Hip Fracture - how long until operation?

[EssexMan55]

Hello

My elderly father fell over and has fractured his hip. He has been in hospital since Friday afternoon and so far there is no sign of an operation to fix this. We have been told they will operate, but the nurses just say they don’t get told any details about when it will be so they can’t advise further.

we are worried because we have read the longer the wait for the op the more likely there will be complications and less likely it is he will regain mobility. He was completely independent until the fall, driving and walking everywhere. He is 83.

does anyone have any experience of this? If this is true about a long wait being is there any route to complain and put pressure on the hospital to get on with operating?

Thanks!

I'm so sorry to hear about your dad. My DM83 broke her hip in August, also on a Friday. Nothing happened over the weekend and we were just told she would have her op "soon". If my memory serves me right she had her op the following Tuesday.

My DM has regained around 80% of her mobility but this can also be attributed to the fact she also has a very arthritic knee (which caused her to fall we think in the first place). They pinned her hip rather than replace it which I have never really understood as we were never able to speak to the doctors ourselves and DM's memory is not great.

If I can offer any advice at all it would be that the after care they receive when they are home is critical. My DM lived with us for around 8 weeks (we converted our dining room into a bedroom as it was next to the downstairs toilet). She did have a carer coming in (arranged by the hospital) for a couple of weeks during the morning to wash and dress her as I was at work but I then ensured she was eating properly and helped her with her exercises etc. It worked out well and my DM was able to return to her own home. We have had to make some adjustments, ie a stairlift, although she can walk up the stairs now but we worry about her knee giving way. We have also had to take out her bath and replace it with a walk in shower.

Having said all of the above my friend's DM80 had a hip replacement a few months ago and is now almost totally back to her original mobility!

Wishing your dad a speedy recovery.

Aunt 91 at the time had a fall and needed hip op. Think she waited 2 days for the op. Was in hospital for 12 days but saw physio and was sitting on chair next day. No help given at home and was given a zimmer to use. Lives in a bungalow so only one step to get into the house. We arranged a door rail for back door. Had to raise cushion for her chair at home and extra cushion at her back. She managed fine. Really important to do as physio says.

Maybe tney are waiting for the teams to come back to work on Monday.

If you haven't heard anything by Tuesday morning, I'd ring the Consultants secretary and ask which day the op is scheduled for

We had this problem when my mother broke her hip at 86. There were signs up everywhere in the dept saying how important it was to do it as quickly as possible but they kept telling us when it would be and then it would be cancelled due to an emergency coming in. They left her 3 days and it wasn't a good outcome. I wished we'd made more fuss but you kind of feel you are in their hands. I just felt they prioritised younger people which in some ways you can understand but it doesn't help when it is your loved one involved.
I hope she gets the op quickly now but push as much as you can.

Not a hip but when DH broke his leg on a Friday he didn't have his surgery till the following week. They explained that they don't have many surgery staff on at the weekend and emergencies come first - I think he was due to have the surgery on the Monday but got bumped a day or so because emergency cases needed the slot.

Thanks for all your replies. Have been told it will be more than a week before they operate!!

That does seem a long time. Did they give a reason for it taking so long?

I'd have a little chat with PALS and the surgeons secretary. It's amazing how patients can get moved up the list if a few questions are asked

They said it needs a very specific surgeon to do the job. When we asked if private is faster have also told it can be done sooner if we pay privately.

There are standards for the management of hip fractures and if they’ve already said over a week it sounds like his injury is not a ‘bog standard’ hip fracture. I’d be very wary of heading down the private route for something like this (especially if it requires transfer to another hospital) - he needs proper orthogeriatrician/icu back-up and that’s less likely in the private sector.

My Dad had to wait a few days as he was on a blood thinning drug, Warfarin, and it was dangerous to operate with these in his system. Could it be that?

Thanks again everyone. The operation eventually happened Wednesday, they got him into chair already but he can't yet walk.

I am confused about what happens next. There is talk of "nhs respite" care - what is this exactly? Apparently another patient on the ward has been sent home on the grounds respite centres are all full and the children live nearby and so can look after them.

He has asked us to investigate private options and we have spoken to one care home that offers respite care. But they say all they can do is care for him, whilst any physio has to be organised by someone else. They said all NHS would provide is a once a week visit. Is that what he would also get in the "NHS respite" centre or it would be daily? In which case the private option does not sound suitable (unless we pay for a private physio to come in ourselves)?

I don't know what area you are in but we have some old small hospitals in our area that are no longer used as main hospitals but now have rehabilitation wards that take generally elderly people recuperating after operations rather than bed blocking the main hospital and there they get daily physio. I would check was is available in your area before looking at private.

Post-op NHS physio for elderly hip fractures can be very hit and miss, depending on your local services. If my 83yo dad had fractured his hip I would try to track down a specialist and pay for private daily physio. MIL had two elective replacements and recovered very well doing her physio at home, but she was very highly motivated and it was all planned round her.

Locally we have a lovely rehab home targeted at the private hip/knee market - it's expensive but you get physio daily or more, there is hydrotherapy, lovely surroundings and good food. There is likely to be one near you - google/phone private hospitals if you're interested.

I would advise you that you are in the strongest position to negotiate while your dad is still an inpatient. Don’t be fobbed off with vague promises that it will be all sorted out when he gets home. He should make the most of the physio and occupational therapy in hospital and you can reinforce and help, e,g, when they think he can walk with someone or remind him to exercise as the physios advise.

Does he live alone? He will probably need the OTs to go out and check he can manage and what aids he may need, raised loo seat, gab rails, zimmer, perching chair etc.- they can do a home visit with him while he is in hospital. Unless it’s changed, usually up until 6 weeks of care at no charge can be provided at home on discharge for everyone that needs it ( not means tested).

Just keep repeating, he lives alone and is vulnerable, I don’t want him to end up as a failed discharge (where they discharge him with no proper plan and he can’t manage, falls again etc.). If he has enough money, it may be good to reinforce NHS physios with a private physio, but I would take what you can from the NHS, otherwise someone is likely to write in the notes, daughter said she would arrange private physios. I would think carefully about offering to stay with him when he comes home, tell them he lives alone - once you have NHS care in place you can always stay over, but I wouldn’t advise offering this up front as you will end up with nothing or very little in terms of support.

i had the same problem with my elderly aunt - after 3 days of no surgery i told them that this was unacceptable and that i wanted it done the next day. they did do it then but why should you have to battle with them. she did not gain her full mobility and went into a care home where she was happy but just went from bedroom to her chair in the lounge. if i were you i would not accept this delay

lh

i would pay for a private physio it is not that expensive and one to one works well. you should not have to but there a few alternatives with the state of the nhs

lh