What can we do now so we don't become 'bed-blockers' in the future.

Calendargirl

Convalescent homes would be good, but no money to run them. Our largeish hospital, 20 miles away, was where you went for operations, but then transferred to our little cottage hospital to recuperate. This was of course many years ago.

So much better than nowadays, but cottage hospitals no longer exist round here. Also where elderly folk might spend their last days was often there, cared for by local doctors and nursing staff, made visiting for family and friends so much easier,

There is money to run them - if the government (any government) chooses to invest in public services. You may have noticed that this current one doesn't! Nor the one before it. Or the one before that one!

Cottage hospitals were ideal for patients who did not need critical care and were no longer acutely ill. They only needed minimum staffing levels and provided facilities for tailored exercise and rehabilitation back into the community, giving people - especially the more vulnerable elderly - the time, space and confidence to get back into the swing of things. Our local cottage hospital had a cafeteria run by volunteers and a small library with books and games donated by the local community.

Now you are pitchforked straight from your acute bed into your home with carers (when they can be found) giving you 15 minutes per call to attend to your needs. Purely anecdotal but according to a couple of hospital porters I've spoken to, there are quite a few (but how many?) patients who are re-admitted to hospital because they simply were not well enough to cope. It would be interesting to know factually just how much money has been 'saved' by doing away with these hospitals and replacing them with 'care in the community'.

Our local cottage hospital still exists but with a much reduced capacity - there are only 29 beds for a population of roughly 500,000 people.

What can we do? - vote appropriately in the next election, so that we get a government who understands that word "service" does not signal an opportunity to pursue their dogma of competition and jobs for the boys.

I have both a key safe and an alarm pendant. I have never had to use the latter thankfully, but as I live in the country it feels good to know it is there.

There has been a reduction in community hospitals - when I was in social work I spent quite a bit of time making sure that people had rehab on leaving hospital; when I left it did not feature at all.

When I was first in social work in hospitals - longer ago than I care to contemplate! - most surgery (e.g. hysterectomy, hip replacement) resulted in a 2 week stay in a convalescent hospital. I don't think we need to go back to that, but we need to be able to offer this for those for whom it is appropriate.

I do have some treats, of course I do but I tend to eat 8-12 a day (mostly veg) and cycle around here, up some hills, from spring through to autumn.

I do need to keep my muscles strong and that was easy up to this autumn, when I was lifting heavy garden stuff and indoor furniture. All done now and I need to remember to use my hand weights that are laying on the floor by my chair and my hand strengthers

Bone strength is a very big and important factor, that battle between osteoclasts (bone degraders) and osteoblasts (bone builders) I know about that important impact exercise, star jumps, thumping down stairs and this winter I put my rebounder (with a T bar for safety) in the hall and do around 40 in and out jumps at a time, good for my bones and gives me some cardio

My mum had a severe stroke and she was slim and so was every person in her stroke ward. My bmi is likely to be higher because I have muscles, which are heavier. My muscles support my bones and protect my body structure

It's difficult, because you could take the best care of yourself and then still end up in hospital because of a fall, for instance. My inlaws are very elderly now (91 and 95) and my MIL has had two prolonged spells in hospital - and then in our local community hospital - until they could get a car package in place for her to come home. My FIL had a fall between Xmas and New Year and spent over a week in hospital, meaning MIL had to go into emergency respite care - but because she has been in there for more than a week, her care package has been withdrawn, meaning that we now have to go through the whole process of getting it reinstated. God knows how long that could take.

I realise now how thoughtful and far-sighted my dad was, 20 years ago, as he booked himself into a care home for ten days after an operation, as he did not think mum was up to looking after him at home. In the event he made such a good recovery that he was ready to go home in under a week. It did not cost a fortune and saved everyone a lot of worry.

There used to be two 'convalescent homes' near us. Seems daft that something similar isn't being put into action.
On a personal level, I try to keep as fit as possible by exercising, eat as sensibly as possible, don't smoke and drink rarely these days. It's not exciting but I feel I'm doing what little I can to help myself.
I recently met up with an ex colleague who happily told me that she 'likes a drink' (an understatement!), and never eats any fruit or vegetables. She prefers a pill for everything and thinks the NHS is for exploiting to get as much as possible for herself. I left feeling like Sam Eagle from the Muppets.

Rishi has just mentioned "Virtual Wards" in his interview with Laura K. Being monitored online at home sounds good but what happens in an emergency?

DD has a key safe so that it's easy for family to get in for childcare etc. I don't think it's just useful for the elderly.

Fleurpepper

Community Hospitals are rare indeed these days. But they are not, and have never been, dedicated for rehab in the proper sense.

Sorry Fleurpepper, I didn't see this before I posted. I think you are right. Many basic things need to be more available locally with the hospitals really dealing with the extreme needs.

Casdon

Cottage hospitals have been rebadged as community hospitals or local hospitals, or wards in general hospitals have been designated as rehabilitation wards, so beds do still exist. However, there are a lot fewer of them because due to the lack of funding in the NHS many thousands of beds have been closed.

I do wish we could be more positive and call them recuperation wards. People may not even need to go into hospital but just recuperate from something and then go back home. These could also be used as a stepping stone from hospital to home.

Having said that I think the second part is happening in our local large town.

Community Hospitals are rare indeed these days. But they are not, and have never been, dedicated for rehab in the proper sense.

Fleurpepper

nanna8

Aren’t there rehab hospitals there then ? That is where people recovering but not well enough to go home go here. I’m thinking my mum ,who lived in the UK, was right to totally refuse to go to hospital because she firmly believed they ‘killed old people’. She died in her own home in the end.

Rehab hospitals are the norm in so many countries, but not in the UK, sadly.

Read my post above Fleurpepper, yes they are still in the UK. The BMJ did a survey in 2017, when the Community Hospitals Association estimated that there are 327 community hospitals in England and 500 in the UK overall. More have no doubt closed since then, but there are still a substantial number open.

nanna8

Aren’t there rehab hospitals there then ? That is where people recovering but not well enough to go home go here. I’m thinking my mum ,who lived in the UK, was right to totally refuse to go to hospital because she firmly believed they ‘killed old people’. She died in her own home in the end.

Rehab hospitals are the norm in so many countries, but not in the UK, sadly.

AussieGran59

As a nurse I can assure you not everyone in hospital is there because they haven’t looked after themselves. I see just as many skinny people as I do overweight ones. I see fitness fanatics and couch potatoes. Yes, eat well to feel good but having your weight at the recommended BMI is no guarantee of anything.

That’s very unlikely AussieGran. As two thirds of adults are overweight, you’ll be seeing at least twice as many. But a healthy lifestyle is not just about weight anyway.

Message withdrawn at poster's request.

Cottage hospitals have been rebadged as community hospitals or local hospitals, or wards in general hospitals have been designated as rehabilitation wards, so beds do still exist. However, there are a lot fewer of them because due to the lack of funding in the NHS many thousands of beds have been closed.

Convalescent homes would be good, but no money to run them. Our largeish hospital, 20 miles away, was where you went for operations, but then transferred to our little cottage hospital to recuperate. This was of course many years ago.

So much better than nowadays, but cottage hospitals no longer exist round here. Also where elderly folk might spend their last days was often there, cared for by local doctors and nursing staff, made visiting for family and friends so much easier,

I don’t like that BMI thingo at all, AussieGran. Reckon it is based on skinny little runts and not normal people.🤸‍♀️🤸🏻

Message withdrawn at poster's request.

Aren’t there rehab hospitals there then ? That is where people recovering but not well enough to go home go here. I’m thinking my mum ,who lived in the UK, was right to totally refuse to go to hospital because she firmly believed they ‘killed old people’. She died in her own home in the end.

Maybe that's partly true M0nica but DH ate healthily, wasn't overweight and had a great intellect. It didn't stop him getting cancer and dying before both his parents.

I use poles and yaktrax when out walking. I have broken my wrist twice and never want to do that again or worse. I also have a keypad.

My poor DM fell in her own flat and wasn't found for 13 hours. She had broken her hip and her alarm was on her bedside table instead of round her neck.
Once in hospital she became incontinent because nurses were too busy to bring bed pans or help her to the loo.
There was a convalescent home for her for a few weeks but this was 15 years ago and things have not improved. She returned home to a care package and lived for a few more years.

valdali

There are still rehab hospitals & wards but sometimes patients have to wait longer to get into rehab than they would for care to be set up at home. Likewise with "good home support" there are dedicated teams working with most hospitals that provide just that, but they are very busy and there may be a wait for that option. The other problem with it is that after 6 weeks the home care / support visits are no longer NHS funded & unfortunately not everyone transitions back to being independant, so at that point they may end up back in hospital.As others have said, keysafes don't take long to fit but that certainly does delay discharges by a day or so for some people, and every day counts in getting people home before they're deconditioned, or pick up an infection, from a long hospital stay.

Thanks valdali, it’s good to hear from somebody who knows the system.

One of the most important things we can all do to help prevent us becoming bed blockers is to do balance and strengthening exercises, including plenty of walking. Reduce your risk of falling.

I read that newspaper article too MOnica. It was in the Mail.
It made very disturbing reading didn’t it?
A representative from, I think, Age UK was also calling for elderly patients to be assessed both physically and mentally on arrival in hospital and again upon discharge, and if there is a deterioration in either of those then the hospital should be held to account.

There are still rehab hospitals & wards but sometimes patients have to wait longer to get into rehab than they would for care to be set up at home. Likewise with "good home support" there are dedicated teams working with most hospitals that provide just that, but they are very busy and there may be a wait for that option. The other problem with it is that after 6 weeks the home care / support visits are no longer NHS funded & unfortunately not everyone transitions back to being independant, so at that point they may end up back in hospital.As others have said, keysafes don't take long to fit but that certainly does delay discharges by a day or so for some people, and every day counts in getting people home before they're deconditioned, or pick up an infection, from a long hospital stay.

That's what we are doing Monica trying to use it not lose it.

The other thing to do is look after ourselves: weight within BMI, waist inder 32 inches, healthy diet, high in fruit and veg and plenty of exercise. Keep your mind alert and active.

The better you look after yourself, the less likely you are to ened up in hospital.