Patients with nobody to take them home after surgery

[Aerom]

I do wonder how do the NHS cope with patients who have no one to take them home after surgery. There are people living alone with nobody to take them home or have somewhere to stay overnight. Or could have their regular friends who would have done this but on holiday, busy at work, unable to drive due to injury or recovering from surgery themselves.

The patients are not allowed to go by public transport or taxi.

The ambulances are usually for the elderly

I will eventually have no one to pick me up in years to come

Yes this. You don’t need permission to leave unless you’ve been arrested or sectioned. Of course the NHS have your best interests at heart but there’s nothing they can do to stop you leaving if you have capacity and haven’t been detained! I hate all this talk on MN of ‘they won’t allow you to do x’ whether it’s a school or healthcare. You’re an adult so just calmly tell them you’re leaving and you’ll call if any issues.

From FIL experience in Bristol they put them in an ambulance and dump them at home alone.

He was 85 and coming out after a broken hip.

It was horrendous as we live nearly 200 miles away.

End of the day if you have capacity and you're prepared to sign that you're leaving against medical advice - they can't hold you unless they section you and they're very unlikely to be able to find grounds to do that. Different if it involves someone vulnerable or a child when they're likely to contact social care - but I've seen some jaw droopingly dicey unsafe discharges from the perspective of community health and a "they did WHAT?!?!" contact on a Monday morning

Hospitals cannot stop you leaving if you have capacity even if against medical advice.

But the same hospital that insisted my sibling have an adult collect from ward after a minor op with sedation, decided to unexpectedly discharge in an ambulance my elderly, very frail, dementia suffering parent back to their home after several weeks as an inpatient (where they live alone) without speaking to family or arranging the necessary care. The ambulance team only had to turn around and readmit as the parent didn’t have keys so couldn’t get in. So I get a bit skeptical about their citing patient best interests.

I recently had a minor procedure with sedation at a private hospital - they wanted an adult to attend hospital to accompany me home but equally nobody was allowed up to the ward. It would have been very inconvenient for Dh to come so I just claimed he was Downstairs and got an uber.

I wasn't being snarky I meant from the hospital point of view I obviously have no idea about your circumstances and you didn't explain in your post so stand down no need to attack me.
If this was not directed at me apologies.

That’s shocking @StuckInTheUpsideDown- any why didn’t they check for keys before they started the journey! What a waste of time and risky for your parent.

I’m 60 plus and divorced 4 years ago after 39 year marriage. on my own now. Yep, it’s an issue

part of reason I have focused very hard on developing a social life (not intuitive as I’m an introvert and so have to force myself) is to develop a support network. I put myself out to offer lifts to other people to hospital, gps or anything really (collecting car from garage) , I use it as a way to make connection, get to know people and have a number of people I’ve “banked” favours with to ask in return.

i am member of local U3A ,which is a fantastic base to develop that sort of network, and most folks are in same situation. We all just muck in when needed. Asking for help is accepted and norm, and a great way to strengthen relationships.

sure, it’s an issue if it’s a GA and you’re supposed to have someone in your home ..but I’ve been in that situation before when married and exh refused to cancel a work trip to be at home with me, so hospital booked me as overnight admission. So no issues with that really , you just need to be assertive. If you’ve no one to look after you, you are not fit to discharge. Simple. Yep, you may have to wait a little longer if non emergency, but it is still a basic assumption that people have care at home and csn go home. You need to tell them the consultant team clearly that is an incorrect assumption and you’ll need to stay in.

my friends usually stay with me till evening for stuff like sedation or spinal. Thy even stayed after local recently, becuase I needed a lot (MOH) and one of them as ex nurse said i could be more wobbly than normal after locals given the dose. I’ve stayed and cooked meal for people with cataract surgery discharge where seeing to cook tea on first night is a bit fraught.

put yourself out as much as possible to support people in way you’d want to be supported when the need arises.

I got the tube home after surgery. I walked out of hospital with a friend and then went my own way home.
it’s how it is for lots of people I’m sure.
I don’t have anyone to watch me after surgery either. I just have to say someone will be with me.

But yes it’s an interesting question because this will be the case for a lot of people I’m sure and I don’t know what would happen if the hospital wanted any proof. I guess that’s why they keep it simple. Someone has to collect the patient and then the patient has to confirm they won’t be alone that night.

My last surgery was major and I was kept in hospital a long time very unwell. This was lucky really because I needed the monitoring.

it’s like everything in life- it can be a lonely old time with families not always around- friends not always available. People are busy and human connection is not always a priority.

I agree that there should be better options for those who have nobody to pick them up - either all the time or those who would usually do, are unavailable for various reasons

Like @Limehawkmoth I also think that we ('society') also need to take some responsibility for being a community for one another though.
There will be some people, of course, for whom this isn't possible, but the overwhelming majority of people could do a bit more to build those communities (or villages as tends to be said on here) themselves.

I've collected people from hospital and stayed with them, and I'd have no hesitation asking other people to help me if and when I need help, because that's the way community works. However, you see so many people on here who close themselves off to the idea of being part of any communities, then they seem puzzled by the idea of people helping one another out.

I wont have anyone either OP

What seems odd to me is tht they're so stringent it seems about stuff like this, yet they'll discharge frail elderly people back home with no care package at the drop of a hat.

It’s true that they can’t stop you leaving but before any kind of surgery I’ve always been asked if there will be somebody to take me home. So would have to lie if I didn’t have anyone.

Honestly it was awful. When we complained they said “oh but they were medically fit to discharge and when asked they said they were happy to go home today and could cope by themselves”. Well but parent is a terrible judge of their ability to self care, because, oooh, dementia. And OT said they needed carers for at least 4 weeks and unsafe otherwise.

Frankly I think they just wanted the bed and hoped we would be bounced into just sorting it out at home.

I’ve had to several times. I get myself home on public transport and get myself into bed. I’m used to not having family by now.

@StuckInTheUpsideDowndementia care is a disgrace! I had a situation with my mum. They said she has capacity and wants to go home. Obviously they didn’t actually check her capacity or ask our opinion. I told them it was an unsafe discharge and they kept her in. Thankfully that got social services moving.

That was the same with my late DGM. She said she was fine to go home, when she was not both physically, mentally as in dementia. She was at home for 2 weeks before she got a place in a care home where she died 14 months later. During those 2 weeks, she had 4 carers coming in at different times and sometimes the gap between carers was 1.5 hours later

This is my experience too.

It does seem to vary a lot whether they check or not. Last year, I had a colonoscopy with sedative so couldn't drive myself home. DH waited in reception for me. I had a sandwich post procedure and the nurse said I could go home after I'd finished it. No checking that he was actually waiting for me and I wasn't getting in the car to drive myself. But then is it really their responsibility? It's my insurance I'd be invalidating.

But my mum said that when she had one, a friend was picking her up and they walked down to reception and handed her over to him!

I’ve stayed overnight in this situation before. The requirement was someone to be present with me overnight, not just a lift home.