Elderly hospital visit

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I've got an elderly relative who has a hospital appointment to remove a cast for a broken arm. They live with someone who is nearly 90 with a heart condition who can barely walk to the bathroom because of their breathing difficulties. They are terrified of going to the hospital, for obvious reasons. I've explained that the risk now is considerably less than it will be next week, in a month, or maybe six months plus. So, my question is: can someone who currently works in a hospital environment give an opinion as to what the risk currently is for that elderly person to visit the hospital, assuming they take plenty of hand-washing precautions etc.? Their visit will take them through the A&E waiting area.

 Phil1919 30 Mar 2020
In reply to wurzelinzummerset:

This may not be useful, but I took my Mum to hospital on Friday and they were very thoughtful and caring to reduce the risks. The department she went to was strikingly less busy than usual. Visitors are banned and there seem to be less accidents/issues for them to deal with such as drunken behaviour etc. I think its a case of balancing risks. 

Rigid Raider 30 Mar 2020
In reply to wurzelinzummerset:

Haven't most non-urgent appointments been cancelled?  Police who post on Cycle Chat are saying it's extremely quiet so they are all tidying up paperwork and swotting for Sergeant's exams so I wouldn't be surprised if A&E departments and many other areas are very quiet, though of course nobody is going to tell that to the Great Unwashed. 

Thanks for both the replies. The information was useful. The appointment has not been cancelled as I assume they don't want to leave an old person with a cast on their arm for an extended period of time. Anyway, it seems now, after a phone call, that they may be moving the appointment to the least busy time to reduce risk.

 henwardian 30 Mar 2020
In reply to wurzelinzummerset:

I'd DIY this one. Cutting a cast off should just be a question of patience and care using whatever sharp things you have in the house. More than any other single place, hospitals are the epicentres for spreading the virus (the only person I know who had definitely had the virus is a doctor). While I'm sure the staff will make every effort possible to minimise the risk, it's still a risky visit. I'm not a medical professional, just commenting about what I would do in your place.

In reply to henwardian:

I had considered this, and still am. I think you can soak them and unwrap them that way. However that misses the doctor having an opportunity to check out if everything has fixed as it should. I'm sure that will provoke a few more responses...

 henwardian 30 Mar 2020
In reply to wurzelinzummerset:

What kind of injury is it? And on what bone/ligament/muscle?

 two_tapirs 30 Mar 2020
In reply to henwardian:

> I'd DIY this one. Cutting a cast off should just be a question of patience and care using whatever sharp things you have in the house.

The appointment with the consultant will also assess that the arm is healed well enough to avoid going back into a cast, as well as fitting of correct size tubigrip for continued support.  

In reply to henwardian:

Bone. Either the ulna or radius near the wrist. Broken and displaced. They got it back into position without surgery.

 SAF 30 Mar 2020
In reply to wurzelinzummerset:

I'm a paramedic, were working in collaboration with GPs and advanced paramedic practitioners in our control room to leave as many people (particularly those at high risk) at home at the moment. Also it is unlikely you would be able to enter the building with your elderly relatives, it really is that strict in hospital at the moment.

Personally I would phone and ask to speak to an orthopedic surgeon or specialist nurse and see if they can guide you through assessing the arm at home to make sure it's is ready for the cast to be removed and do a DIY removal of the cast.

In reply to SAF:

> Personally I would phone and ask to speak to an orthopedic surgeon or specialist nurse and see if they can guide you through assessing the arm at home to make sure it's is ready for the cast to be removed and do a DIY removal of the cast.

Thanks, that's interesting. I'd be interested in any other comments specific to that from those with the knowledge. 
 

 henwardian 30 Mar 2020
In reply to wurzelinzummerset:

Sounds like a pretty simple break. I'd remove the cast at home.

Taking into account what two_tapirs said, you should be able to work out the size of tubigrip required and order one from the internet.

Do a bit of very gentle experimental movement to see if he/she still has the normal range of movement.

Moving forward, build up use of that hand only very slowly to minimise chances of a re-break if it wasn't healed up enough and should have had another cast put on it.

It's a hard call to make with both Corona and a re-break with further complications (e.g. damage to the wrist arteries) are very worrying risks.

 marsbar 30 Mar 2020
In reply to henwardian:

Is this the kind of thing a community nurse can do maybe?  Or are they redeployed?  

 Andrew Lodge 30 Mar 2020
In reply to wurzelinzummerset:

Where are you? I have a large pair of plaster removal shears.

 Mr Lopez 30 Mar 2020
In reply to henwardian:

> Sounds like a pretty simple break. I'd remove the cast at home.

I wouldn't unless being directed to do so by the practitioner. They will want to make a series of asseseements, from confirming adequate bone union to skin condition and correct blood flow, even more so being an elderly person.

Better phone the department expressing their concerns and do whatever they deem best..

 Pedro50 30 Mar 2020

My 94 year old mother broke her wrist 5 years ago. Although it healed reasonably well she was incapable of the discipline required to carry out the stretching regime and self-physio and now sadly has restricted movement, despite our nagging. 

In reply to Andrew Lodge:

> Where are you? I have a large pair of plaster removal shears.

Well, I'll keep it in mind, although I think she may suddenly decide she'd rather take her chances with the NHS if she saw me turn up wielding those. Anyway, the hospital appointment has now been shifted to a quiet time at the end of the week. So, I'll review the situation in a few days.

In reply to wurzelinzummerset:

just a word of  caution, that there  is a risk of some well meaning jobsworth pulling down a Safeguard rule book to justified themselves, and the large salary as they work from home.  

DIY it and risk it if you are dexterous with your hands,  Plaster of Paris will not soften in water 

good luck and a happy healthy  birthday to your  relative next time it come around as we hope it will 

 Timmd 30 Mar 2020
In reply to wurzelinzummerset:

> Well, I'll keep it in mind, although I think she may suddenly decide she'd rather take her chances with the NHS if she saw me turn up wielding those. Anyway, the hospital appointment has now been shifted to a quiet time at the end of the week. So, I'll review the situation in a few days.

Bingo, you now know how to get her to go.  

Bless her, though, it must be a concern, and it's sad the way worrying about things can sometimes increase with age.

Post edited at 23:21
 NBR 01 Apr 2020
In reply to wurzelinzummerset:

Yesterday my father who is a cancer patient recently finished with a course of radiotherapy (so very vunerable) had to go in for an MRI to see how effective it had been before surgical assesement.

He felt up to driving, so we followed in our car (which we stayed in) just incase. The hospital was amazing, they got him in and out in about half an hour and at no point did he feel unnecessarily expossed. Luckily here in Norfolk numbers of infected/in hospital are not too high.

My advice is to contact the hospital to check what to do first, they will have considered  this stuff and may have set up a safe route/proccedure for vunerable people etc.


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