Hi @Trisha2 - I don’t know the severity of your husband’s stroke, but I wonder if maybe we might be expecting too much too soon? I mean, for my Mum a half hour of physio / SaLT would have been quite exerting.
I just wonder what sort of assessments have been done to determine the care needs for your husband.
What exactly does the physio who is very kind and helpful have to say about the capacity for your husband to take on the physio?
I wish you and you husband a safe discharge and successful recovery.
Fao all readers of this note, I want to be absolutely clear that what I write here is my attempt to try to help and to share what we have already experienced so that you do not have to go through a steep learning curve unless you want to.
I appreciate, I may have misunderstood what you asked and therefore, if you feel that what I am saying does not apply to you or if you find it distressing or in anyway something you would rather not have to read, then please IGNORE the below “lessons learned” that I am sharing with you. If on the other hand you feel it may benefit, please take from it as much or as little as you wish.
It is not my intention to waste your time or to deviate from the subject you wish to discuss and for answers you seek*
NOTE:
WHAT FOLLOWS IS BASED ON OUR PERSONAL EXPERIENCES AND MAY NOT REFLECT WHAT HAPPENS IN OTHER PARTS OF THE COUNTRY AND TO OTHER PATIENTS.
At this point, I have to point out, our experiences are the consequence (I am not sure if this is the best way to phrase this, but I am not proficient in English) of DELIBERATE DISCRIMINATION AGAINST PATIENTS OF A CERTAIN AGE GROUP.
You may already know this, but the MDT (Medical Decision Team) will write up a discharge package for your husband and each of the disciplines caring for him will have their section in the report. So the consultant will write a summary of how the patient was presented and what treatment they had. Other specialists will have their own sections in the report and so the physio will write what they did for patient and what they recommend as ongoing care post discharge. Similarly, the dietician will do the same and so on.
On the note of the discharge summary, again purely based on our experiences, it may not necessarily reflect reality (sorry, but the real world is sometimes different). As an example, Mum’s discharge note said she needs to be turned every two hours in bed. The notes said the nurses did that whilst in-patient. No - this did not happen. We were with Mum 24/7 when she was in-patient and we know exactly what did and did not happen. So this two-hour turning is what is recommended and what might be a criterion on which the hospital is measured, but the harsh reality is this is not what happened. Nevertheless, the report is there as a baseline or reference point.
When Mum was in hospital, she was essentially bed-bound and so the physios would come and try to sit her up on the edge of the bed and see if she can support herself, what sort of cognitive abilities she had. On occasions Mum would fall asleep within minutes as it was too much for her at the time. With the limited availability of trained staff, this then meant that her slot of physio was only 5 minutes (from say a scheduled slot of 15 minutes). This meant the pace was slow and it was quite a while before she even got to see the inside of the gym.
What is supposed to happen and what actually happens are very different, at least based on our experiences. On some days Mum didn’t even get to sit out in the riser/recliner chair or the wheelchair. This was due to there only being shared equipment - 6 people were sharing two chairs !!! So you had a slot and sometimes if you missed it, you missed it.
Also, the reality for us was that even in the hospital, Mum only every had “full” access to staff on 3 days of the week - Tuesday, Wednesday and Thursday.
The way it worked was Weekends was skeletal staff and duty doctors only. Physios and other specialists did not work weekends for in-patients.
That meant you had your meals and a bed bath if you were lucky. Of course, they are very hot on medications and so you ALWAYS got those on time and indeed they took priority, so the meds rounds took a lot of the time out of the day.
Fridays - were discharge day and so the whole day was focused on discharging patients. It was a tick-box thing where it seems the hospital was trying to meet some sort of NHS targets 
Mondays - these were some sort of admin type day when doctors caught up with what happened over the weekend or something and so again very little happened on Mondays.
For us this was the reality of the NHS hospital we were being cared for in.
At all times, most staff were nice, however they were often stretched and ultimately the hospitals goal became very clear, once they had pigeon holed Mum and that was to “free up her bed”.
Namaste|
