Dad in hospital 6 weeks and keeps getting infections - should we/can we move him out to private or respite?

[LindsayLaing]

82 year old Dad fell at home 8 weeks ago and fractured his spine. Up until that point he was fairly mobile. Paramedics who came out missed this and he wasn’t admitted to hospital until 6 weeks ago when he couldn’t get out of bed one morning. They decided to treat it conservatively - physio, back brace etc. since he’s been in hospital he’s caught flu, pneumonia and two chest infections - doctors said this is unfortunately common. He’s also had a blood clot on his lung from being immobile and is now in adult nappies and has a catheter as he cannot get to the toilet. He has COPD and low blood pressure which caused his fall - his blood pressure plummets when he stands. They’ve just started him on a new medication for the low BP (started last night 6 weeks after being admitted). Mum and I are now feeling that they’ve given up with him and she’s worried he won’t come out. He went in with a fractured spine (which docs think has now healed itself) but now has loads of other problems caused by being in hospital. They keep saying he’ll be discharged soon but then something else happens. He’s been moved 3 times and each time he goes to a new ward they seem to start all over again. They apparently only have a few physios for the whole hospital and he’s lucky if he seems them for 3 minutes a day. The longer he lays in bed the less chance he’ll walk again. Every visit we try to talk to a doctor and they tell us different things and we never see the same doctor twice. Mum has complained to PALS. Would a private hospital take him on in the middle of treatment or would a respite place be better for him? They will have funds soon from their house sale so could pay for some private care for a while. Thanks for any advice.

Oh bless you, a private stay will cost thousands upon thousands and he’ll likely have the same issues. His immune system sounds very weak right now. He can’t go to respite yet, he needs medical care. So sorry you’re going through this.

He sounds like a very unwell man, they wouldn’t keep him in if he wasn’t. Again, I’m sorry you’re going through this.

Private hospitals are very good at taking in basically healthy people who need a knee replacement or a gallbladder op, doing it, getting them back on their feet and ejecting. I’m not sure they’re so good at dealing with something less well defined or more long winded.

Hospitals don’t keep people in for the fun of it. Most problems are because they’re discharging people who are not well enough to look after themselves.

From my own 83 year olds mother's experience (she was hospitalised for one thing and then developed something else in hospital and ended up there for three weeks and lost all ability to mobilise properly) get him out as soon as you can or at least visit him and encourage him to walk around a little
They are so understaffed that they won't encourage mobilisation for fear of falls, but at home this can be encouraged.
The hospital will be "safety first" and he would have to discharge himself to get anywhere.
I look back and think in my mum's case hospitalisation absolutely hastened her death, although it was cancer that was on death cert. They only discharged on grounds she was on palliative care package so no active treatment. So many things backfired in hospital...muscle wasting, UTI from catheter, embolism, the loss of agency. Get him out with care set up, hospital bed commode, Zimmer if you can.

Hi there, just a thought, repeated chest infections can sometimes indicate a swallowing problem (dysphagia) - a speech and language therapist can diagnose if there is a suspicion this might be the case for your dad.
Wishing you all he best - I hope your dad recovers soon 💐

But they won't discharge when it might look bad from a tick box point of view. My mum was in a hospital with horrendous bed shortage yet they kept her there for all the wrong reasons. She has to advocate for her own discharge in the end, but the damage was done.

I've been in a similar situation with my mum..in for severe UTI,picked up 2 chest infections leading to a "mild" heart attack.Is he in a shared ward?If so ask for him to be moved to single room.He's infection risk for others and he's at risk too.Also enquire what antibiotics etc he is on - are they targeted to his actual infection?They should send sputum sample to lab and medicate accordingly.Physio should be mobilising him( assuming he still can mobilise) and OT should also have input to get him independent prior to discharge.Make a formal complaint if that's not happening.Also if all else fails get him to walk ward with you when visiting.I can't imagine staff would have an issue if on ward with Zimmer or stick assuming again he has some mobility left and the low BP is under control.Use of a catheter simply because he can't mobilise is ridiculous!

Go ask around local care homes/nursing homes
See if they will take him .
Count on spending 2k a week
For relative the move has benefitted eg better food and just being in non hospital environment . They would not take until off all nursing interventions but if the home has nurses on site in a nursing section eg daily injections or antibiotics infusions might be ok
She cannot walk after fractured hip . She is self paying. She was moved very weak and on stretcher.

@LindsayLaing so sorry to hear about your dad. Unfortunately NHS is failing badly. They will say he is too poorly to transfer so private are unlikely to take him, same with respite. A hospice would say he’s not at end of life.

You need to put a formal complaint in, not just PALS.

I know you probably can’t do it, but he needs to be home. He has to be up and moving in order to fight infections and mobilise.

They wouldn’t be keeping him in hospital unless they thought it was necessary.
Unfortunately what you describe is all too familiar.
My own Dad walked into hospital with me when he wasn’t well, GP not interested in seeing him and sign posted us to A+E.

His bloods were all over the place from the sheer number of meds the GP had prescribed. Nine different tablets in all!

After a week he couldn’t walk and had to be transferred to the bathroom in a chair.
There was very little interest in his failing mobility from the medical staff so one day I spotted an Occupational Therapist doing her rounds and had a frank conversation about it.

She sorted out some Physio for him before he was transferred to a non medical ward ready for discharge .
At this point he couldn’t return home so was discharged to a care home for rehabilitation. NHS funded for 4 weeks and then we have to pay £1200 a week after that.
To be honest it’s touch and go if he can return home.
His hospital stay has absolutely destroyed him, it’s just so sad to see how much he has changed in such a short time.