Photo: parents Alan and Patricia (on the left), son Stephen (back row, 3rd from left) and daughters Joanne (in green), Andrea (in red) and their partners.
It began with something as ordinary as putting the shopping away. Patricia Saunders, 83, was in the kitchen of her Surrey home while her husband brought the bags in from the car.
The next moment she was on the floor, unable to get up. Patricia had fallen, fracturing her arm in the process.
Her husband and main carer Alan, 84, tried in vain to help her to her feet. Next, he called his eldest daughter Joanne and her partner, but none of them could lift Patricia safely.
For several hours Patricia lay on the kitchen floor, immobile and sore, waiting for an ambulance to arrive.
A long wait – and vital preparation
During this long wait Joanne got her mother’s Parkinson’s medication together, ready to brief the hospital.
“We had learned from previous experience to take her Parkinson’s medication with us, plus a printed list of dosages and timings,” said Andrea, Patricia’s youngest daughter.
“Shift changes mean it can be far too easy for that detail to be missed, and she needed it at specific times,” she added.
Without that precision, Patricia’s symptoms could worsen, making mobility, thinking and even communication harder.
When Patricia eventually arrived in hospital A&E staff were caring, but keen to discharge her quickly. Fortunately, Joanne was on hand to advocate for her.
“Joanne accompanying her to the hospital was key,” said Andrea, who was at the airport and on her way home from holiday when her mother fell.
Fighting for a care plan
As someone living with Parkinson’s, falls had become more frequent for Patricia. She had been living with the condition for 18 years and managing well, but just three months earlier fractured the elbow on her other arm.
That history mattered, as her youngest daughter Andrea Barlow, 51, explained: “A&E wanted to put her arm in a sling and discharge her. But with a still healing fractured elbow and now a fractured shoulder she was not going to be able to use a walking aid. If she’d been sent home, it wouldn’t have worked at all.”
At first, A&E said they couldn’t do a care plan, but the family insisted.
“Mum couldn’t go to the toilet or dress herself. She needed proper care in place before anyone talked about going home. You have to be quite forceful and say ‘no, we need a care plan in place’ before they are discharged,” Andrea said.
Eventually the hospital team moved Patricia to a side ward, brought in the occupational therapist and started the formal assessment.
“They offered two routes: home with a care package, or a rehabilitation hospital with a frailty unit, physiotherapists and Parkinson’s nurses.”
“We picked the rehab hospital because they could provide round the clock care that neither my father nor us could provide,” said Andrea.
After the previous fall, the family had tried the home route. The care plan had consisted of six weeks of carers and an occupational health home visit which led to the installation of handrails. Once the funded support ended, the family continued with private care four mornings a week.
“It helped last time, because she bounced back,” Andrea said. “But this was different. With both arms affected, she wouldn’t cope and Dad couldn’t cover the basics.”
Read our complete guide to care plans, to learn how they are created, who can access them, and what they are used for.
When roles are reversed
During this stressful time the decision felt like a role reversal for Andrea and her sister Joanne, 55, and brother Stephen, 57.
“My parents are very stoic. They don’t want to make a fuss, and they want to be at home,” Andrea said. “But after a fall they can regress to being childlike and you become the adult. It’s a shock to see how vulnerable they suddenly are.”
For now, the siblings are relieved that their mother is being cared for in the right environment.
“It has been a stressful and emotional time. The focus has been on mum, but we don’t want to neglect dad either because he has become more frail,” said Andrea.
Having her siblings nearby to share the mental and physical load has been a huge support.
“We try to offload to each other and keep it away from our parents, and we make decisions together and share who is doing what,” she added.
Looking ahead – and speaking out
The biggest question for the family going forward is what happens next?
“I do worry about the long term. My parents are quite stubborn and they’re not going to want to move. But I look at their house and all I can see are trip hazards. It’s a death trap in some ways, because you start to see all the things that can go wrong,” said Andrea.
In the meantime, she takes comfort in sharing her story to help others.
“You realise that there are a lot of things you need to know and it’s about understanding the process, what you are entitled to and standing your ground.”
“When the system works it is great but you have to push for it.”
Andrea's top tips: what to do if your parent falls
- 1 Accompany parents to hospital
- 2 Take medication and list of dosages / timings to hospital
- 3 Insist on a care plan before discharge
- 4 Ask for an occupational therapist assessment
- 5 Enquire about transfer to a rehabilitation hospital
- 6 Accept a home visit to assess assistance needs
Our hospital discharge tips will help you to plan ahead for a return home, so the process is as smooth as possible.
Half of over-80s have a fall each year, often at home, but many are preventable. Read our fall prevention tips to help you cut the risk.
