged during working hours do they get a cab home???

Thanks

[ragged]

Come on... surely you don't think NHS can force you to be a carer. Your parent has to explain to NHS they don't have any home support (they deffo will need it). Some sort of recovery centre to stay in.

[Burlea]

My mil had a hip replacement at the age of 88, she stayed in hospital for 2 weeks then went into respite for a month, where she was encouraged to walk etc. She came home after checks made at home eg bars by toilet and shower, chair and bed at the right night.

[FesteringCarbuncle]

There are precautions to follow but there is a new type op where there are no restrictions following the op
Other than precautions there should be no issue. If help is needed a care package will be set up
Equipment will be provided

[hatgirl]

Absolutely not. Ask about reablement/rehabilitation. It's usually free up to about 6 weeks. The hospital will be able to refer

[Mascarponeandwine]

Thank you so much for this info, it’s impossible to find this stuff out on the nhs website. It states that the patient should have someone to stay with them for a week afterwards but doesn’t state what happens if there is nobody to stay. I can’t leave the kids alone and there’s not enough beds to all go to parents house.

What is reablement? I know theres a service that does up to 6 weeks aftercare as I phoned them, but they don’t do anything until parent has had the op and they’ve received the referral (which can’t happen in advance of the op). So they wouldn’t engage further with me.

[HoleyCoMoley]

No, they don't force you or expect you to be there, they may need rehab for a few weeks, the physiotherapist and occupational therapist will see them before they discuss discharge plans. They can ask for reablement at home for a few weeks, maybe you could help out with a bit of shopping or light housework if you want to. Hospital can arrange transport home, sometimes it is a taxi if they are able to get in and out a car but relatives can also take someone home. Hope they recover quickly.

[tasmaniandevil]

My DH had a total hip replacement about 12 weeks ago and he was not discharged until he could walk with sticks and go up and down a few stairs. He definitely needed a lot of help in the first week home with dressing, putting shoes on, getting in and out of bed and general looking after.

There is no way the hospital would let a patient return home without care in place as it is very serious if they fall and possibly dislocate the new hip.

[Whatsthisbear]

DGM had hip replacement and no one lived close enough for support or was free enough from responsibilities to move in. She was in hospital for a week post op and then sent to the local cottage hospital for a few weeks for recovery-3 if I recall correctly- and then supplied with higher seat pads and Zimmer frame for home use until she was fully recovered.
All transport to cottage hospital and then to her home was by ambulance transport. Your DP won’t just be shoved in a taxi and sent home following the op.

[HoleyCoMoley]

If they need after care they won't be discharged home without help, reablement is community care, the hospital arrange it, you don't need to do the referral, it will be done after the op. The social worker, doctor, nurse, therapists and discharge team will probably get together with the patient and you if you want to discuss after care, exercise and that sort of stuff. I have seen people in their 80s walking a few says after having hip operations. People recover differently, wait until they have the op.

[Mumof1andacat]

Re-enablement is a term care pack with a view to it coming to an end at around 6 weeks.The carers encourage the patient to become more confident and encourage independence as the weeks progress. At the end, there's normally an assessment to see if the patient requires a longer care package. Some patients need less than 6 wks input but that will be assessed as the weeks go on. The nurses and therapy staff will assess what care package is needed once the ok takes place. Each patient is different so some come put of hospital requiring non like my dad other's might be different. Hard to know until the ok takes place

[TakeAChanseyOnMe]

As others have said, you won't be expected to be the carer. You might be able to help out in ways like getting an online shop delivered, or if they need carers temporarily, to fit a key safe outside.

Hope all goes well with the op - elective hip replacements generally have a pretty short recovery time, especially if the person is fit before.

[Mascarponeandwine]

DH and I can do shopping at the weekend, we have housework covered so that kind of thing will be ok. It’s things like if he needs surgical stockings put on first thing in the morning, will the nhs send someone to do this?

Perhaps the nhs is not quite as on its knees as I thought. I really wondered if a couple of days after the op they’d tell him he could be discharged and that’d be it, over to him to get himself home and make any arrangements he might need or want. That was certainly the case when I had my last c section 8 years ago - I could barely walk with pain and the doctor said you can go home as we need the bed! How I made it I don’t know.

[haggisaggis]

My Dom was discharged from hospital after partial hip replacement resulting from a fall. No questions were asked as to whether there was anyone to look after at home. OT assessment in hospital but based on her getting in and out of a hospital height bed. Once home it was apparent she could not look after herself. The care plan put in place before discharge was a 10 minute visit in the morning and another visit in the evening at dinner time. She was unable to get into bed by herself. My disil and DB moved in with her for 1 week and after that we paid for private care over night until she was able to look after herself. Yes she was provided with toilet frame, commode, Zimmer etc but she was basically discharged expected to look after herself - but could not. Unfortunately you are right to be concerned.

[Mumof1andacat]

If he has a care package for the morning they will help him wash and dress inc red stockings. Re-enablement is normally funding by the local council not the nhs

[Mumof1andacat]

It would be very unlikely to get someone to be there over night as part of the package.

[hatgirl]

Yes it's shocking that women post c section are expected to go home and 'keep calm and carry on' and look after a newborn after major abdominal surgery.

Fortunately (because it's not a race to the bottom, even though post c section women are just as deserving) there does seem to be some provision retained for elderly people following hip replacements.

Depending on the procedure it will most likely be a short hospital stay with a small amount of physio/OT input. Then home with a reablement package (a few visits a day and some adaptations) and then longer term support if needed.

The hospital will talk you throughout when it happens. Unfortunately ops often get delayed etc so there's no point planning anything too fa in advance. For the same reason social services won't take a referral until the opmhas actually happened, but can act quite quickly once it has.

[hatgirl]

And yes, if over night care is needed it will most likely be provided in a rehab centre rather than at home.

[FesteringCarbuncle]

Of course reablement can't promise anything now. They have no idea of the situation until the op is over
Don't worry. Hips get the gold standard of the NHS. Everything else is on its knees but we still provide an over the top service to hip replacements

[Mascarponeandwine]

Thank you, I’m relieved to hear that there does seem to be some provision for elderly people post op.

I only have two big experiences of the nhs. One is the c section discharges where they don’t care what state you’re in, as long as the wound is not infected they discharge you and make you the community teams problem (who also haven’t got time to do anything more than confirming it’s healing). The second was when my other parent died at home - I called 111 who asked me to confirm the death (how would I know for sure?) then they said they’d put us down the priority list for the doctor call out as the living have to be prioritised. 5 hours it took,3am the doctor finally turned up. In the cold light of day I don’t disagree, but I subsequently had counselling for that experience.

Then it gets more complicated as hip op parent initially had a pre op in the private hospital (op would have been paid for by the nhs). The private hospital said the nhs pay for two days and after that the private hosp discharge you, after care is your responsibility and not their problem. So they just chuck you out because there’s no more money. The nhs said they’d pay for the hip op but wouldn’t get involved in after care as parent would be in a private hospital. Gp said let the private hospital discharge you, stand in the car park and phone the gp and he’s immediately refer you into the nhs hospital. Luckily op is now in an nhs hospital so that complication is no longer relevant.

So overall I was expecting that parent would be discharged from the nhs hospital and end up standing in the car park wondering what to do next. Glad to hear it might be a bit better than that.

[stressedoutpa]

Op, hip replacements on the NHS are very streamlined. Patient has hip replacement and the physios will have them out of bed and walking the next day. Providing all goes to plan they will be home after three to five days.

If they have no support at home then the reablement team can help but it's best to get this in place rather than waiting until they're in hospital as it can delay discharge.