Home alone 1 day after hip replacement: 78-year-old man objects
Hospital says quick discharge common, but patient sent away with no home care says it's like 'senior abuse'
A Miramichi man who was sent home 28 hours after undergoing a minimally invasive total hip replacement at Moncton's Georges-L.-Dumont Hospital is calling his speedy discharge a "blindside" that left him alone without support before he was ready.
Lorenzo Doucet, 78, went in for surgery on March 6.
After the procedure, the surgeon dropped by his room to tell him he would be released the next day.
"That's when I started saying this doesn't seem right," said Doucet.
Nevertheless, Doucet, who lives alone, started figuring out how to get back to Miramichi.
"In the meantime, I started getting more anxious and asking, `Well, what kind of help am I going to get at home?'" said Doucet.
He said staff told him that he wouldn't be receiving care at home, and that other people go home in the same condition.
But by the time his drive arrived, he began to panic.
"I can't leave, I'm not going home without help," Doucet said. "Just doesn't make sense to me to throw me out on my own ability when I have none."
After a discussion with hospital staff, he was told they would arrange for an extra-mural nurse to come to his home the next day.
But the next day came and no one showed up at Doucet's house.
"I was just getting overwhelmed," he said. "I was home alone and felt very abandoned, scared, frustrated, and thinking that the system — the communication system — has to be fixed."
Quick discharge common at hospital
Sharon Smyth-Okana, director of surgical services for the Vitalité Health Network, said it's not uncommon for patients to go home the day after a hip surgery.
In the case of a minimally invasive procedure, patients at the Dumont typically go home within 24 to 48 hours of surgery, and within four to five days if they underwent a standard hip replacement surgery.
"Maybe some patients sometimes compare, in the community," said Smyth-Okana. "They don't realize the procedure is different."
Smyth-Okana said patients receiving a minimally invasive hip replacement surgery tend to require less care after the procedure, but if a patient is evaluated as needing services at home, they will not be let go until everything is in place.
"We've made 500 minimally invasive hip replacements in eight years, and we've never had a complaint," she said.
Meanwhile, Dr. Will Allanach, chief of orthopedic surgery at the Moncton Hospital, said hospitals have been making an effort in the last year to decrease length of stay. Bed availability is one of the main factors causing long waits for surgeries such as hip and knee replacement in the Moncton area, especially in winter, he said.
- Moncton wait times for knee and hip replacements longest in New Brunswick
- 'We need help': Moncton surgeon seeks provincial resources to shorten wait times
He said he's not surprised an elderly patient would be discharged home alone only a day after surgery, but some aspects of followup care could be better.
"The age doesn't necessarily dictate when a patient is ready for discharge," Allanach said. "It's how healthy they are, how mobile they are and how much pain relief they have.
"I guess the education before the patient has surgery, as well as the co-ordination of their follow up after could be improved upon."
Allanach said his department is reviewing some of those aspects.
Appalling, says patient advocate
Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights, said she was sad to hear the patient had to manage by himself for three days until an extra-mural nurse showed up at his house.
"That's absolutely appalling," said Cassista. "That's inviting recurrence for him to fall down and to come back into the hospital."
She believes hospital staff should have offered him the option of going to respite care, or a special care home, at least for another week to recover until he was able to get some care at home.
Cassista said she wonders how many others are experiencing similar frustrations.
"The system is not user-friendly," she said. "The communication basically is really broken and I think it needs to be taken care of or looked at."
As for Doucet, he considers himself lucky he was alert enough to ask for the help he needed but fears other patients might not be as capable.
"To be told to go home, feed yourself, bathe yourself with a sponge bath, don't do this and don't do that, and beware of this, and beware of that ... in my opinion at the time, I felt this was senior abuse," said Doucet.