"Poor discharge"

My 92 year old father was discharged from the orthopaedic unit at the Golden Jubilee Hospital Glasgow. I can’t fault the nursing care and the operation appears to have gone well. 

However throughout his time in hospital , my dad was concerned about his lack of physiotherapy input. There was no joint school prior to admission, luckily my father had a previous knee replacement at Hairmyres, where he attended joint school and had marvellous physiotherapist input throughout his stay and follow up from the ERAS team, so knew what to expect. 

This time however his physiotherapy was very limited. My father wasn’t given a board and “ donut” to practice his knee bend and there was no leaflet or instructions given to him that would have allowed him to do exercises on his own. 

Several times I asked for a physiotherapist to contact me so that I could raise concerns about his home environment and alert them to obstacles that may have hindered a safe discharge. No physio called or spoke to me or any other family member during our visits. 

On discharge his analgesia was not prescribed on a MAR chart, so carers couldn’t give him pain relief, a horrendous over sight, which has left him in pain since discharge.

He was only given one zimmer, as mentioned before there were environmental issues within his home that meant he needed a zimmer at the bottom and top of his stairs to allow him to get from his stair lift to his bed room. Luckily I was able to obtain one. 

The stairlift makes a turn before going up stairs and my father needed to have an excellent knee bend to allow him to get both feet on the foot rest of the stairlift. If not his foot would hit off an electrical cupboard at the bottom of the stairs. One of the already mentioned environmental concerns I had. Needless to say that level knee bend was not achieved prior to discharge and as a result his foot hit the cupboard preventing him from using the chairlift to get up to bed. As it’s the only way of getting to the second floor of his home, my dad has to stand up on the stairlift to get past the cupboard. Totally unsafe,  luckily he always has someone with him at bedtime or I don’t know what we would do. 

On discharge no information leaflet was given to us that explained his community care plan, who would give him his anticoagulant injection, carry out his knee dress or what outpatient physio was arranged. 

Luckily again, after several phone calls and enquiries we have managed to find that out. 

We were told that it would be several weeks before any outpatient physio would take place. We feel this is absolutely ridiculous and makes the whole surgery pointless when coupled with the complete lack of instructions or exercise plan given to my father by physiotherapy on discharge.

Fortunately the District Nurse was able to speak to the community physiotherapists in our area and they will come out sooner and I have got an exercise leaflet from his last surgery and we are following that plan. 

Lastly he was given a letter telling him about his review appointment via a virtual clinic. I am not sure how that will go ahead when, at 92 with poor hearing and eye , he would never be able to communicate remotely that’s if he had a computer, smart phone tablet or wi-fi. Surely, prior to discharge it should have been confirmed that he had access to the internet for this review to take place.  

All in all a shambolic discharge in my opinion, that in no way shape or form was patient centred. Lucky for dad , a family member was a senior charge nurse in elective orthopaedics for many years, or I have no clue what state he would be in.