Would a surgeon refuse to carry out an operation if no appropriate aftercare is available?

[MyShinyWhiteTeeth]

I have a relative who needs an urgent operation. She wanted to go to some of our other relatives afterwards and stay there until she recovers. The relatives have said that won't be possible.

The normal process is 2 days in the hospital following the operation then they go home. If there is no one available at home to help look after them then they stay in hospital for an additional 10 days.

She really doesn't want to be recovering for 10 days in the hospital but the people she wants to stay with are not fit enough to look after her; they also don't have the space and they will struggle to get her to return to her own home afterwards.

The relative has now said - Doctors have said she probably won't be able to have the operation as there is no back up aftercare available as she needs someone to take care of her properly

I distrust what she is telling me. Is it likely that the surgeon will refuse to operate or is she just trying to force her relatives to agree to take care of her?

Depends on the operation and it’s criticality. I have known surgeons refuse to do a knee replacement if there’s nobody to look after the patient.

It's urgent and they are trying to get it scheduled asap. She was initially trying to refuse to have it.

It would depend on their age, their functional ability and the operation.
No NHS hospital in England is going to offer 10 day post operative stays because there was nobody at home unless it was a fractured neck of femur or similar. Then a care package would be arranged pre discharge.
Most surgeons aren’t unduly bothers about normal adults being looked after properly. Trusts have length of stay as a measure of success. Very few operations can discharge to care of relatives at 48hours or require a 10 day stay. Ten day stays would only usually be for major operations requiring specific medical or professional nursing care not social support. Trusts are also measured on the number of cancelled operations, so are usually reluctant to do so unless beds aren’t available.

I'm going to try and find out more information. I'm not getting clear answers about what was said so I'm more inclined to not believe what I'm being told by her. The words used seem unlikely to have been said by professionals.

I'm a nurse and that UBS's very odd.even the biggest spinal surgery we do only use a stay of 6 days.

Ring the unit where she is due to have the op and ask about aftercare.

BUT she can not force herself into the home of another adult and insist on staying. If necessary she could always source a private care agency to come in and provide care post op.

It’s not beyond the realms of possibility at all. Depends on the nature of the operation & their normal health. Perhaps your relative could organise some time in a convalescent placement (essentially go into a nursing home) for the post-op period if they have no relatives able to support them/don’t want to stay in hospital - I’m aware of several people over the years who’ve done this.

Most hospitals have a team that can organise interim carers for someone on discharge and the OTs can organise any additional equipment like walking frames or commodes and even hospital beds.

This happened a few years back with a relative; he was kept in hospital for an extra couple of nights, but he couldn't not have the surgery.

Apparently the operation is still going ahead. It was her local GP who said the surgeon might refuse to operate. Does that sound likely?

It seems like she actually will be fine to go home a few days after the operation with appropriate after care packages. She doesn't want to be in the hospital or at her home and is pushing to stay with the favoured relatives.

My mum had a massive surgery on her abdomen after a cancer diagnosis. She was told that she should expect to stay in hospital for 2 weeks so not an unreasonable timeframe to be kept in.

Is she making it up - saying she can't have the urgent operation unless she can stay for 10 days with the relatives she wants to stay with?

Is it that she doesn't want the op? She can refuse it if she has capacity and understands the risks.

You know, it might not be that she's just making it up. There are so many people involved in organising surgery that she might be getting different information from different people or putting bits and pieces together and getting it wrong or filling in the blanks with assumptions.

Smacks of manipulation and guilt tripping with a side of doesn't want to pay for care/wants relative to do it for free and fuck their ability to provide it. I'd develop a thick skin. 'Oh, that's a pity. Hope you figure something out.' 'Oh, I can't have the operation.' 'What a shame. Hope something can be worked out.'

She now has another pre-surgery appointment and family will go with her so they can support her and also to find out what is really going on and let others know about it.

She does seem to be deliberately spreading misinformation. I've bailed out for now as I've had enough. I will be helping out with shopping and cleaning after she gets home but I'm not going to be used to persuade other relatives to host her.

I hope they all step back. Sounds like she's trying to move in by stealth. I'd be furious if someone tried to blackmail me like that.

Are the relatives she wants to stay with very elderly?

What's it matter if they're not elderly, they don't want her moving in by stealth, they don't have the space and the OP says they are not fit to provide the care she needs (or demands, sounds like she might be the demanding type).

The relatives she wants to stay with are semi-retired and that have a variety of health problems themselves but are actually pretty active. They provide childcare for younger more distant relatives. Sorry to drip feed. Staying with them would mean the children would not be able to stay overnight (which they do 2-3 times a week according to work-shift patterns) and they'd likely struggle to manage all three. They don't want to do it either.

She feels they owe her more than they do to the children's mum and is very upset when they said no. They were very close as children but have grown apart the last 15 years.

They need to stand firm and just step back and keep telling her NO.

Is your relative elderly herself? Hospitals will usually want to know upon admission a patient is going back to a safe environment to recover, this helps reduce readmissions which Trusts are penalised for.

If not able to stay with family, have you explored local respite care in a residential setting for post hospital stay?

It sounds like the patient doesn't want any other option but foisting herself on these relatives, though.

If you can find out what the operation is someone might have more of an idea what a normal stay is. It does sound like you may not be getting the full story.

Especially if she is elderly, social services could organise carers to visit her at home.

My mum was in hospital for just over a week for a triple heart bypass. She was 66 and otherwise healthy. After her discharge I stayed with her for 2 weeks and she had carers for a while after that. They helped her wash and dress, got her meals and did light housework.

I've been in 1-3 nights after various laparoscopies and 3 nights after major ankle surgery. After one surgery away from home I stayed near the hospital in a hotel for a few nights. I just lay in bed and ordered room service. It was fine. Had there been a problem, I could have rolled into a taxi back to the hospital.