Mum in hospital after fall and dislocated shoulder worried about her progress

A little update ..... before I go completely insane!!

My mum finally was discharged for a second time after 3 weeks in that hospital, this time to a really lovely nursing home in her home town. She was just starting to settle in and the home had physios on standby to start work on getting her up and about again when she took another dip and was re-admitted to hospital (the original one that she went in with the dislocated shoulder).

The home manager said she suspected a urine infection (she was quite correct) caused by the catheter that the hospital had put in and which was not removed before she was discharged. Mum has been in hospital 2 weeks now - intermittently on IV fluids and still catheterized having failed a TWOC apparently - and we are still no further forward in getting her to discharge which was supposed to be a week ago. What is worse, the prolonged hospital stays are starting to affect my mum mentally ... she is starting to experience patches of confusion and sometimes struggling to to get the 'right ' words out when she is trying to explain things. I suspect some hospital induced delirium from not only the infection but also the disconnect from her old schedules and outside life. Strangely her appetite has markedly improved during the last month and she is eating a good amount and getting as much tea down her neck as the nurses are (un)willing to get up and provide her - she struggles to drink the cold water left on her table so it is not helping her fluid intake.

What is frustrating me and my mum is the fact that the hospital is not giving us any clear indications as to any progress. When I question the nurses they just reel off the notes from their PCs which I have to decipher myself - can't get to speak to the doctor or consultant in charge of my my mum's case and I have to keep repeating over and over again that before she was admitted with the dislocated shoulder she led a perfectly independent and mobile life. Just about everything she has suffered since that point is as a result of hospital-acquired infections and I suspect no real effort has been made to get her out of bed and moving in all these weeks - leaving her bed-bound with complete disruption to her previous bodily ablutions.

Has anyone been in this situation with pronged hospital stay? I am temporarily at a loss as to how to resolve this situation and get my mum out of there and into some proper nursing and rehabilitation care. She is not getting this in the hospital and frankly the medics and nurses don't seem to care. They are for more interested in ticking off their boxes and hardly engaging with the patients unless they have to performs obs or procedures.

Oh your poor mum, and you, coming down with a virus, it usually happens when we become stressed, just when you don’t need it.
I just think your going to have to wait it out, and hope the hospital take good care of her, and she improves sufficiently to be placed in rehab again, hopefully the same place but if not they’ll be a different one 🤞

If your mum is well enough they should be encouraging her to get out of bed and to the toilet, although I know from experience their often too busy. Really hope you can get your mum well enough to be moved again. It’s such a bad time of year with all these bugs going about. Take care.

This situation is becoming an ongoing saga I'm afraid to say.

Mum was declared fit for discharge by the hospital although clearly she was not without a spell of rehabilitation in any fit state to go home. Hospital transferred her to a new rehab nursing home on 27 December. She appeared to be settling in but then I had a call from the unit on Wednesday evening last to say that she had become unwell again and was taken into hospital - yet again suffering from another chest infection - pneumonia.

I was not able to visit her until yesterday as I came down with some virus myself and was out of action for a week - just relaying on my brother to update me on progress. Have to say that the nursing staff in the new hospital were lovely and encouraging and the hospital does seem to be determined to get to the bottom of the underlying infection - more so than the previous hospital who had obviously not cleared the infection up.

So back to square one. All I can say is that despite events my mum is looking a little brighter - mentally and spiritually and was actually saying yesterday that she wanted to go home - although how we are going to manage that is up in the air at present. Not even sure if she will be re-admitted to the rehab unit as the staff there advised that they will not hold her room placement for more than 48 hours.

Just now I am at my wits end thinking about all this and not being able to make arrangements for my mum. Just want her to be able to regain a little mobility and be comfortable on her hopefully eventual discharge but can't do anything practical about it for now.

I'm not expecting miracles here but the longer she remains bedridden the worse things will get and I don't want her to get to a situation where she will never get out of that bed again. Does anyone have any practical advice here - I could really do with hearing some encouraging words of experience here and no better place than Gransnet ladies.

However, the proposed move sounds like a good idea and I hope your mum can make good progress with her mobility.

Is physiotherapy now called occupational therapy? I've always understood the two were quite different from each other. If it's help with mobility your mum needs, isn't that physical rather than occupational?

Hi. That sounds like good news. At least they’re giving your mum a chance.i hope it’s a good day unit, is it attached to the hospital ?
My mum has been in five different rehabilitation units, the better ones were the so called hubs, independent of the hospitals.
The last time she went in to a unit attached to the hospital, they rarely got her out of bed let alone any physio.
She could still walk with a walker, she was transferred from there into a care home aged 92. She had a few more falls whilst in the care home and passed away 6 months later.
Hope your mum is transferred soon.

Well it has been another week in the hospital and I had a chat with ward sister on Christmas Eve. She advised that the OT team and doctors are going to transfer mum to reablement facility for 6 weeks to get her up and about and functioning again before any discharge to home. She is medically fit but not sufficiently physically to get home under her own steam. Hope the team at the new facility are better than the hospital OT who my mum advises are not very nice and doing sod all!

Just waiting on a transfer date.

I really hope you get the help your mum needs. It’s difficult always having to be the one fighting her corner, but so worth it.
My mum didn’t have the best physios either I suspect like the rest of the NHS it’s not fit for purpose anymore, but at least she has you, and a will to get better. Fingers crossed.

Katyj

Hi. Your mum seems to be doing well apart from engaging with the physio, do you think it’s the pain that’s hindering her or is she just too weak and tired ?
When my mum fell and broke her hip she was exactly the same. After three weeks in hospital they sent her to a rehabilitation hub. She had a very slow recovery, it took three months to get her walking with a frame, she was 87 then. They then sent her home with help from enablement carers.
Hope they continue to help your mum regain her strength and confidence. It can be a long and frustrating road.

Well I can only hope that my mum can be referred to the same type of facility to help. She will need help when she gets home but I want - for her sake - her to have some level of mobility so as not to be totally dependent on the home carers for every move. That would really finish her off and I know of old when my father was alive, that the local STAR home care package is indifferent to say the least.

Mum said that the physios she has seen in hospital are not very nice or understanding - that was certainly my impression of the physio that I talked to who seemed unwilling to engage with mum and only concerned at clearing patients out to home care. Told her straight that I wanted mum to be transferred to specialist re-enablement care and that the physio/discharge team should make every effort to find a placement for mum and at least give her a chance to regain a 'base level' mobility. Mum is trying but is tired from the infection and of course in pain from osteoarthritis which is flaring from the 3 weeks of bed rest.

Hi. Your mum seems to be doing well apart from engaging with the physio, do you think it’s the pain that’s hindering her or is she just too weak and tired ?
When my mum fell and broke her hip she was exactly the same. After three weeks in hospital they sent her to a rehabilitation hub. She had a very slow recovery, it took three months to get her walking with a frame, she was 87 then. They then sent her home with help from enablement carers.
Hope they continue to help your mum regain her strength and confidence. It can be a long and frustrating road.

Just read this - thinking of your Mum ….hope she will be able to get back to some form of normality x

Well to update …. mum has been off the oxygen for 3 days and now off fluids …. just taking painkillers for the continual discomfort of the after effects of the fall … I am wondering if she has done more damage than first thought or whether she is flaring with osteoarthritis on top of everything else. Spoke to the OT today who advises that mum is not really engaging so far with the physio and they are struggling to get her even sitting on the edge if the bed let alone on to her feet. As they are considering discharge now this is quite worrying. I have asked them to look at transferring mum to reablement care for a thorough assessment and more specialist physio in the first instance - rather than discharge to home where she will be laid up on a hospital bed and totally unable to function …. That would really finish mum off … as she said to me today I hope I am not going to be like this to the end of my days … and then asked if anyone had found her walking stick yet … it disappeared shortly after she was admitted.

Aah bless her. She sounds as if she’s on the mend. By the sounds of it she is strong willed, so I bet it’ll not be long before she’s wanting to be out of bed.
My mum was exactly the same, always got up and walked whenever she could, even if it took two nurses and a walking frame.

Small, but positive steps drbledu 👍

My mum seems to have improved since she was moved to that new room. She is eating more and drinking more - although not without assistance - still not able to coordinate her 'useable' arm with cup. She has been trying. Still on the antibiotics and intermittently with fluids but have noticed the last couple of days that she is now starting to cough and clear her chest which I trust is positive.

Mum generally seems to be getting back to herself - not sleeping as much and more awake and focused and conversing about everyday things. The nurse told me that the physios have been in (she is on the radar) but my mum has declined the help so far - but they won't be giving up as they have to get her back on her feet and recover mobility. The nurse and I have stressed on her the importance and she is aware that there is no way she will be allowed home until such time as she has recovered a measure of her former mobility. Expect she will be kept in a while yet as they monitor her infection progress and general recovery which may be slow.

Dealing with things a day at a time for now.

I do thank all of you for your encouragement and kind words.

Macadia

Remind them to call you if they are planning on moving her again. I write a note with my phone number on my husband's arm so they don't forget.

I wouldn't want them to call me for a room move. I'd probably think they were calling with bad news. Also l rather their time was taken up looking after the patients.

So glad to hear your mum’s improving. From your description she sounds like a wonderful lady - I love that she likes to ‘know the ins and outs of things’. Good for her! It must have been a very worrying time for you and your family.

Fingers crossed things continue to improve🤞 The GN community is certainly sending her healing karma

That all sounds more positive. Lovely for you all that she has her own room too. Hope she continues to improve.

Remind them to call you if they are planning on moving her again. I write a note with my phone number on my husband's arm so they don't forget.

Good to know your mums situation is looking brighter in every sense of the word - looking better and brighter with a single room and a view from the window - sounds promising. Thinking of you both 💐💐

Glad to hear that the Tazocin is helping and your Mum is a good bit brighter, drbledu23. Hope this is the beginning of her steady recovery.

Saw mum yesterday - she had been moved again! This time to a single room away from the open bay - much better and quieter. She now has a window view and tranquility and some nice staff tending to her.

I was relieved to see her looking much better - awake and sitting up - and having regained some appetite - and talking about this and that. The new antibiotics (Tacozin which one of you specifically mentioned) seem to be doing some good. Staff nurse called it the ‘internal domestos’! Have asked the nurse to get the doctor to talk to mum during the morning round as mum is cross that on one is telling her anything. She does like to know the ins and outs of everything!

Popping in again later today to see what is what

Aah yes I know that morning sinking feeling which comes in waves during the day too. It’s awful having a loved one in hospital. I have a much loved uncle in there at the moment, we haven’t been able to visit now for five weeks because of Norovirus on the ward, he can’t communicate by phone now either.
It’s going to take a long time for your mum to get over a bout of pneumonia especially at her age, she’ll have many up and downs unfortunately. I expect she’s not feeling herself and probably lost her sense of humour at the moment, who wouldn’t.
Hope you at least get to see her and a positive update. Take care

I think we are a long way off that point yet. Am going in to see mum tomorrow - have been away working for 3 days. My brother has been in to check on her the last couple of days - on Sunday she was more alert and talking about this and that and telling him off for rushing off! Today she didn't sound too good - says no-one is telling her anything and that the nurses are saying if she doesn't get better it will be her own fault. Sounds like they were engaging in a bit of banter but it seems to have bothered mum ... brother also said she was breathing a little heavy which I suspect might be the pneumonia infection. Need to talk to the doctor and nurses and get an update ... have been waking up each morning with sinking feeling and waiting for a phone call from the hospital with bad news .... it is really getting to me.

Hi. Yes your mum will need to be assessed whist in hospital by OT and then assigned a social worker. This is often the tricky part sometimes there’s a waiting list.
The last time my mum was in hospital, last year, there was a six week wait to see the SW it was then another week before the OT could assess her flat and then another two weeks before the carers were assigned to her. I hope this is not the case for your mum. But just be prepared for some frustrating delays.
They may suggest enablement carers for the first few weeks these are free. She’ll then need a financial assessment for her care going forward.