My mother (very early stages of mixed dementias) is(was) supposed to have bunion surgery next month, which was to be carried out under a local rather than general anaesthetic as per her consultants advice. It's fairly urgent now as she's in pain and has reduced mobility. This has been on the cards for a while (surgery was initially advised quite a number of years ago, but she opted to try and manage without surgery at that point, not realising how bad it would get). Care following the surgery was apparently all in hand via her CPN, but her CPN has now been off sick for a number of weeks (months?). She does not yet have a social worker, but I think that I may have managed to get the ball rolling on that. I have just found out that because the surgery is to be carried out not at the local hospital, but at a clinic with no facility for overnight stays, care following the surgery is not possible. The only option, it appears, is to start the whole referral process again, with an initial assessment within 18 weeks, to get a referral to the hospital - which apparently only does the surgery under a general anaesthetic. I am feeling suckerpunched. We made it very clear that living about 3 hours away, we were not able to provide the after care that she would need (apparently minimum 48 hours around the clock care/supervision, and 6+ weeks close care following that). We thought the care was organised, and she has good friends and my SiL close by who could keep an eye. After a days 'phoning and emailing, we now have a replacement for the CPN - a mental health nurse, who is going to look into this - she sounded lovely on the telephone. So, I guess, partly this is just an explosion of frustration, and partly a request for any suggestions that can help me find a solution. I have spoken to Age UK who have pointed me in the direction of a number of factsheets, but they do seem focussed on emergency care in the event of accidents, rather than essential scheduled care. I am hoping (somewhat desperately) that the MH nurse will be able to at least point us in the right direction - I haven't even broached the distinct likelihood that the op may not be happening with my mother yet.