Hip replacement - when should an 82 year old be discharged from hospital?

That's good to hear Weeme
But I ask - why is the care plan not put into place automatically, resulting in much stress and worry to the patient and their family?

I hope your father makes a good recovery.

Weeeme what a relief this must be for you and hopefully for your father. Please God he recuperates well and gets back home in a fit enough state to manage again.

My 90 year old neighbour fell and broke her hp for the second time the week of her husbands funeral which she could then not attend. However she was moved to a care home after surgery to recuperate and now she is home and doing very well. She was told she would have carers every day for help with getting up. Within three days she had cut that down herself to three days a week. She does have a stair lift and a downstairs loo and indeed a very good daughter nearby (and a nice neighbour !)

That is what we should expect , but seldom get from our NHS , but when they do get it together care is second to none . Poor man , I hope all goes well and he is fully mobile soon

Come up trumps now - but the worry for everyone by not making this clear in the first place is unacceptable.

Don't talk to me about hospitals missing fractures on x-ray!! - my life has been turned around by that. Surgery that should have happened on Day One was not done because a fracture was missed - I am still paying the price many years later with pain and poor mobility. Grrrr!

What a relief.

That sounds more like it, weeeme.
Best wishes to your Dad for a full & speedy recovery.

An update for all that have very kindly contributed. It’s now been agreed he will stay in hospital as long as it takes for him to be medically fit. The plan thereafter is that he will go into a dedicated unit for convalescence and rehab until he is fit to go home with a full care plan in place. After a bad start, it seems the NHS has come up trumps.

Dragonfly46. That’s more what I would have expected. I think one of the problems might be that he is a hardy old soul, doesn’t like to admit he’s in pain and not coping. How he managed to get around with a broken hip for 4 days beggars belief. Discharged first time around with a zimmer which he couldn’t use and a packet of cocodamol. He’s sitting up in bed now, chatting up the nurses and generally charming everyone, god bless him x

When my mum broke her hip she was operated on the next day, kept in for 2 weeks and then sent for rehab for 2 weeks even though my dad was at home. She was in her 90's and when she came out there was a care plan in place!!

Also to clarify that although he lives alone he does have family and friends support. We’re all pulling together to make sure he has the best of care. Unfortunately our experience hasn’t been the best so far but are trying to get everything in place for his discharge. Everything takes time and at this time of year it seems putting together a fully functioning care package seems a bit disjointed as people go off on holiday etc.

Thanks everyone for your input and advice. His op seems to have gone well though he is in a lot of pain post op and suffering side effects from pain relief. He certainly wouldn’t have been a candidate for day case, he’s way too frail and has had an amazingly hard time of it since breaking his hip. Admitted on Monday, 12 hour wait for ambulance, sent home next day with nothing in place and break not even diagnosed. He struggled until Thursday, readmitted and op on Friday. Hoping they will keep him in at least over Christmas to get him back on his feet, literally!

He should have to pass a stair assessment if he doesnt plan one level living with the therapy team before leaving.

They may or may not inspect his home depending on various factors. If they don't it will be an active decision based on the information they have been given and how different he is to pre admission. Not every elderly person will have one. The therapy team should be able to discuss individual circumstances with you.

Staying in hospital at this time of year is quite risky for older people. They are particularly vulnerable to Norovirus, "pajama paralysis", and other serious complications that can turn a delayed discharge into a serious deterioration. It can even trigger or exacerbate dementia and deleriums and mental health issues as at this time of year there is an increased risk of bed or ward moves in the middle of the night which is avoided as much as possible but does have to happen during "winter pressures" and can really knock older patients back.

Nanabilly, day case hip replacement ops are happening already.

www.bbc.co.uk/news/uk-scotland-46597998

When I had the hip replacement - 13 years ago - I spent 4 days learning how to walk and navigate the stairs. The OTs made sure I could use the kitchen and get in and out of the bath, using a bath seat. A neighbour who'd had the op had lent me a raised loo seat and a bath seat as well as blocks to raise the height of my bed and a 'helping hand' grabber. Social Services assessed my needs and supplemented all these aids with a wheeled trolley to carry food from the kitchen. As I live on my own, my sister came to stay for a week just to keep an eye on me. I found that I slept quite a lot. When my DS and family came for a weekend and took me shopping, it was fun to use the wheelchairs provided in M&S and Sainsbury's.

I had the same problem when looking after an aunt and uncle, both with dementia. Social Services refused to do a home visit because it was 'too far', (20 miles). I was doing thesame round trip daily and sometimes twice daily and the hospital 5 miles away that she was in, was - just - into another council area, so 'out of county' the nearest in-county hospital was 25 miles away. No I will stop there. I have ranted before about what happened. 10 years after the event it still upsets me and makes me very angry.

Yes, exactly!
It certainly wasn't because we 'couldn't be bothered' with my mum.
I asked time and again to see somebody (anybody!) before she was discharged, and got a phone call at about 8pm on a Friday night to say she was already discharged and waiting for me to pick her up!

No-one elderly should be discharged from hospital until there has been an assessment by the local Social Services Department as whether his house is suitable for his discharge and whether there are a full set of support measures in place.

Here is a link to the Age UK Factsheet on hospital discharge, which explains the whole system and all the people who need to be involved before discharge can take place. www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs37_hospital_discharge_fcs.pdf Make sure it is adhered to.

Hospitals will often try to discharge patients without going through this process, because they just want them out, but print the factsheet out and take it with you and make sure your father is fully assessed before he is discharged

Nanability - "family can't be bothered to do their bit in after care."

That seems a bit harsh! I worked in hospital discharges and relatives were in the main keen to do their bit.

I should say he surely won't be sent home..... but he will need to be assessed, and if necessary, a care package will need to be in place, along with a commode and anything else he might need.

Surely you can't leave him on his own at home over the festive period?

If it was my DF I couldn't possibly do that, even if it meant foregoing my own family Christmas.

He won't be discharged home - he'll probably be going to a rehabilitation unit somewhere. I assume he'll need carers for a short time, at least.

I'd say as soon as they are able to so that another patient can be dealt with and he's not bed blocking which often happens because family can't be bothered to do their bit in after care.
Can't remember who it was that said 20 years ago you stayed in for 11 days .. Well 20 years ago you had to stay in for 5 days after child birth but now you are lucky to stay in for 6 hours .
Probably in a few years you will only get a bed for 6 hours after a hip replacement. Who knows . Maybe there will be no nhs then at all.

Have chairs been checked to make sure they are not too low because he could dislocate his hip if they are.

Most patients are supplied with various aids at home before they are admitted. Things like a raised toilet seat, a commode, a gadget for getting socks on without bending, long-handled shoehorn etc. Has your Dad got these?