FIL broke hip in fall- how to get help for him please

[SundayLieIn]

My FIL fell last night and broke his hip, it is being replaced today.

My concern is that he will be released from hospital into exactly the same situation that caused him to fall in the first place- namely PIL are really not coping at home, but really can't / won't see this.

Is there a way to ask for an assessment for him and if so who do we approach/ what do we ask for? Is there any process in a hospital where they consider this sort of thing before they leave?

Problems in brief are FIL only sleeps about 4 hours a night so is permanently exhausted and disorientated, but says this is because he is so busy taking his medication etc, eats little because he is worried about food interacting with his warfarin, (always takes such advice to the extreme)and is now extremely underweight, their kitchen and toilet areas are filthy as both are too frail to clean them, they won't have more help in the house, as they fear the intrusion and loss of control.

I think it all centres around FIL's mental health. He has always struggled with control issues but has had the physical strength to domineer and now this is failing finds it very hard- he is anxious and sometimes paranoid, and his trains of thought are actively harming him but he can not see this eg "I can't go to the gp to get my antibiotics because I have to stay at home to complete my new medication charts so that I will remember to take my antibiotics when I get them"

MIL had a terrible shock finding him on the floor last night and is very anxious, almost detaching from reality.

What can I be doing to get them some more help and to help them see they need it?

Hi

If you speak to them at the hospital and ask them if they have done a 'falls risk assessment'. If this shows he needs help regarding his safety they will work with him with a physiotherapist, and possibly occupational therapist to make sure that he is safe at home :)

Have you spoken to social services?

Thanks, I will get DH to ask about the falls risk assessment (he is at the hospital, I am at home)

Social services is not something I know anything about so hadn't occurred to me to think about them- would they be interested in this?

When my aunt had a hip replacement she was only allowed to go home once the hospital knew there were measures in place for her to be looked after. Mention your concerns to the hospital.
I would get in touch with social services.

My mum had help from social services when she broke her leg. They were very good - loaned her equipment that she needed to get around while she was recovering and checked that she would be okay at home.

Thanks, Annebullin, do you know how social services did this- did the family contact them or is it something that can happens through the hospital?

I'm not sure sorry - one of my sisters may have contacted them.
You could ask at the hospital whether they refer on or not?

Whilst he is in hospital he will come under adult services ( social services) at the hospital.
As said above he also needs an OT assessment. Ask the ward to make sure that these happen. However in your shoes I would also ring the OT and adult services depts directly and express your concerns.

Thanks, the advice is much appreciated. I am texting it straight to DH as I read it.

My PIL had carers visit a couple of times a day when MIL broke her hip. It was arranged via the hospital.

Raise your concerns to the ward. They will then make the appropriate referrals to Social Services, Occupational Therapy and Physio for assessments. He will not be discharged as long as you have concerns regarding his safety so make sure you are assertive about what it is you feel he needs and do not accept a discharge home until you are sure everything is in place.

Ideally, he shouldn't be discharged until adult services have put a 're-ablement' package in place.
Be firm about requesting this and emphasise that you see it as essential so as to avoid him being readmitted to hospital (I believe that hospitals get penalised if patients 'bounce back' to hospital after discharge).
Speak with Age UK about your concerns. Your PIL might give the impression to strangers that they are coping, but the reality is different. Age UK might have some resources of suggestions to help your PIL readjust.

Thanks, really useful to know they won't discharge if we are seriously concerned, I had a horrible thought that they would just let him out and the whole thing or worse would just happen to him again.

"Your PIL might give the impression to strangers that they are coping, but the reality is different" ....

This is exactly the problem, TheHouse.

I think they are very scared at the idea of losing more of their independence, so they try very hard to appear OK when they have to, and of course it just means that they stagger on as before which isn't very safe for them.

But it is difficult to know how much DH should go over their heads, knowing they will be really unhappy with him if he does so. (They see talking to anyone outside the family about a problem as disloyal).

I will contact AgeUK, thanks

I don't think your PIL are unusual in that Sunday - I have several friends with both parents now elderly, who sort of work together to say that they don't need help, when the opposite is true.

I would really strongly suggest you talk to the hospital,and make sure they do investigate the fall thoroughly. You want them to be looking into "Why he fell" as often this indicates underlying conditions. Also "Why he broke his hip".
If you (or DH) make yourself known as "interested and involved" it may help counter act your ILs attempts to gloss over and make it seem they can cope.
To be independent you ILs may well need help. At sometime you may want to discuss what form this will take. Now might be a good time to talk to your MIL without your FIL interferring, so find out what she really thinks.