Hi there,
New to all this…
My 86 year old gran is currently in hospital with a broken pelvis, following a nasty car accident. She has been in for three weeks and was in a lot of pain initially, both from the fracture and some lacerations. They are still treating the latter, but allowing the fracture to heal by itself, with phsyio. She also had tests for a suspected heart attack, but these were inconclusive as far as I can tell. She has only started moving around in the last week and can now walk painfully around the ward with a walking aid.
We assumed she might transfer to an intermediate/rehab centre locally, but yesterday were informed that she may well be discharged home this weekend, if “medically fit”. They said she was “too capable” and wouldn’t qualify for intermediate care, based on answers she gave the physio and OT about her living arrangements, care etc. They are proposing to discharge her without any care support and without having done an assessment of her home. I assume she will get physio visits and possibly wound care, but am not entirely clear on that.
She lives alone in a ground floor flat and was previously very fit and active, doing all her own shopping, cooking, cleaning etc. She also drove until very recently when she decided to give up her own car. She has, however, had two major falls in the last year or so, one which landed her in A&E with a suspected broken nose, and one trying to step up into her shower, leading to a nasty leg wound which took 3 months to heal and has left a large scar. She has also had some problems with her eyesight (two recent cataract operations and slight AMD that makes transitioning from different levels of light more difficult).
For her to go home, we would need to get a trolley, toilet seat, suitable chair, possibly a different bed, a panic button system etc etc. She would also be unable to use her bath or shower safely, or wash her hair, so there are concerns about hygiene. She often has home delivery for her groceries, but uses a step to reach high kitchen cupboards, which obviously now wouldn’t be safe. Previously, she cooked all her own meals, but would now be unable to safely use the oven or hob… All her doorways have lipped thresholds so moving a walker around would be difficult and unsafe. She has tried crutches once, but wasn’t confident on them at all. Her flat has steps to the front and back doors, plus a very high threshold to the latter, which would prevent her from accessing her patio/garden.
So we are very concerned about the plan to discharge her with no support. Neither myself or my aunt live in the same town (although we are both within 30mins drive) and, whilst we are able to help with shopping, a little cooking and cleaning etc, we can’t be there all the time to assist with getting up, dressed, washed etc, or to assist with every meal. My aunt and uncle both work full time in busy jobs and I also work part-time, around looking after my young children. We are also concerned that, having been so active and independent prior to all this, she will be tempted to try and do too much too soon… I’m not clear at all whether there is a “care plan” of any kind on place in terms of what goals she might work towards and when it might be safe to try undertaking various tasks, nor what follow up reviews or physio is planned.
With more time, we may be able to arrange some private care and get all the necessary equipment in place etc, but it feels like they are rushing her home before she (and we) are ready. The ward isn’t full to my knowledge, so no acute bed issues, although I do understand that they don’t want medically fit people staying in hospital longer than necessary. Overall, we were very shocked that no home assessment would be carried out, and that she wouldn’t qualify for any intermediate care at all. We understood that up to 6 weeks intermediate/reablement NHS care should be available, but it sounds like they have “assessed” her based on her answers to their questions alone. As family/potential carers, we weren’t involved in that discussion, only advised afterwards that she is likely to be discharged straight home in the next few days.
Does anyone have any advice? We are obviously going to request a meeting with the doctor, physio, OT etc. Are there any other services that we should be involving? Or any sources of information that might be of help? She is obviously very keen to get home, as anyone would be, but we desperately want to avoid her having to cope alone too soon, and potentially having a fall that lands her back in hospital.
Thanks in advance,
Tigs
Should this be our first course of action?? Had planned to raise our concerns with her hospital team as a first step… but does it need to be taken higher more quickly?
