How would you feel if I decided to sell your house?

Some of us during our lives will fall and break our hip. It is a common event especially for older people. What might surprise you is that as you are taken to hospital for treatment this might be the last time you will see your home. You may be treated very well and speedily for your injury but because of delays in post-operative support there is a significant risk of immobility.

“10 days in hospital (acute or community) leads to the equivalent of 10 years ageing in the muscles of people over 80”

This muscle ageing is mostly unrepairable and the likelihood of you becoming permanently immobile is significant. At this point there is likely to be a decision taken by a clinician that they are going to sell your house and move you to a new home. You will probably not be asked whether this is what you want or what you want at all.  I have seen this happen in many health economies I have visited. It is not a rare event it is all too common.

Prescribing treatment is what clinicians do. We shouldn’t be surprised by this. And of course if my doctor or nurse tells me I need residential care then that must be right. Mustn’t it?

The truth is that this is often unnecessary. There is a great deal that can be done to help you remain in your own home surrounded by the things that are important and precious to you. This is what happens when a non-social care professional prescribes care for you. They often don’t realise that the cost of your care will come from the sale of your house by the local authority.

My view is that social workers should not undertake surgery and clinicians should not do social work. Many do not realise that you can be supported to live in your own home (with support) and have a life. Yes you may have to make compromises such as living in your home downstairs. But it is entirely possible. And the decisions taken about how you can be cared for are yours, no one else’s. Social care staff will work with you on what can be done and you will decide on the type of future you will have. I find that hospital staff do not realise what can be done for you in your own home and that people who are more needy than you are already being supported sucessfully in their own homes

The clinician’s motivation is good, if misguided, in that what they want to do is to ensure you are safe.

Safety seems to be a very common word used to support these type of decisions. And while there are many excellent institutions that can care for you, you may find that because of the need to keep you safe, your life has become devoid of anything that matters to you, of any pleasure or meaning and your home is a place you will never see again. You will be alive but you may find that you have no life. All because you had a fall.

Think before you prescribe long term care - would we want this for ourselves, I am not sure we would?

Think Home First

See Liz Sargeant's article describing why home first is so important http://fabnhsstuff.net/2016/02/17/developing-home-first-mindset-liz-sargeant/

Author - Charlie MacNally - Social care lead with ECIP (Emergency Care Improvement Programme)

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@MacnallyCharlie