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?

Each time my DPs have come out of hospital I have had to send photos and take detailed measurements for the O T. I wished they would keep the measurements on file because it was a pain. All aids such as raised toilet seat, raised chair legs, front door step were “temporary” borrowed from Red Cross for years.

Your DPs have to accept that they need some modifications. I’m fit and in my 60s but considering a grab rail now when I get my bathroom done up.

Their generation are so proud. I understand but at the end of the day it is everyone else picking up the pieces when they fall.

When my grandad was like this my mum paid for a daily cleaner / helper for an hour a day for a few weeks and told him it was free from the council. By the time she’s been there for a month or two he was happy to take on the cost…

My mum has just had her second hip replacement aged 80. She was only expected to stay in hospital one night and then I drove her home. She had to do the stairs test before leaving. We've moved a sofa into the garage temporarily to make way for a bed in the living room and I had to send my brother to buy a proper chair. I've been here for 13 days and need to go home tomorrow. Mum is doing brilliantly, is very mobile, but we still haven't tackled the stairs and she still hasn't slept in the bed (she's sleeping on the sofa/chair - but not getting much sleep). She is having a wash in the downstairs loo for now and I will bring lots of clothes downstairs so they are easily accessible before I leave. I will be calling round on Friday for her physio appointment then periodically from there.

I think your parents may struggle, but completely appreciate that there is little you can do if they've made their minds up. They are a worry, aren't they?

My parents did similar. I spoke to the OT privately and expressed my concerns. They arranged for visits and put support in place without mentioning our conversations at all. My parents still have no idea that I spoke to anyone. I

I’m 65 and had both my hips replaced last year after complications following radiotherapy for bowel cancer. I was in a similar situation to your Dad after my first hip op as I didn’t have a good leg to rely on. I couldn’t do stairs either and we don’t have a downstairs toilet either.

Firstly I slept in a recliner chair downstairs for a good 9 months. It was surprisingly comfortable and made it easier to stay on my back as you are meant to sleep on your back for 6 weeks post op. We have an outhouse/utility room and embarrassing as it was at the time we got a commode so I could go to the toilet downstairs and my husband emptied it as necessary - I do have a stoma though so it was only ever wee! We only have a bath too so for a good while I had a strip wash at the kitchen sink and again my husband helped me with the bits I couldn’t reach. He then helped me wash my hair at the kitchen sink too. There are loads of aids that will be invaluable to your Dad - grabbers are still my best friend! And you can buy a really good sock aid on Amazon for about 8 so he can put his own socks on.

I am not sure if any of that can be use to you and your Dad but with a bit of help from your Mum he may manage surprisingly well. I’m still having physio now, a year after my last op, so he may take a while to get back to how he was. Wishing him a speedy recovery!

Feel your pain! Sound very similar to my parents, only my mother has dementia and dad was doing everything at home. I would go in of a day and they’d tell me he refused any hospital to home help, as he had a nasty infection that kept him in for about 7 weeks, next day something else, next day how great a pair of daughters he had nearby etc.

Essentially be we took him home, sat him down and said if they didn’t instigate care at home or adaptations in the bathroom we would refuse to come and do anything else.

They then accepted it and we’re a year or so down the road and they are more than happy with the carers and love having them in and the adaptations have stayed even after full recovery because it was obviously helpful even without the injury/illness.

We the daughters still do lots but it’s the ‘nicer’ things like taking them for lunch, etc all of which went because we were doing the domestic duties of their home.

It’s not easy, I know we’re lucky we have a good relationship with them and whilst they knew we were ‘joking’ they also understood it was about long term being able to stay in their home which they’re desperate to be able to do.
Good luck!

This is where you're wrong. If he's coming out of hospital as a vulnerable person he will get a free package of care and advice on adaptations, for example you can get a board to put across the bath so that your mum can sit on it and bath/shower herself, perching stools for kitchen and/or bathroom, commode, etc. And a carer to come in 2 or 3 times a day for a short period, not to care for him, but to make sure he can safely care for himself, teach him how to do simple tasks, etc (this is an nhs service not social services).

You need to ask to talk to the discharge nurse (urgently) and ask her to liaise with the home pathways team.

Who cares if your parents are cross. How are you going to feel if he falls down the stairs or scalds himself trying to make a cuppa?

If he "will" get that why hasn't he?

Mum didn't when she was in hospital last either, and he had a spell in hospital previously, before they decided to replace the hip, and nothing then either.

If neither of them are honest with the OT, then they won't get it.

When my DM had her shoulder replaced we found the orthopaedic unit was a very slick machine, OT and physio were there every day, all very well used to seeing elderly people and the lines of 'my daughter will do it' etc.

The help was there but if your relative says they don't need it, there's not a lot they can do.

He may have rejected the help

Because he's been refusing it / telling them he doesn't need it.

I'm sure it varies from region to region. But I think all NHS trusts are supposed to provide support to get a elderly patients out of much needed hospital beds.

This is why @Doubleknow needs to act NOW to get NHS support. If she waits until he is discharged and then goes to social services he'll be on a waiting list and won't get support for months.

My mum has had both hips replaced over the last 4 years. Both times she had occupational health arrangements for raised toilet seat with a frame thing around it, a chair (like an armchair but higher) a seat pad, a walker thing, a seat for the shower etc.
My mum is a very fit 71 year old. She needed to use all of the things she got from O H for quite a long time. Please make sure these things are in place before your dad comes home. Particularly the chair, I honestly don’t know what my mum would have done without it. She also relied on my dad a lot for help getting in and out of bed, helping her get on the toilet safely etc.
Don’t underestimate the help your dad will need. It sounds like your mum is not fit enough to help.
Also make sure he does his exercises that they will give him, it makes all the difference.
Best of luck to you and your dad, hope he gets home soon.

He has told you he isn’t being honest with the drs and OT as he is keen to get home. You have visited him most days but not spoken to a dr or OT to put them fully in the picture. As a result he isn’t getting what he needs to be safely discharged.

Either he or your mum or both will suffer as a result. You need to be open and honest with the doctors, OT, social services and your parents about their living arrangements, how they are likely to cope and what help you can provide. And the faster the better.

If they have a wet room put in if they do sell it could easily have a bath added under the shower. This is what my sister is doing with a house she has bought. Would they consider a stairlift? That could easily be taken out. The people who lived in my house previously (council house) had a stairlift. It was taken out before we moved in. I only know because I was told they had to take it out before I got the keys.

My DH had a THR a coupe of years ago - he’s 51. It seemed to be an overnight stay for everyone unless they had complications whatever their age, and his surgeon said the ideal patient was older rather than younger as the muscles didn’t protest so much, so I expect hes outstayed his welcome at 10days really.
The things I’d suggest to help - reclining arm chair, he slept in it for a couple of weeks as more comfy than lying on the bed.
Three crutches - leave one upstairs and one downstairs and one to hop up and down with, saves carrying the spare!
Keep up with the physio and the pain killers. Hes fairly tall and used the loo raiser for a good while. It took a good 6mths to feel it’d been a good idea, and 18mths ish till he forgot he’d had it done.
If you’re really concerned that him coming home will be a disaster, what about respite care at a nursing home? My relatives home had people recovering from surgery as temporary residents quite often, if they’re self funding it’d be easy to arrange and would take the pressure off your poor mum!

Dont delay his discharge and come up with all the "unsafe discharge" nonsense, he has capacity and would be a self funder anyway

Far too often relatives think hospitals are going to solve every issue under the sun once someone is admittednot you op but others on the thread
Hes had a new hip and is mobile, great

Hes had surgery, the longer he stays in the more he will decondition or catch/ get an infection, physio is stretched to the hilt and community physio 18 -30 weeks wait, he will be better at home

He washes at the sink, or with a bowl fine
He walks to a small downstairs loo -fine
A urinal is a few pounds from amazon
Check for trip hazards, rugs/ uneven doorways and clutter

Community prescriber is your friend here, check in your area

Going in too hard with carers etc can be overwhelming and cause relationship breakdown
CP is usually a calm, friendly sort who will work with the client to gain trust
Can sort a temporary free hot meals trial, this usually goes down very well and then they can continue it
Advise on pendant alarms
Advice on a cleaner

If he will accept it Community physio to get him doing the stairs
Good luck!

Presumably he's told them he doesn't want it. That's what happened with FIL - was told he was entitled to a couple of weeks of 'free' care when he came out after his partial hip replacement and he told them he didn't need/want it and was discharged. When DH rang SS to say he really did need it, they said that because he'd been discharged he was no longer eligible for it and would need to go through the usual process and would have to fund it himself. FIL obviously said no to that...

Also re them not bathing for months: a strip wash at the sink has probably been quite easy during the hot summer but it’s getting colder now. Unless they plan to get the heating on full to warm up the bathroom the frequency of strip washes is likely to drop massively as it gets unpleasant in a cold room. They need better options.

If there is going to be some IHT to pay after their deaths then any home improvements they pay for now will effectively be at a 40% discount eg spend £5k on a new suitable bathroom which will only reduce the post IHT value of their estate by £3k. And might actually increase the value of their house by £3+k anyway. Tell them that you would rather they had what they needed now than have that extra few £k in the future.

My mum always used to tell me about how her parents had said they would do x and y when the time time came but when the time did come, my grandparents resisted doing anything of the sort and eventually a crisis meant they came to live with my mum. I used to laugh and say to my mum, "I hope you remember that when you get old". What happened when she got old? You've guessed it, she resisted help and interventions saying "I don't want anyone in the house" and "we don't need any help" etc until a crisis. Maybe that is likely to happen here. One of my siblings used to say "just tell them that to do that and get them to do this" - fat chance of that though. Your parents aren't your children and so there is often a bit of winging it during the end of life phase as you balance their dignity/ their capabilities/your own anxieties about them- you just have to do the best you can. I suspect you'll get many answers with neat solutions and some of them might be quite helpful suggestions but you'll be restricted in what you can put in place by your parents' resistance - it's a common scenario. .They're lucky to have a daughter who takes an interest in them - best of luck with it all.

You have my sympathy OP! Sounds like they won’t change and will do an unsafe discharge home, just make sure you aren’t relied on to pick up the pieces.

If you are deemed to have capacity you can do what you like, have a filthy house, bath once a year, anything. It’s how these hoarders houses that you see on tv happen- if you have capacity you can live however you want. If they don’t want a package
of care, adaptions or help then that’s their choice. It’s a ridiculous choice but it’s their right to make it.

You seem to have the right approach though, you can offer advice but stay out of it. The old ‘you can lead a horse to water’ springs to mind!

I'm a hospital OT on acute medical and orthopaedic wards. This is uncommon, we deal with these kinds of situations a lot. Feel free to DM me.

I meant not uncommon!

You really can.
I have a huge very "good" dining table and chairs. Got fed up with it and moved it into the garage. It's stood on it's side on a piece of carpet with a sheet over the top. The chairs are stacked and have dust sheets over.
If I get away with not using it this Christmas it's going!

It's so frustrating OP. Oldies who have money but won't use it to make life better, a house that's not future proof and no willingness to adapt. I've seen so many friends in the situation of being unwilling carers. My mum didn't have any money but what she had she spent on cleaners and later carers. However when she was in hospital she also fibbed that her DDs would move in and look after her. When we said no they arranged an Occ health visit and lots of adaptations were fitted free of charge. The house sold instantly regardless.

My Grandad who has dementia did this, my DM are her siblings had to speak to the nursing staff and tell them none of it was true! They had just believed him.

They discharged my DM 80s from hospital after an operation even though they knew she didn't even have a downstairs loo and had to sleep on a sofa as she couldn't get upstairs I don't think they care.