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've said many times the best way to avoid IHT is to spend it.

Mum can't get in or out of the bath, or at least she's worried that if she got in she wouldn't be able to get out. They only have a shower over the bath, so the same applies there. I think she could if she had rails, but....

If he hasn't already left hospital, then you need to talk to the discharge team and tell them he's fibbing about his home circumstances and that it would be an 'unsafe discharge'. Otherwise the hospital will take his word for it and happily free up the bed for somebody else.

Oh, this sounds so familiar to a member of my family, including the many months of not bathing because the bath is not accessible but they won't have the work done to create something accessible (despite have the money to do so, and family happy to arrange it for them). Also refusing all carers, cleaners, adaptations etc. It's so difficult, but if they have capacity and understand the risks, there's really very little you can do.

I think it's right that he comes home and I suspect he wouldn't meet thresholds for a care package, but I do think there are lots of adaptations that would make him (them both) safer, and just make life easier.

Say no and speak to social services. He needs an assessment of his situation.

The therapists can arrange small adaptations if they agree, when you visit I'd tell him that telling lies won't help anyone, you won't be there to help and it's best short term if he has a bed downstairs, it doesn't have to be forever, he needs a stairs assessment if he refuses, he might end up falling so that's ridiculous. Have they got a telecare system, keysafe . Will he be getting home reablement? Or home physio.

Can you talk to the discharge team and ask for a referral to an Occupational Therapist? They will visit their home and make some recommendations and may even provide some equipment. But your parents will be able to say no to some/all of the recommendations. my elderly parent accepted some of the suggestions and refused others (however sensible).

Definitely better being out of hospital if there is no medical need for him to be there
So many elderly people end up institutionalised with muscle weakness and incontinence when they’re too long in hospital
A loo downstairs is great. He can have strip washes until he can navigate the stairs again and social services can lend you a hospital bed for downstairs until he no longer needs it.
He’ll get six weeks post discharge care anyway

I haven’t read all the responses, but in our area there is a Home from hospital service provided by Age UK. for 6 weeks. It’s free - light cleaning , etc .

All of this!

"The physios etc witness them every day". Your local hospital must provide a waaaay more comprehensive level of inpatient post-op care and rehab than many.

The physio said my dad wouldn't be discharged until he could do X and Y. This wasn't adhered to. We paid for private follow up physio after he was hurriedly discharged one Friday afternoon.

It's all very well saying that patients shouldn't be blocking a bed if they can just about cope but what is the point of replacing a hip or knee without proper aftercare to enable them to actually benefit and reduce their dependence on healthcare services/others.

My dad does the same thing, he lives alone, and he tells them I will help but then rejects my help. So I have to just let him be or he turns on me and will stop talking to me (he is coming up for 78)

Many people prefer showers to baths these days, We have two bathrooms and they both have walk in showers and no baths.
This is just our personal choice, we are not elderly or disabled.

It’s not a bad idea to get home asap

Can a carer come in to help if that is affordable?

Yep my father did the same. He was even offered a stay in rehab but the ‘wonderful daughters’ line was given. My mum similarly has serious health issues. I’ve stepped back for my own sanity as they won’t even have a cleaner in, consequently the kitchen and loo are increasingly grim.
They are not short of money.
The other wonderful daughter now has her own serious health issues and is beginning to see that my pleading with all of them to put some plans in place wasn’t me overdramatising but my hard earned experience of parenting a child with disabilities while dealing with my own health issues.
I have to put my own mask on first.
While many Elderly people can be like this, it isn’t the norm and as women have kids later, work for longer and people live longer the family care model is less and less viable.
The govt can’t have it all ways. If they want us all in the workforce paying tax in to our 70’s they need to organise sustainable childcare and elderly care.

rant over.
don’t feel guilty. At some point they will have to face that they need more help and while of course you can and should help organise that (assuming you have a decent relationship) you can’t do it until they are ready to accept it.

I know this won’t be helpful but if he is able to sleep on the sofa and has a toilet downstairs that’s probably all they will care about. My Mum was discharged after a hip replacement with terminal bowel cancer and severe copd in the same situation. They said she could have a wash in the kitchen sink and weren’t concerned at all!! I had to fight really hard to get help under the continuing healthcare scheme (this only applies when someone has a terminal condition or dementia etc).

He can't bum shuffle upstairs after a hip replacement as it's too much flexion for the hip.

As he has capacity he is allowed to make unwise choices and decisions.

As pp said, call an ambulance when he gets into difficulties, don't swoop in and save the day.

This is a very difficult path to walk and you have my sympathies.

Even a chair lift can be removed so can be sold to them as "temporary". And if the dining room table can't be moved "because", then the "temporary" bed could go in the living room, no? Good luck!

My nana was the same. Also, there’s no arguing with that woman so in the end my husband did a bunch of work on the house that allowed her to be independent for longer and did it for cost under the condition that she would get outside help when the time came. She agreed but ended up dying before she needed to move out - probably willed herself to death.

If they can afford it, I would suggest adaptations to their house is a good compromise to start with. A lot of older people get like this and to be honest I kind of get it. I know I’ll try my best to be independent as long as possible myself, but I hope I’ll know when it’s time to throw in the towel.

But....the walls would be damaged by the drilling. A bed wouldn't fit in the living room without getting rid of a lot of stuff, there's barely room to put your feet!

If at all possible I would tell the hospital that bed = sofa and bathroom = small toilet but other than that just let them get on with it.

Set very very clear boundaries, call ambulances for problems, practice responding “oh dear, what are you going to do about that?” , rather than “I’m on my way/I’ll do that after school pickup”.

Either they will be fine or there will be a crisis. With parents like this I think the best strategy is Que Sera Sera.

Not read all the replies, but would they consider a stair lift? They are easy to install and maintain and can be bought or rented. If the house was put on the market they can just as easily be removed. Both Mum and MIL have them and swear by them after initial reluctance. My mum (in her 90s) use it to transport both herself and laundry to the first floor.

Hi, OP, you'll find yourself in good company over on the Elderly Parents Board. A chance to vent to others having the same experience!

@Doubleknow I sympathise as I had to fight my father to do anything to make his life easier! I think you have to accept that he is going to come home then try to make it as easy as possible
He will be given some aids to help him at home- like crutches or a frame but there are some things he will not be given that could make like easier.

If he will not have a bed downstairs (which does not have to be forever!!! and when are they planning their next dinner party anyway!) would he accept a riser recliner chair? These do not have to be the super super expensive ones
https://www.amazon.co.uk/Electric-Recliner-Armchair-Massage-Heating/dp/B0HC5Q8GCY/ref=sr_1_30?sr=8-30

It is an absolute essential to put on a raised toilet seat (I speak as someone who has just had a joint replacement, once again this is not forever but will enable him to get on and off the toilet by himself)
https://www.amazon.co.uk/Mobility-Capacity-Elevated-Disabled-Recovery/dp/B0FRNNGV4D/ref=sr_1_37?sr=8-37

A thing for picking stuff up off the floor
https://www.amazon.co.uk/Magnetic-Disabled-Mobility-Reaching-Extendable/dp/B0GCFDZ62S/ref=sr_1_6?sr=8-6

this was really useful for me
https://www.amazon.co.uk/Replacement-Surgery-Recovery-Elderly-Mobility/dp/B0GYF37K6L/ref=sr_1_8?sr=8-8

A thing to help getting in and out of a car
https://www.amazon.co.uk/Car-Door-Handle-Elderly/dp/B09HWW6TYV/ref=sr_1_4?sr=8-4