Dm non weight bearing after busting her knee - hospital want to discharge to home

[whojamaflip]

Dm broke her knee very badly 6 weeks ago and has been in the local community hospital since. Completely non weight bearing through the leg and has been been told it will be at least another 3 weeks before physios will allow her to toe touch.

hospital now want to discharge her next week to home where she lives alone in a rural area. House is on many levels with steps between rooms and uneven floors. Assume there will be a care package in place with carers coming in but in my opinion this doesn’t feel very safe?

it is an option to ask for her to move to a rehabilitation facility instead?

This is common.

i broke my ankle with a major break in multiple places and required a couple of surgeries.

the usual criteria for discharge is that they’ve given you crutches and you can do the steps on crutches.

does she have other health issues?

I found it helpful to hire a wheelchair.

is there a loo on the ground floor?

If your mother has been in a community hospital for 6 weeks it sounds like she's had the free reablement package as described by NHS England and anything further may be means tested. Your best bet is to contact the discharge liaison team at the hospital to ask about the plan. Lots of bed bound people are managed at home with a care package so there could be an argument she doesn't actually need to manage uneven floors, etc.

Hospitals need to sort bed blocking, we no longer have convalescence homes and if family can't help, social services will provide a care package. I think the system needs an overhaul to be honest

Ok I thought she may have already had her 6 weeks package. Wheelchair is not suitable as due to the nature of the injury as yet she cannot bend the knee enough to sit in one. She’s not at the stage of crutches or zimmer yet and is still bed bound. It was a really nasty injury which involved ripped ligaments and shattered bones in both the upper and lower leg requiring plates and pins and an external fixed brace

we’ve had no discussion about ongoing care needs at this stage just a throwaway remark to dm by one of the nurses to tell she would be going home next week!

You may be fortunate and entitled to carers coming in between 1-4 times per day paid by the nhs for a further 6 weeks but they may be difficult to put in place in a rural area.

I lived in a multi storey house after leg surgery - not ideal but slept on the sofa with extra height added on rather than be holed up upstairs - it was do able on two crutches and non weight bearing with phone round neck in case I fell. I coped with washes etc as I could not manage stairs.

I sorted out furniture so if I fell it was against tables etc . Also got a lot of food that was microwaveable from the cook shop and had a table next to it so I did not have to carry anything. All pretty miserable but better than hospital.

I am always desperate to get out of hospital - if your mum is elderly you may find she deteriorates further if she languishes in hospital for longer - if she needs help and can afford to pay she may find some one on her local Facebook group that provide companion light cooking and cleaning services - if the nhs won't fund.

In that case you need an OT assessment and to get the district nurses involved as if she is bed bound she will end up with sores unless she gets daily physio and proper care.

Hopefully it was a throw away remark as you tend to get a lot of conflicting news on discharges.

Best option would be NHS funding a care home for 6 weeks if you have not already had the funding?

Something was said to my mum during a recent hosp stay,I made it very clear I wasn't around to help as I live 4 hours away. She actually stayed in a further 4 weeks and has only recently been discharged with a care package. Speak to the staff, ask what the plan is.

It doesn’t like you really know what the plans are and are potentially getting worried before you need to be. Speak to her OT. But yes, people do go home living in a ‘micro environment’ or even bed bound with care and hopefully rehab at home. I doubt she is just in bed in hospital, but if she is, they can have her doing that at home, she’s not medically unwell so doesn’t need to be in hospital.

My mum was discharged home while bedbound following a foot fracture. Her injury was not as major sounding as your mum's but she could not use crutches and was under strict instructions not to weight bear at all.
She was provided a hospital bed and a commode plus a care package. It was a pretty bleak existence for the 8 weeks or so until she was able to start wearing an orthopaedic boot. But, better at home and away from hospital acquired infections.

Does your DM have funds to cover spending a few weeks in a care home while she recovers further?

When my DM was in hospital after surgery for a broken hip I noticed there seemed to be a strong push to move patients on after 2 weeks. There would be throwaway comments about 'going home next week'. In fact DM spent 3 months in hospital.

As is the way of things one thing triggered another. DM now has advanced vascular dementia and is on end of life care in a care home.

Nothing here for district nurses to do

She will require an OT assessment for equipment at home.

Hospital will have social workers who can arrange a package of care - possibly paid for. There doesn’t seem to be a reason to keep her in hospital if she could be cared for at home

Could you take AL / carers leave and stay with your DM for the first week. Gives you time to see the level of care needed and arrange.

She is not going to get daily physio.

Exactly. And OT & district nurses would do physio either

Make it VERY clear to the hospital that your mom has no one at home to
help her and YOU won’t be doing it as won’t be there either! Do NOT mention helping or anyth Or they won’t put in carers or anything and also will just discharge her jome
wirj no shits given as to how she will
Cope!! Until she can get round her house alone and manage to get to the toilet
alome
etc she can’t be discharged! ASm to
dpesk to the social worker and OT etc at hospital and make this very clear your mim
has no
one at home
to help her and lives ruraly otherwise they will expect you to be lifting her onto the toilet and cleaning her up etc 24/7

Im 64 and was confined to bed for a whole year while I waited for a hip replacement which was screaming agony, also trying to work from home full time and live alone. I was left there with zero assistance and GP said if you cant cope you'll have to go to A&E. A&E said dont come here we are not social services!!!!
I had to apply for PIP which I got very quickly which paid for a weekly cleaner and I just had to order everything in via internet.
It took me an hour to get to the bathroom.
I ended up on morphine which made working from home and doing online patient consultations a right laugh as I was completely stoated.
I managed to get some crutches and hired a private physio to come and show me how to do stairs on them.
A neighbour had a key and would let deliveries in.
It was a total nightmare but this is the NHS now.

How old is your mum?

You could have had a care package from adult social care. Im surprised no one suggested this.

Yes you can ask for this but would depend what rehab is available in your area and whether rehab is likely to work for her - depends on age etc. I would ask