Dad has "told fibs" to be allowed home from hospital

[Doubleknow]

He's been in for 10 days after a hip replacement. He's doing OK, but the recovery isn't happening as quickly as he expected. (He's 85).

I've visited most days, but never spoken to a doctor or OT, both he and Mum have full capacity, so all the important conversations have been with them.

He's desperate to come home, but still very frail and not very mobile.

They live in a big house with no downstairs bathroom or bedroom. (I know, but as I said full capacity).

He has "fibbed", his words, to be allowed to come home. He's told them he has a bed downstairs (he means the sofa) and downstairs bathroom (there is a small downstairs loo) and, I strongly suspect, that he has a wonderful daughter nearby who will be at his beck and call!

Mum is elderly and disabled herself, but very stoic and will get on with doing what needs doing, which would include caring for him and the house with only one working leg. They are both determined not to have outside help. Neither has had a bath or shower in months, although they are very particular about being clean, and they don't seem unwashed, so must be doing a decent job.

I will do bits, but I can't offer "care" and in any case they're not expecting that, they just want the hospital to believe it so that he's "allowed" to come home.

I think I just have to leave it and let them struggle, as is their choice, but it seems all wrong.

Are there other options?

I think they need some help to keep being independent. To be honest, I think you're Dad is better off out of hospital - mentally and regarding infections.

Do they have a cleaner? Food delivered? Why can't they have a bath or shower? Maybe get a walk-in shower put in for them? Do they have any savings?

Of course, those are all perfectly sensible suggestions.

They won't have adaptations (like the shower) because they "don't want the place to look alike an old folks home", I think partly becayse of concerns about selling.

They have loads of money - IHT is my Dad's favourite topic of conversation, but they won't spend it on anything they don't think they need, their definition of need being different to mine.

They won't have any help because of "privavcy" and a fear that everyone is out to rip them off.

10 days is a really long time to stay in hospital after a hip replacement. My mum was 83 and only kept in for one night. I would try and talk to a doctor yourself and find out why they haven’t discharged him already.

Literally absolutely the definition of the norm from experience.

You need extremely clear boundaries about what your availability is and let them get on with it.

Call ambulances if necessary rather than fill gaps because it get unsustainable very quickly if you have other demands on your time like work and children. .

No real suggestions but sympathy! My Dad did similar once. In the end it turned out he probably was better off out of hospital, certainly in terms of his mental health, but we were very annoyed at the time!
When my Dad came out the OT team came the same day and fitted up the house with rails, raised toilet seats etc which was very helpful. He was also offered a care package (which he mostly refused 🙄). Have these been discussed at all?
Eta my dad was in for a long time following an accident, not because of a hip replacement, so the allowances may be different.

Call and ask to speak to thr discharge team. Just t because they have capacity doesn't mean you aren't allowed to express concerns

Is there a room downstairs - a dining room - which would take a bed? Or would a stair lift be a possibility, for them. If the OTs inspected and said a proper bed was needed, you could then offer to help set it up for them. Even if it's not essential now, it could be useful for them in future, and would be ready.

How do you know that he's told them he has a bed downstairs? Has he told you, or have they? Either way, you have a good excuse to say to him - Now, that downstairs bed you said you wanted. Shall I come round at the weekend and start to get the dining room clear for it? We can put the table into the garage/shed/wherever for storage.

(If he would accept an OT assessment of the home, they would also but up rails for him in the large rooms/doorways, to help prevent another fall. Do stress to him the if you do this now, it could save him from falling again later . . .

He probably is better off out of hospital, so I can’t really blame him for that one.
Meal deliveries would be a good idea, if they’ve got the money they could get Donald Russell which is aimed at the whole population rather than wiltshire farm foods.
I would try a get them to have a shower fitter saying that most people never use the bath and prefer a walk in shower these days. My parents have live in their current house since their mid 50s and have two shower rooms and one bathroom and they would have taken that bath out if there was enough ceiling height for a shower. Neither have had a bath in 20 years. It’s only me when I visit that uses it!

He must have done the walking up and down a flight of stairs test as they definitely don't tend to let patients leave without being able to do that.
Why was he in for 10 days? Did he have an infection?

No, he hasn't he's walked in the corridor, but not stairs. That's why he's told them he doesn't need to negotiate stairs at home.

No infection, he just seems to have been hard hit by the operation. Nothing went "wrong" but he was very unwell in himself for a few days.

They'd be furious if I did anything that delayed things though, and as PPs say, he probably is better away from hospital.

They won't consider a bed downstairs - it would mean getting rid of the dining table, which was expensive and good quality you know.

He told me he's fibbed about the bed. I don't know what else.

Did they not have anyone visit to check the house before he went to hospital to have the op?
I'm sure my mum did so they could bring the relevant appliances to help.

Then whether he has fibbed is irrelevant. Either the situation at home is a safeguarding risk and therefore needs to be dealt with which may or may not delay discharge.
Or its irrelevant because getting home is a priority.

Tbh i think its less likely to delay discharge rather than reduce the support and equipment they are entitled to to get home. But only the discharge team can tell you that.

With my parents we contacted the elderly care team via their GP, and they sent out a team - I think from social care - who assessed the house, put in grab rails and various other adjustments. It was all free (if your dad is worried about money). It seems to vary who does that work but the GP is a good place to start and it's not hard to get (it's not means-tested).

It would also be very worthwhile sorting out both forms of power of attorney now if you haven't done so already. Makes you calling and sorting care out possible, if they still have capacity.

Agree with other posters: don't rush to step in and help. It very quickly becomes overwhelming with parents who won't accept outside help (but are very happy to take the help that you offer). It's not sustainable, and it's actually not the kindest thing to do, even though it might feel that way, and even though your parents might guilt you into it. When my parents FINALLY accepted carers / help, they did admit how much easier it made things.

Appreciate it's so frustrating when your parents are in denial, though. Why does that happen so often? Mine bleat on about not wanting to be a burden but, really, the only reason they are/were is because they didn't accept the realities of getting old. Ggggrrrrr.

If they can afford it they should definitely have some adaptations done. Why struggle to recover from this when they can get help?
At the very least a higher toilet seat and some risers for the furniture. I fear he could take a fall and end up back in hospital. 😟

Maybe stress that any adaptations are temporary, i.e. only until he recovers. Might make it more palatable, esp. if he's worried about the house looking like an old people's home.

(My dad was the same. The irony being his decor was so old-fashioned it was unreal - he just thought it was terribly 'modern' ;))

@Doubleknow will the hospital be arranging a care package on discharge?? sometimes thry arrange a support package.
Its very difficult with elderly relatives who refuse to accept help.
Sending hugs

I’m so sorry as this sounds really hard for you but I agree with pp who have said he is better off out of hospital despite the risks.

the number of older people I’ve known go into hospital for something non-serious and be dead a couple of weeks later is high! It is such a risk in terms of infection but also mental attitude. But I do appreciate that there are risks and it’s hard for you to manage.

Ultimately if they have capacity there’s not much you can do.

can you arrange an OT assessment to get adaptations to the house? Would they accept a hand rail etc

I would use the threat of telling the hospital the truth as leverage to getting them to get assistance and make the adjustments to the house they need to be safe. It’s pretty hardcore and they won’t be happy about it but at least they will be safer.

He shouldn't be blocking an orthopedic bed just because he has stairs. They wouldn't just keep him there anyway. They need it for others who've more recently had hip surgery.

As long as he can use his bum to shift up and down stairs he'll be ok? Or just sleep on sofa for a week? But why not tell the truth then at least he might get a carer or some equipment?

Once the person can get in and out of bed and make it to a toilet and back with a mobility aid then they can leave. The physios etc witness them every day so they can't really lie about their mobility level as they'll hound you out of the bed to do exercises.

They may not feel ready but the hospital will think they are. I saw it happen to everyone in my ward.

Ultimately even if he had no downstairs loo they'd just order him a commode. They wouldn't let him just stay in the hospital. They may send him to a rehab but that's often for those who live alone.

Absolutely. Anyone who moves into that house is going to see it as a project and want to rip everything out anyway. The bathroom is at least 30 years old. Quality and well maintained, but...

A walk in shower wouldn't make it look like an old people's home, modern/upscale homes have them.

Your parents' living conditions sound unsatisfactory in general (not just post-op), they need better washing facilities and some outside help. They have the money to provide all that, so it is their choice not to have it. So let them get on with it. I know that sounds harsh but you don’t have any option.

Despite the fibs your father will be better off at home, there is no medical reason he needs to stay in hospital, and it isn’t the hospital’s fault he is too stubborn pay for the help and facilities he ideally needs.

There are any number of things he could do to make life easier at home, but he doesn't intend to do any of them and there is not a lot you can do about it.

Agree that he's better off out of hospital. Why hasn't your mum had a bath or shower? Is it that she can't get up/down the stairs, or she can't get in/out of the existing bath/shower?

You have my sympathies. It's frustrating to watch people struggle when some things could be made better by a relatively simple fix, like installing a walk-in bath or wet room. My mother was the same, right down to IHT.

If money is a trigger for them, you could come at the argument from that perspective - it's better to spend money on adapting the house to meet their needs and get some extra help, like a cleaner, than allow the tax man to take it.

Also, not all adaptations have to be cheap and make their home look like an NHS ward. I saw a beautiful hamam-style bathroom which was made for someone with limited mobility, but wouldn't look out of place in a really posh home - the seated area was part of the wall, all tiled beautifully. I can't find a link, but here are some alternative design options.

https://www.absolutemobility.co.uk/blog/bathrooms-for-disabled/