Dad deteriorating in hospital - just want him home

[Bedbouncer]

Dad is 86 and had a fall which broke his arm a week ago. He was putting the lawnmower away after mowing the lawn, which illustrates how well he was. He was also still driving and mentally very sharp. Since being in hospital he has deteriorated shockingly- he struggles to string a sentence together and is hallucinating, which I assume is the effect of the painkillers, but the staff - who appear pleasant enough- assume that's just how he is, and don't take him seriously. He also hasn't managed to walk since being admitted and is complaining that some of the staff are rough with him. He lives about half a mile from me with my 82 year old mum, who is also still very sharp, but wouldn't be able to manage him by herself physically as he is. The hospital suggested discharging him to 'a rehabilitation unit for intensive physio', but the potential places they have in mind look more like care homes to me. I would be happy to move in with my parents for a few weeks to help while he gets back on his feet. I think he just needs to get off the strong pain meds - there's nothing wrong with his legs! I work from home, very flexibly and can work anywhere. But am worried I might be biting off more than I can chew. Due to speak to his occupational therapist at the hospital tomorrow. Do I say we want him home, or go for the rehab/care home??

I was coming on to say some of this.

As someone who ended up trying to take care of an ill and newly immobile 87 year old Dad last year, I would urge caution too. I fully understand the instinct to just "get them home" but it really isn't always that simple. You have to be certain that it is manageable, and the NHS will wash it's hands of you if you take on the care.

My Dad was supposed to be discharged to rehab because while on the ward (pneumonia, but not Covid related) his legs had weakened so much that he lost his ability to stand or walk. He needed intensive physiotherapy in order to have any chance of even standing ever again but he didn't get it. They didn't discharge him to rehab and just hoodwinked my mother into thinking that all was much better than it was and sent him home. That made our lives impossible, even with privately funded carers coming in four times a day, and in a bungalow too (so no stairs).

I was totally unable to manoeuvre my Dad around, and even when the carers were present it was almost impossible. Dangerous even. My Dad wasn't even a big man.

I am urging caution, though I do know from experience exactly how hard this is on everyone. At least get answers to your current questions and an assessment of his likely ongoing needs before bringing him out.

You will need to know that you will be able to cope, and believe me when I say from experience that it was fiendishly difficult. Never underestimate the problems and challenges involved in caring for an immobile adult. They are very difficult to support so even getting to the toilet at all can become a problem. It really isn't just a matter of bum wiping, that is just a small part of it. I ended up cleaning up shit from the floors and furniture. We ended up in crisis and the carers had to involve the Adult Social Services Crisis Team.

I'm sorry you are in this position. I do know it is awful, and I hope you find a suitable way forward.

Sorry if my post above sounds extremely negative but I was on the receiving end of the "just get the patient (my Dad) home" policy when the NHS itself did just discharge him with virtually nothing in place. It was counted as a failed discharge and it was utterly traumatic for us and for him.

Now, when I hear this type of story I am wary. Some people have been trying to explain some of the difficulties to you. The difficulties are unfortunately VERY real. It isn't just shoving a bedpan under them and/or bum wiping. Moving them at all is a challenge even with the right equipment (for which training is required).

You will not be give bed rails in a home environment if there is confusion or dementia. As leaving them up creates a massive fall risk as the person will try to climb up and over the rail.

I’m a doctor who looks after elderly patients. I would ask for a meeting with Ward sister , doctor from the team and therapists. Talk to them about POA ans his current needs.
I would caution you against just getting him home if he can’t walk.

I had a similar issue . My Aunt , 97 ! lives with me and fell , hurting her hip and dislocated her shoulder. After hospital , where she was bedridden , it was suggested that she needed rehab. In meetings , we agreed that the very minimum she needed to be able to do was to be able to walk with her frame again and have use of her hands to eat , etc. Unlike hospital , rehab should have regular physio to get patients ready for discharge to home. Also this allowed a new Care package to be put in place with extra visits.

I believe to go straight home from hospital would be very difficult for your family to manage. It is harder than you can imagine .
It is unfortunate but he is lucky that you are available to advocate for him. Do try and get the full names of anyone you talk to about it ie Dr , nurse , care coordinator. It does help.

I’m sorry you’re going through this. We had a very similar situation with my 89 year old dad last year, and my sister and I fought hard to get him home with the support he needed there. Within a matter of days we got him a hospital bed, commode and carers 4 times a day for 6 weeks. He went from being almost entirely immobile, having hallucinations and pulling out his tubes in hospital to walking (slowly) to the post box. You know him better than the hospital staff do-it’s very hard for them to take a holistic view with frequent staff changes, so get him home if that’s what feels right. Good luck xx