Transporting broken ankle long distances

[twatchops]

Posting for traffic so apologies.
mother visiting. Severe ankle fracture requiring 3 hours surgery.
6 hour drive back to her home. AA are fortunately recovering her car.
Non weight bearing and using a frame. She can't come home to me due to stairs and toilet set up so needs to travel directly home. No ambulance/hosp transport available.
Physio suggesting leg up on back seat of car with wheelchair transfers to service station for toilet breaks.
Is this reasonable 4 days post surgery? Any helpful suggestions or recommendations for wheelchair hire?
She won't contemplate going on train with me which I think will be easier to manage.
Hosp keen for discharge ASAP.

HELP! Travel likely on Fri.
(And please feel free to send sympathies... it will be a long journey...)
Private ambulance unaffordable and taxi driver unlikely to be able to help her with toilet....

Has everyone who is suggesting an ambulance travelled in one recently? The last one I went in wasn't comfortable. My car has a much more comfortable suspension. Maybe I was just in an old one 😂. Also, would an ambulance travel slower?

The OP's mother is not fit enough to undertake a six hour journey.

At age 9, dd did something similar. We got her to my mother's bungalow a few days later. DC staying there befor we went on holiday. At 9 it was extremely difficult manoeuvring her in and out of an MOB. Mother has a bungalow and lived two miles from the hospital. The doctors advised dd was not up to a holiday involving a long drive and we cancelled. After ten days at my mother's she was able to make the 2 hr journey home. We removed a seat for this.

The POp's mother is 70. The hospital needs to sort out a temporary nursing home or keep her in hospital.

HeddaGarbled It's a situation where the hospital would weigh up the relative costs. If the OP's mother has to stay in the hospital for many more days not only is that costing every day she may prevent someone having elective surgery (for which the hospital is paid more) due to a lack of beds. Also, the longer she's in the more likely she is to acquire an infection which would require treatment and potentially an even longer stay.
The ambulances used for hospital transport are different from those used for emergencies (sorry if that is obvious)

My aunt (similar age to your DM) has just had a knee replacement (not the same, I know, but similarly incapacitated) and is going to a nursing home for ten days after her hospital discharge, which is why I suggested that earlier. Is there maybe somewhere local that your DM could go for a few days while she got a bit stronger and more able to undertake such a long journey?

At such an early stage post-op, she'll be in pain, easily tired, and might risk doing further damage to her ankle, with long-term repercussions.

It's a difficult situation for everyone - I hope you get something sorted for her.

Absolutely talk to PALS. usually patient transport is provided if there is a medical need. There is in your Mothers case. Either the hospital can provide or her home CCG can provide it. It might be worth ringing them too.
To the previous posters worrying it isn't an emergency vehicle out of action it is a transport vehicle specially for this purpose. The London teaching hospitals for instance transport patients all over the country. It's a consequence of having centres of excellence in big cities, not all the patients are there.

Tell the hospital you are unable to transport your mother, don't give a reason, just say you can't. They will then have to sort it out. You will be made to feel very guilty but keep telling yourself it's not safe for you to take her. Also she may need an OT assessment done at her home too, I'm not sure of the criteria. For this but it would happen for a hip replacement say. Contact the community nurses attached to her GP surgery for advice. Good luck with it all

I'd refuse to take her, for her sake. I think the hospital should provide appropriate transport.

When my mother broke her hip, the hospital wanted me to give her daily injections. I was shocked and refused and wouldn't let them discharge her to me. Suddenly the District Nurse was available to give her the injections!

I had to use an non-emergency ambulance patient transfer service when I had to travel to a rehab centre when I left hospital after a double knee replacement. I would have had to pay, but cost of ambulance and 2 1/2 weeks in rehab centre was completely covered by my private health cover. It is transfer either in an ambulance or a suitable van, with a staff of two who I gather are not paramedics, but still trained in what they are doing.

I'm in Australia but out of curiosity I googled it and the UK has a similar service for which your mother may be eligible. Obviously, I have no idea about cost or availability, but it may be worth a look.
www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/Ambulanceservices.aspx
or this:
www.scas.nhs.uk/our-services/non-emergency-patient-transport-service/

Sorry, I re-read your post and you've obviously looked into all avenues, so my info was completely redundant.

It's dreadful that the NHS won't transport her, when they claim to have non-essential ambulance services, because she certainly sounds a prime candidate. The logistics of a long trip sound very difficult.

All the best.

Red cross loan wheelchairs, I think it was £10 deposit when I had one, but I didn't take a refund, told them to have it as a donation.

There should be some wheelchair accessible taxis where she can either stay in wheelchair or transfer.

Oh and look out for a PM.

Genuinely, you don't have to do this. If transport isn't available, discharge isn't an option. You cannot drive 6 hours in a car with your mother's leg elevated safely. You don't feel that it is safe or viable. She needs transport.

I'm obviously a bita younger than OP's mum but had a similar ankle injury which had to be fixed with screws, plates and a great big bolt basically running right through my ankle. Whilst I think the journey will be unpleasant I don't think there is much risk of worsening the ankle injury. Ortho surgery is really a bit like meccano and once all the metal is in everything should be pretty secure.

Oh and don't worry about the heparin injections too much either. I did all mine myself and it is quite easy - they give you prefilled syringes and you just have to inject under the skin rather than into a vein. Again not nice but not something that needs to be done by a nurse.

Please don't attempt this by train. TrIn travel by wheelchair is stressful and eventful enough when you're not in pain.

I too had a similar issue a couple of years ago with a bad fracture dislocation injury whilst in Scotland on holiday. The hospital did offer me ambulance repatriation home to South coast but I wanted to discharge myself to relatives in Edinburgh who collected me and I did travel for 1 hour with my leg supported full length on the back seat. The journey from Edinburgh to home was obviously a much longer drive. We had a car with quite a big space between driver and passenger seat and the gearstick was far forward too(old model renault grand scenic) We put a couple of sleeping bags/coats etc in the space and I sat in back middle seat with leg fully extended. It was my most comfortable drive home from Scotland ever! However, service stations were a nightmare and at one I had to beg a wheelchair from an ambulance that happened to be there, just to access the toilet as although they have nice big toilets thney are often a long walk away. Also getting out of the car was tricky. You have to push front passenger seat as far forward as you can and fold backrest forward and try and get leg/backslab angled out of the door. I have very long legs at over 6 ft tall so maybe that bit is easier for others. Do you know anyone with a car that has a gap between 2 front seats who could loan you it for a day. Can you rent one. Or insist on repatriation by ambulance. It would be far cheaper for the hosptal than keeping her another night in hospital. See if the hospital can arrange for a community rehab team to visit your mum on the day she gets home to ensure she has all the necessary equipment and that she is safe to be independent. They can put in short term help with personal care and meals if she finds she cannot safely manage.

OP - if a nursing home stay is impossible, is there a cheap-but-nice hotel anywhere near you, where your Mother could stay for a few days until she had recovered a bit from the shock of the accident and surgery, and where you could pop in from time to time to check that she's OK (or even better, where your father could stay with her)? Most chain hotels and many private ones now have lifts and rooms suitable for people with mobility difficulties. I was very keen to get out of hospital after a major operation but it was a 4 -5 hours journey home, which the medics said was too far. So I and DH stayed in a hotel about one and a half hours from the hospital for just for a couple of nights. I spent the time resting/pottering about, with nothing else to worry about. Made all the difference how I felt for the second part of the journey.

If the downstairs loo is an issue OT at the hospital should be able to supply a commode. They did for me. Privacy may still be an issue but it's better than a 6 hour car journey surely?

And contact PALS

Your poor mum. I did something similar when in the states ( no surgery there but not weight bearing) and had a really horrendous 24h getting back. However, she and you will make it. Sideways on the back seat of the car def, it might take quite a while for her to get in and out. Minimal drinks, one loo stop only. Shed loads of painkillers. Pillows for her back, head, possibly her knee. Light fleece blanket. Hugs

Have had a broken femur 3 times so higher than ankle but one of the surgeries to insert metalwork was through the knee which I couldn't bend and the other 2 times a lock leg brace after surgery. Easiest way to transport for me was leg straight across the back seat ontop on a bed of pillows. Tbh I just wanted to get home so I loaded up on pain killers, had a wheelchair from Red Cross to and from car and gritted my teeth. If you are worried about bathroom breaks and your DM is catheterised at the mo then they could leave it in and get a district nurse to remove once she is home.

Another option, depending on how tall your mother is, would be the E-Z-on harness from In Car Safety. It's £168, but would allow her to lay safely across the back seats with pillows, using the back seats as a bed.

What would the hospital do if your mother didn't have a dd or a dd who owned a car?

They'd expect her to make a suitable alternative arrangement Roses

Hospitals aren't responsible for getting people home from their holidays, if they are medically fit to travel.

...that's why everyone should have travel insurance...

Exactly my thoughts Yellow.