Realistic recovery in elderly 86 year old male relative broken hip

[Chenecinquantecinq]

HI looking for advice really please. Elderly 86 year old relative next of kin. He is very stubborn with some eccentricities at play. His house has no central heating or washing machine (he says too hot and he wants to do plumibng himself) he flatly refuses to allow me to organise this even though he'd get a grant. He allowed me to get an alarm but he didn't use it regularly so when he fell in middle of the night the police eventually broke in (he'd bolted door internally). He is currently in hospital due to go to rehab but after this he is insistent he is going home. He was barely managing at home shuffling about. His stairs are not compliant to building regs now more steep narrow ladder type. Will the NHS discharge him to this environment? He has no downstairs facilities except a loo. My mum (his sis in law) who is elderly herself and lives an hour away in feeling guilt as she promised her sister she'd look after him. Anyway just looking for anecdotes of a realistic recovery in a frail 86 year old man please? thank you

MIL broke her hip at about the same age. She went to rehab, and is still doing ok in her nineties, although she is much slower on her feet. She lives in a flat though, so no stairs to contend with. Does he have a downstairs bathroom?

Sorry, just seen he has a downstairs loo. As for whether he would be discharged to his current situation? I was discharged last year from foot surgery with a hospital bed on my ground floor and only a downstairs loo, no shower. But I had someone to bring me washing water and am 25 years younger.

DM broke her hip in March, aged 87, so 9 months ago.

She has lung problems which means she gets tired easily, which impacts on exercises, impacting on recovery.

She is still mainly using a zimmer, recently graduated to sometimes using 2 sticks.

She uses a stairlift but recently managed stairs at dentist with support.
We got bath removed and replaced with walk in shower.

She has carers daily to help wash and dress. DF does the cooking and fetching, and helping her get ready for bed.

She couldn't cope on her own.

They shouldn't discharge without OT visit. They should be able to provide NHS funded carers 4× daily for 12 weeks. I would look into a stairlift and exoect one to be there before return home.

Ask for adult social care to get involved.

My mother broke her hip at 90 and during lockdown. Similar setup house wise - we turned her living room into a kind of temporary bedsit, moving a bed from upstairs, having a small table and chairs etc. My brother bought her a tiny fridge, and she managed washing in the kitchen sink for a while - not ideal but safer than going upstairs. Her house was inspected when she came out of rehab and she rejected many of the suggestions but did have a walker which she shuffled between kitchen and living room with.

It definitely knocked her confidence a lot and recovery took a while but she's 94 and largely back to normal, living in the same place, doing all she used to do. She does carry a stick but uses it more for pointing than leaning on. 😳

It really varies. There is a big chunk of people who die within a year of a hip fracture but a lot don't.

My prediction will be that your relative will end up agreeing to a few things like a package of care in order to get out of hospital, and will then cancel it all as soon as he crosses his own threshold - exactly like the alarm. He will probably have more falls now and more hospital stays.

I don't think your aunt should have got your mum to promise anything, and she must know that he will go on doing what he prefers. Isn't that what she would want for herself?

Thank you so much for the responses. I think as @PermanentTemporary predicts this is the likely outcome saying what is required to get home then cancelling care unfortunately hopefully I am wrong.

My Mum broke her hip over a year ago, she was already on a pallative care pathway with mulitiple illnesses so a different situation.

The surgical registrar was very honest with us and said older people who break their hip will have reduced mobility. He said someone who walked by themsleves would need a stick, if they used one they would need 2 and if they had 2 they would need a zimmer but if they used a zimmer before it was likely they wouldn’t walk again.

Does he have capacity to decide - even if he is making what looks to you like a really bad decision? If so, then he will probably be allowed home as is. If you want to get involved then you can try raising the alarm by contacting the hospital social worker or social services.

OP, I think it’s safe to assume this will be the new starting point on his release.
From your short post, he has determination, but he’s unlikely to use it as a superpower to work with you and ‘do all the right things’.
You and DM should brace yourselves for his resistance. I’d be gaining knowledge of the care homes in his / yours/ your mum’s area, or on the level elderly rented accommodation if he has funds.

Update the NHS are discharging him. Amazingly they were attempting to do this without an OT visit to his house to assess and provide any necessary equipment. Absolutely shocked even the Ward nurse said to me he’s not ready. Apparently this is all on the advice of one physio. After desperate e mails to Discharge Team I’ve managed to delay it until a Social Services visit to his home to assess. The lady in the Discharge Team off record basically said start looking at care home options as agrees there may well be further accidents. There’s nothing they can do apparently when someone has capacity even though they know it’s unsafe. I knew this but amazed they were going to send him home without a prior home assessment. Anyway very frustrating as it’s so obvious where this is headed.