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?

If he wants to improve he’s going to need some physio. You can get private physio to do home visits and even if some NHS physio does materialise it’ll bring the gap and supplement, as it might not be very frequent.

He has to actually do the physio. Yes they you can buy private physio at home but you have to do the practice.

Agree
I dont think people understand that you get physio 2/3 times a week max but are meant to do the exercises yourself in between

What was his level of mobility prior to the surgery @Doubleknow
Sounds like he has deconditioned

Lifting your foot is hard but a dressing gown belt is a good aid and once he is back in his bed it helps get your leg into bed. Satin sheets to help you slide into bed a bit easier. Lots of cushions to help you get comfortable in bed as you have to sleep on your bed. Bin bag to sit on in car , dressing gown cord to help get leg in and out.

Really difficult if they don’t want help, lots of us have been there. If you can persuade them to do the downstairs shower room then a Burlington Regal comfort height toilet is very good. You can get traditional style shower that is surface mounted so the pipe is something else to hold onto along with nice grab rails.

An extra hand rail can make a big difference to the stairs though it does depend on the stairs themselves and how steep they are. I had my hip done as a daycase and was home in bed upstairs before 7.30pm. Previous owner had the extra handrail, we left it and painted white. There was a stair lift as well apparently but no sign by the time we viewed.

It is really important that he gets up and move regularly. Instructions I was given was 5 mins per hour which was a struggle the first few days but does get easier. The exercises are really important too. My Mum didn’t do them and never recovered her mobility.

Some surgeons don’t now put you under hip precautions ie. Keeping the leg at 90 degrees . Mine said the latest research is indicating that it doesn’t make a difference, I wasn’t happy to test that.

Sorry you are going through this OP.

Does your mum know she can get a bath lift, which just sits in the bath and she sits on and it lowers her down? Doesn’t need any screws or anything, it’s on suckers. It’s what I use. Or she can also get a bath stool or bench that sits on the sides of the bath and she can sit on it and use the shower.
i don’t know exactly what only having one working leg means for her, so it may be a bit awkward lifting her bad leg over the side of the bath but it’s theoretically possible and doesn’t need anything permanent installed.
As someone who has been disabled all my life these attitudes towards things that are disability/elderly related make me laugh. I just don’t get it. Why suffer just because something looks a bit different, but I’m experiencing the same from my mum and mobility aids. I love to say to her “Oh so using mobility aids is embarrassing is it?!” Pointedly looking at my chair. Apparently that’s different. Madness

My wife’s uncle and aunt were a bit like this. 3 legs between them and they argued against a stair lift and care.

We’d been to visit and my parent’s situation came up. Who had a stair lift, daily care etc etc.

Looking back I was, maybe, a bit harsh in what I said - but they got one, no one died on the stairs and they did have carers in. It had been too much for their daughter who lived nearby - who had enough caring to do with her own offspring.

I think we shamed them into getting one with ‘what if’ arguments, selfishness, ‘you are both frail’ etc.

It may be time to start having tougher conversations. It’s a hard time when you have to make increasingly more decisions for your parents after a lifetime of not doing so.

All the best with this.

its possible to get a stairlift within a week. Shop around, consider reconditioned ones.

Elephants feet for chairs, beds etc are a quick easy and safe solution as are wheeled trolley trays.

I've not long gone through similar with some relatives. If they have capacity it's a tough one, especially as I imagine you don't want to do anything they don't want to do which could cause a falling out. I found the best way was to suggest certain things regularly and then as time went on and things got harder, they had my suggestions implemented believing it was their idea.

Do they eat all their meals at at the dining table? If not why not just swap the upstairs bedroom and downstairs dining room furniture around. That way nothing needs to be disposed of or out into storage and can be swapped back if that ever becomes necessary.

They are part of the generatiion that makes do and mends, that won't downside nor get rid of stuff, so you need to working with those constraints. Is it not possible to add some space to add a walk-in shower to the downstajrs cloakroom with some building works . Tell them that extra bathrooms are popular additions and it won't devalue the house. If they are disabled they don't need to pay VAT on the adaption works for downstairs bathroom . Maybe that tax saving could be used as an incentive? .

Could a small sit in/walk in shower be fitted somewhere downstairs? Some of them can be fitted very quickly and easily.

And maybe a sofa bed?

From experience with my own parents, the quicker they leave hospital, the quicker the recovery.

And if shopping will be a struggle, maybe home deliveries? Even if they’re not online, you could do it for them.

You can’t go up and down stairs on your bum after a hip replacement!!!! You are not allowed to bend below 90 degrees for 6-12 weeks!

Sounds like he wouldn’t be capable of it anyway, and trying to stand up again at the top of the stairs would be so dangerous,

This sounds wreckless op. You need to accept they’ll be pissed off but you need to report it. If he has a fall it could be incredibly serious, that’s before taking into account the low quality of life. Why has no one been to check their home is safe?

I've had one hip done in January and getting next hip done in November. I found sleeping in a recliner better than bed for about 3 months post surgery.

Exercises are straight forward and I tried to do them multiple times a day, short walk 3 times a day.

Do you know why he is struggling to lift his feet? It could be his adductors. Extremely painful if it is. Mine took Jan to mid August to let go and stop hurting. They also impact ability to reach feet. You can get sock putter-onerers from amazon that are really helpful.

Final tip, for car rides sitting on a plastic bag can make it easier to swivel around.

I love my walk in shower. Very in style these days and would be a great investment / update for them. I also got higher toilet height when I redid the bathroom. Godsend.

Restrictions post surgery depend on the technique the surgeon used. I had zero restrictions apart from not driving for 5 weeks.

Thank you, I didn't know that was a thing either. Dad would have liked a soak in the bath when he got home yesterday, and I said if you'd modified the bathroom maybe you could, but mum wasn't keen on a walk in bath were you'd have to sit there while it filled (?).

I've sent her the link. She's a bit more willing to consider things and when she wants something she does usually get her way.

I would again advocate for an OT visit, and a private one can take a week or two to set up. Though tbh it’s worth getting the NHS one too. Now they’re actually at home they may be more open to it. They will give more of an overview of possible equipment. It’s what they do.

I mentioned up thread the Marks and Spencer dinners.
They do a small portions range and heathy a option range. I think they're cheaper than farm foods.
Plenty of veg bags and fruit. I also had those little rice puddings when I was ill. Long life so can be kept in the larder

My mum had a bathknight it was fabulous. I used it when I was pregnant.
I couldn't have managed without my aids.

Does your dad need a frame? They are free.

Fwiw I am paying the same price for a retirement property with walk-in downstairs shower that I paid for my 5 bed. Adapted properties are in short supply and in my village they go for a premium.

Edited to say
Apologies OP just seen your update that your dad is home now. Hope he's doing well. Just wanted to say, take all the help you can get and also you can call organisations like Age Concern who have all the local info. Wishing you all the best..

This has happened twice to relatives. In both cases the relative said "No No, I don't need that, I just want to go home." But One relative had a stair lift put in, a suitable hospital style bed, and bathroom rails. The equipment gets given back when no longer needed. I don't know if there was a charge for this, possibly NHS.
Another relative had a month in a recovery unit. I think there was a charge for this
But all these arrangements had to be asked for /chased whilst in hospital. The relatives in each case said they would manage, but they had no idea what might be needed. it was necessary for the people looking after them.

They really do need an OT assessment before they do anything OP. I would ring the LA and ask for one. Depending on income they may even be eligible for a disabled facilities grant. An OT can cast an expert eye on the layout of the house and look at the combined problems of your mum and dad, and can advise on the best and most up to date adaptations. Otherwise they may just be throwing money away. It also sounds as though they should both be claiming attendance allowance, which would help pay for what’s needed.

Definitely push for an OT assessment. It’s tempting to buy some of these great suggestions provided here but it’s mostly from folk who have organised it for themselves. The danger of getting involved to this extent is that they will become dependent on you for solutions and it delays the inevitable requirement to use professionals.

I would try and come up with some stock phrases when they bring up problems “Oh that sounds tricky maybe you need an OT assessment “
or if they try and rope you into personal care “ Oh that sounds like a two person job. Was there talk of a care package?”

No one wants to leave their elderly DPs floundering without support, but they were offered it and said no. If you plug the gaps it’s a slippery slope which usually ends badly for all concerned.

If it helps tell them about my mother in law, who is getting rave reviews from her private OT - the OT has been able to block the pressure to move to a nursing home from her daughter (who is just worried about her) as she is actually doing very well at home. She has benefited from the OT’s advice about specific handrails and equipment though. I know from my work that there are bits of equipment that are brilliant in some circumstances and actively dangerous in others - the expert advice really helps.

Oh god no, those walk in baths look dire. I’d freeze to death waiting for it to drain.
The bath chair I have is a called aquatech orca. Hope it helps!

It wouldn’t, the only thing really that will make keep them safe at this point is either retirement village or live in carer and serious adaptations.

This is a tricky phase when adults with apparent capacity are making poor decisions like irresponsible teens.

The key is guiding them gently but firmly to a situation where they are not in danger to themselves or each other.

Is your father walking with a frame?

I’ve got a walk in tub with a shower above. It’s a sit down tub half the size of a bath and it’s got a built in seat. You open the door, sit down and then fill - it really doesn’t take very long to fill and drain. Might be a good alternative to a full size bath.

Sorry but yes it would - of course it would. A care package with two carers four times a day is standard in this situation and will help massively with washing, bathing and dressing and a few household tasks while they work out what else is needed. And a phone call to the GP is all that’s necessary to have district nurse involvement to ensure skin integrity and infection care. A retirement village and serious adaptations come at a price and are longer term. They may not want to move - certainly doesn’t sound like it and anything more than simple aids and appliances will either be subject to a disabled facilities grant, or them paying themselves if they don’t qualify. The issue is what happens right now as OP isn’t able to offer significant care and her mum is disabled. An OT assessment is a matter of urgency.

Just let them get on with it.
They are adults - you don’t need to infantalise them.
Just make it clear that in an emergency they need to call an ambulance.