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?

Have already posted re walk-in baths but just to add - my PILs also got carers in and found them very helpful (once we had persuaded them that they didn't need to entertain or look after the carers...). Again, you can sell this as something that will help keep your parents independent. We had become very concerned at how worn out my MIL was by caring for my FIL and the carers relieved a huge amount of pressure. It's amazing how much help is out there once you know where to look/how to ask for it.

Go with it, OP.
He has full capacity and a healthy current account.
Let them reap what they sow.

OP, How is his physio going? Is he easily able to walk the corridor with the physio? How realistic is it to think he will be able to walk up the stairs with assistance? Who will be expected to assist him on the stairs?

Is he expecting to go up and down the stairs regularly as he wants or is he happy to stay upstairs until he gets stronger?

What will happen if he gets home and cannot manage the stairs safely, or without a lot of pain? Is there a sofa he can sleep on? It won’t be comfortable, but is it even an option?

@Doubleknow you have my sympathy. They sound exactly like my parents who refused help despite being well able to afford it, and insisted on just battering on, whilst making everything really difficult and unpleasant for themselves. It ended very badly for them I might add

But as they have capacity there is realistically absolutely nothing you can do. Eventually o had to step back and set firm boundaries so I wasn’t constantly anxious about them. I did their online shopping and visited every so often (far away)

bloody nightmare

@Doubleknow
Just seen these
https://mobilityhire.com/hire/bathroom-aids-hire/portable-shower-pod/

My widowed mum is 80 and just had her second hip done. Private unit but NHS funded (so I guess she was considered low risk). She was in for one night. There was no assessment of her home. DH and I moved a bed downstairs, bought risers for the bed and a couple of half steps. She washed in the downstairs sink and I rinsed her hair for 3 weeks. I stayed for a week then popped in several times a day with help from my teen DCs. No support was offered because ‘my daughter lives close by’. I had to chase the hospital for a walker and raised toilet seat. Luckily my mum is really undemanding and realistic and was happy for us to move furniture around. Including precious chairs going in the garage.

OP I think you need to spell things out to your parents. If they don’t allow minor adaptations to their home they will lose their independence altogether. You also need to have boundaries in your own mind, you can’t solve everything for them and they are adults. I’ve just had a useful conversation with my therapist about not feeling guilty and responsible for my mum. Obviously offering what I can.

I would ask to speak to the doctor and explain the true circumstances. Ten days is a long time to be hospitalised after hip replacement and if that indicates a potential problem an OT/physio home visit should be arranged to make sure he’ll be safe at home. When my DH was hospitalised his mobility was affected and the OT arranged two visits - one to assess the house and provide any simple adaptations, and the other with DH himself to see how he managed before discharge.

If your dad has ‘volunteered’ you to be his carer, then you really do need to speak up and say that’s not the case because once he’s discharged it’s too late. The hospital social worker can do a care assessment and while they can’t force him to accept care if he’s got the mental capacity to know what he’s doing, neither can he expect you, or a significantly disabled spouse to care for him with seriously reduced mobility.

Speaking from the experience of being physically disabled he’s in for a shock when he comes home because in hospital everything is on the same level and easily to hand. He needs to realise that expecting everyone to rally round him and act as the nursing staff did is unreasonable and won’t be happening.

I don’t know if anyone’s mentioned this, but your parents are eligible for a Care Act assessment. The Care act bought in in 2014 makes it the local authority’s responsibility to do an assessment on anyone with care needs or anyone who cares for someone with care needs. You can contact your local authority and make a request for that to happen.

You can also speak to the local authority about the best way to apply for help under continuing healthcare (CHC). This is accessed via the NHS but the local authority can advise.

Any help via the local authority under the care act is means test tested. However, if your dad is eligible for any help under CHC, that is not means tested. Asking for assessment under either of these routes doesn’t mean anyone is going to try and ‘get them in a home’ or anything as dramatic as that.

It’s worth getting the assessment to see what can be offered. I will also add that mental capacity is issue specific. So a person can have capacity to make decisions in a lot of domains of their life, but there might be one or two issues where they do not understand the reality and are not in a position to weigh up the options. In that scenario, unless there is a lasting power of attorney appointed for welfare and/or finance, then professionals make the best interest decision.

If he doesn’t have an LPA, you need to get this sorted ASAP.

@Doubleknow my parents are the same albeit a bit younger so haven’t hit the lack of mobility stage yet.
They also have a fear of getting old and being ill. Anything that reminds them of that is being rejected (you imagine their reaction when I started to use a wheelchair myself….)

So I’ve resigned to let them do what they want.
Is it the best care they could get? Nope
Could they have more support? Yep. They can afford it comfortably.
Will they suffer from it? Again yes
But the reality is that I can’t force them. They’ll learn through their mistakes (the Natural Consequences we often use with children) and will stuff in place. Just much later than they could have

Is your dad going to have a visit at home from an OT?
That could trigger support and a freak discusdion with a HCP