Elderly mum had a fall -what next

[HellsBellsSmellss]

DM had a fall Friday night and I didn’t find her until 18 hours later - she’d been on the floor all night. She’s broken her hip and had the repair done on Sunday.

She lives 10 minutes away on her own. She’s 78 and has Parkinson’s. She moved here a year ago from 100 miles away as her house was too much for her, so doesn’t have a massive local network but had been really getting out lately meeting people.
What do I need to do/organise/think about for when she’s out of hospital? She could stay with us for a while as we have a ground floor en-suite bathroom but we have 4 children with special needs and home life is already crazy!

I think you need to try and speak to social services at the hospital (she should have an assigned social worker) as they are the ones that will coordinate everything to do with the discharge. She should really have a needs assessment before she leaves hospital covering whether she's safe to do things like wash and dress herself, prepare herself simple meals etc without being at unacceptable risk of future falls or other injuries e.g. burning herself if she tries to use the cooker. You should be involved in this (a) to ensure a realistic picture of your Mum's abilities is given - not uncommon for elderly person to be a bit 'rose tinted glasses' about their ability to cope out of desperation to get home/out of hospital/not be 'put into' a care home - understandable but not always helpful in terms of getting the help they need and (b) to give input into how much help you and family/friends in general can give. With regard to the latter I would always stand firm on estimating your input at the lower end of what you think you can give. E.g. if her staying with you would be possible but only just and only for a few weeks max, don't put it out there as an option or you can easily find it being a bit of a 'thin end of the wedge' situation where she ends up with you permanently because the social worker will tick their 'family have it covered' box on their forms and disappear forever (not that they actually have box, but services are stretched thin and they are always keen to have family do as much as possible).

I think the ideal solution that you should be pushing for is either for her to be discharged to a 'step-down' care provision, this can be a temporary placement in a care home or a bed in a community hospital, where she would be looked after for a few weeks while she recuperates and hopefully access some physiotherapy/occupational therapy input OR if this is unavailable in your area or assessed as not suitable for your Mum, or when she's ready to leave step-down, she should have a package of care at home which can provide daily assistance with getting up, dressed, washed, get to the loo, ensure she has food, takes her medications etc. Also a visit from an OT at home to look at grab rails, a suitable chair (maybe riser/recliner), walking aids and so on, to try and prevent future falls. She may have to contribute to this financially depending on her income/savings available but totally worth it to keep her safe and maintain independence. You can then supplement this with help and assistance from family, there's always plenty to do that carers can't cover, laundry, housework, cooking beyond the very basics, gardening and so on. You could also take this opportunity if she'll accept it and funds allow to get her used to accepting help with cleaning and household stuff etc - having someone come in to help can provide important companionship as well as practical assistance if you can find the right person...

Good luck, hope it works out for you!

OT needs to assess her home and provide equipment to enable her to be mobile (perching stool, trolley, over-bath or shower seat, grab handles, chair seat raisers etc). Physios in hospital/rehab will work towards a level of functional mobility including stairs if required. There should be team of carers and hcps to provide ongoing support once discharged (often called Intermediate Care or Reablement team) visiting at home if needs be.

Thank you!
Have been looking through local care homes and carers etc and this has really helped me focus. It seems like we need to get things in place now ready for her discharge possibly at the end of next week. We think a local care home with a fantastic reputation might be an option for a few weeks - they’re doing a 4 weeks for 3 offer at the moment. Off to do more research.

Spoke to her this afternoon and she seems to think she’ll be home by the end of June!

DM did respite care in a care home after operations. It was a good way to allow her to recover and regain confidence. However with mobility it is very variable as to whether staff can and will follow physio plans, especially if patient is uncooperative. Having two trained staff members available to hoist or transfer from bed to walking frame is not always easy and there is a concern about falls.

Also you may find she misses out on any community help from NHS or SS team by the time she gets home. The should be a hospital Social Worker supervising discharges of vulnerable patients who may know of suitable short term placements.

We are in the middle of a similar situation, with MIL due to be discharged from hospital post op, but with the added complication that she is sole carer for FIL who has mild(ish) dementia. We have found that hospital discharge will only look at her needs (not his), so only offering a couple of washing/dressing visits per day, while SS have only offered two v brief meal visits a day for FIL (I think because he's essentially safe if he's at home with MIL, but we know that in reality it will be a very difficult situation). FWIW we have decided to pay for a live in private carer for a couple of months, but it is proving very tricky to find anyone with availability in less than a month. Sorry, not much help, but sympathies - good luck!