elderly in hospital

Just a quick note to say that I have added my voice to the growing call by writing to Andrew Lansley. It seems as if I have just found my political (with a small p ) voice.http://www.gransnet.com/te/6.gif

You are feeling the way I felt when my father-in-law was in hospital, depending on proper care being given to him, in his last weeks.
Every time I hear about the hard -working nurses I think about 3 nurses at their station, feet up on the radiator drinking a can of coke.
I asked them to put my father-in-law back into bed because he was tired and slipping off his chair. They told me to wait until the other staff came back off their break.Twice I did this and twice they refused, until I said if they didn't I would and if he fell it would be their responsibility.
I think of the elderly blind man who was trying to find his plate of food, left on his tray, left to his own devices. I think of this blind gentleman, placing his cup on top of his potatoes. I feel shame that I didn't report them but I was afraid that my father-in-law would suffer.
Day after day I watched the 'hard-working nurses' chatting to each other about their social lives. Don't get me wrong, I have witnessed and experienced great nursing care. I know many nurses who are very professional and take their responsibilities very seriously.

abuse and neglect of our older population happens in all areas of society, not just hospitals.I work in an acute care of the elderly ward and see first hand where society (and the government) let us down. Years ago we would look after mum or dad ourselves, they would stay in their homes, and die peacefully in their own beds with loved ones to hold their hand. We don`t do that anymore, we have to go out to work, look after grandchildren etc, GP`s don`t do house calls so families have to dial 999 or take family to hospital themselves, very often for minor ailments, elderly people are brought into hospital with incurable and often untreatable illnesses associated with extreme old age, to die in unfamiliar surroundings with people they don`t know (it`s very distressing to hold someones hand in the middle of the night, to be told by an old, sad,person "just let me go, i`ve had enough, let me die), as a nurse i very often find myself overwhelmed with paperwork, computerwork and ringing phones, the actual care work is done by unregistered, unregulated, barely literate people often heavily tattooed,loud,raucous,swearing! (i`m sorry if that offends some people, not all are like it i know) they wear similar uniforms to registered nurses so we all get tarred with the same brush!. Nothing will change unless money is diverted into the system and into society in general to give the specialist care to our older people, to help them stay in their own homes as long as possible and to die in peace with dignity when the time comes.

We all agree the situation is serious and we need action now.
Suggestions
Gransnet Forum sends 4 representatives from the Forum , with the right experience, to meet with the Minister. These reps use the info from the Forum as evidence of lack of care for older people in hospital. We make it clear that we want action now in the form of local inspection teams who use unannounced inspection visits. We want LINks used as a 'real time' complaint service so that immdediate action can be taken while the patient is in hospital. The funding will be found by getting rid of self -assement and a reduction in the CQC's inspections of Councils.
We devise a sound plan for the future training of all who care for the elderly. This will include Matrons who are not in an office but are ward based. They will have to visit every ward using a strict, unannounced system.
Paper work kept to the essential but massively reduced.
This will all be statutory.
We demand that reps of this group are involved, from the start of the process, in the decision- making.

bringing back the Matrons is not the answer to the problem, it was tried a few years ago and didn`t work, we have ward based managers who are at the mercy of the system as are the rest of us, we are constantly battling lack of appropriate staff and lack of funding for the frontline services. Matrons worked in the ritualistic, almost military, delivery of care of yesteryear, it worked then but it doesnt work now when we try and individualise care for each patient, giving them choices on what they want from their hospital experience (which isnt always what their families want). i am unique at the moment on this forum as although i am in my late 50`s i only did my training a few years ago, Matrons are as relevant to patient care in 2011 as mortar boards and caning in the education system (which i experienced).

Sorry to be a bore , but I still say that care was better in 'the old days' when we had large wards with the Sister sitting at the end .She was able to spot poor nursing skills , patients not eating etc..How on earth modern day Sisters know what is going on in these smaller wards is beyond me . I also am sick and tired of visiting friends and family to find they have been ringing for help for a long time and I have just passed several nurses chatting and laughing at the nurses station !!.Bring back the old Victorian wards .

I agree with you riclorian. I went to visit my sister and found dirty dressings and other medical rubbish on her bedtable, I picked them up and marched to the nurse station found the most senior staff member and deposited the rubbish in her hand. The look on her face was priceless, how a member of the public dare do this to a ward sister ! The cleanliness left a lot to be desired, there was a board from a stretcher covered in bloodstains leaning against a wall in a corridor for the best part of a week.

Nothing is different over here in Australia. My mother is 88 not well, in pain she is lucky that I can spend four nights a week with her and my brother now lives fairly close by. Last year she spent 24 hours waiting in the emergency department at the hospital before she was given a bed. We had left late at night as they said she would be fine and would still be in the emergency department all night until a bed was free. About an hour after we left a bed was found for her and two people came to get her, they did not speak to her at all. My mother said she was wheeled along passages for a long time (it's a huge hospital) then into a pitch dark room and just left. Mum had no idea what was in that room and was very unwell and she said she was frightened. What is wrong with these people, are they idiots?

When my father spent his last week in a hospice the nurses and staff were the most caring people you could meet. They couldn't do enough for my father and our family.

I could start another thread about how some family members steal from and abuse their elderly parents. This has happened to my mother and I have to say it was a huge shock to find out what had been going on.

Nanasue I am sure you are a great nurse and there are many like you. My DIL for one. But even if there were unlimited funds, a lot of very old, ill people cannot be cared for in their homes. We tend to need and use hospitals most at the very end of our lives.
So what, apart from a reduction in paperwork is the way to better manage hospitals so that better basic care is delivered? What part can politicians play in bringing this about?

Agreed JessM. If we have to end our lives in hospital, this should neve be a cause for fear and distress. What can politicians do? Listen and prioritise. Treat everyone as they would wish to be treated, though I am sure they don't believe they will ever be old and ill.

My mum spent many weeks in hospital, three years ago now and then a short time in a care home before she returned home. She actually had a stroke in hospital and the staff "didn't notice". The stroke was a direct result of rough treatment by male member of staff on my mother's first night as an emergency admittance - she was 81 years old at the time!! Her treatment was awful all the way through, I practically lived at the hospital too afraid to leave her bedside. When I did ~ I would return to find her parched because she couldn't reach her drink!!! I tackled the nurse in charge who was sitting at a desk at the bottom of the bed and she said "oh sorry I didn't notice"..........my response is unrepeatable here. Finally when we got mum home, we paid for private tests because I was convinced about the stroke - the results came back and confirmed our worst fears. I wanted to deal with the hospital but my mother was too scared to take it any further. She is well enough now but terrified at the thought of ever having to return to "that place" as she now calls it. She is a very gentle lady who wouldn't say boo to a goose - I guess that's why she was treated so badly. It just makes me very, very sad that these things are still happening :-(

One of the things that struck me joggingirl, when MIL was in hospital is they don't ask "What is she like normally? What can she do for herself? How mobile is she normally etc?" They just seemed to make assumptions, either one way or the other. Also forget that the thing that got them into hospital maybe only one on a long list. And of course some folks, mentioning no names, just say that they are fine when they are anything but fine.

They are sometimes so busy trying to communicate with the patients that they don't talk to family members who are not ill and are not going to say "she's fine".

I am getting on with writing to my MP this weekend.

lewis PLEASE stay with us and help us to put your wise suggestions to work. I would rather be issued with a suicide pill [for me to take when I wish to depart] than go anywhere near a geriatric ward and face a spell in hell. I am not suicidal. In spite of several health problems, I am an exceedingly cheerful "elderly lady".

Suggestions stage 2
Thanks for support of my suggestions. I will stay with you and be ready to help carry them out. If other grans have not seen my suggestions see my previous posting. If you can't find it let me know.

JessM, thankyou for your comments, i think overall this forum is highlighting in a democratic way the complexities of modern healthcare delivery, with the importance of treating every single patient as an individual, and in the case of older people the importance of celebrating long, amazing lives. As you said we do use hospitals the most at the end of our lives, i just wanted to throw into the ring whether this is the most appropriate place for people to be, or whether it is a way of passing on the "problem" that community services seem to shy away from. My area of speciality is acute medicine, not surgery, and of course older people deserve the best surgical interventions we can give them, but medically a lot of acute and chronic illnesses could be managed better without the need for hospital admission. I too have an ageing mother who shies away from telling her GP how she really feels, she says "they aren`t interested in you when you are old" this is a sad reflection on society in general i`m afraid when we don`t value our most senior members
As for the paperwork, Oh dear! on my night shift last night i looked at this with a new interest, we have a booklet to fill in for each patient, with additional paperwork we download from the computer as it becomes available when "new" assements and initiatives are devised. Most (not all) is so that we can document in minute detail our responses to these areas of concern, the reason for this so that it can be examined when complaints arise, inquests held etc, the main thrust being, if its not written down then it hasn`t been done! over the last year or so the amount of documention has increased alarmingly, there will be no reduction in this as we become more and more reactive to the "blame" culture.
Anyway, the main point is...I`m proud to be a nurse! we should be giving help and support to nurses, its a difficult, physical career to be in,especially for us older ones! and i think most of us do a great job most of the time! We are extremely lucky to have our NHS, free all the time at point of need!! thankyou

I have written here about my father's treatment in hospital and even now after 12 years it still upsets me.

the word I think sums up what the elderly deserve is dignity.

Dignity in being treated as you would want to be treated. Many go into hospital with an illness or disease that can be treated but due to the lack of care they deteriorate. Food left out of reach as is the life force of water. Left in dirty nightware due to soiling because bells are not answered for commodes or bed pans. I am not elderly but I have waited for almost an hour in hospital for a bed pan and soiled myself. I was able to defend myself, not able to get out of bed unaided or walk to toilet, and wouldn't stand for any nonsence.

How much longer can we stand by and say nothing? Our family members and friends even us. We deserve dignity, respect and understanding.

BurgundyGran...bless you for your input. Dignity, respect, understanding and compassion are essential basic needs all hospital patients deserve. Those whose only "crime" is to be aged and therefore considered "troublesome" are far too easily over-looked and intimidated. We caring Gransnetters can, if we wish, make our collective voice heard. We can do it...

Human rights applies to everyone (even prisoners). However, exercising those rights depends upon your capacity to do so.

I appreciate nanasue's input as a nurse at the coal face as it were. We need to hear more from medical staff, even if it's just to reassure us that there are more caring nurses than it would appear many of us have come across. It is so important that they publicise the aspects of their workload which we are unaware of and which they themselves feel wastes their time. And I do recognise the point about today's "blame culture". However, if I as a teacher had behaved towards my pupils in the way many nurses treated my mother, society would not have sympathised with me if I had cited my heavy workload as a reason. My basic, fundamental reason for starting up this thread was because there is absolutely no reason at all for any human being to treat another, especially someone frail, vulnerable and frightened with the callous disregard we appear to be witnessing in our hospitals. If unqualified assistants are behaving in an appalling manner, the qualified staff should kick up a stink about it and get these people out. If paperwork is driving you all mad, get together and fight it.

My daughter was recently sent home with a piece of paper on which the nurse had ticked all the boxes, including one which stated she had discussed with my daughter the medication she was being sent home with. She had not. She had had no conversation with my daughter about anything. Had there been a problem, the nurse would have pointed to the paper to prove she had carried out the correct procedure, protecting her and her bosses' own backs instead of the patients.

Everyone working in public sector services will recognise the issue of endless documentation and, as professional people, nurses, doctors, teachers, police officers, should all call time loudly and aggressively on the managerial and bureaucratic mindset which stifles the individual and replaces common sense, kindness, compasssion, all the human qualities we need, with bits of paper to fool us into believing as nanasue says, that if it's written down, it must have been done.

There are callous people out there who palm off their elderly relatives on hospitals and Care Homes. There are bolshie, aggressive, ignorant patients abusing medical staff , so now we have notices warning the general public to treat the staff with respect. Well I'm not rude and aggressive, (but I am getting very bolshie!), and I didn't palm my mother off. Time and time again, I trusted the professionals to do their job. And they didn't. A consultant and a group of good nurses begged my brother to put in an official complaint. They agreed with everything he went to talk with them about, but they felt as trapped as we did. But the managers, the politicians jump when the customer, the voter starts to shout, so come on folks, keep shouting. And if you are a nurse and a good one we will support you if you want to rid your profession of the deadwood. Just shout about it so we can hear!

"there is absolutely no reason at all for any human being to treat another, especially someone frail, vulnerable and frightened with the callous disregard we appear to be witnessing in our hospitals..."

mamanC's words sum it up.

The reason people act that way is that they have stopped regarding others as people in their own right. It is basically that attitude that allows wars; torture; concentration camps and so on.

Some of the comments here need to be cross referenced with the thread in "Other subjects - the last taboo".

We have some posters who honestly do believe that we should have no say in our last days because there is always caring, compassionate ways to make our last days comfortable.

A pleasant tasting farewell potion [which I could have locked away until I choose my own "departure date"], to be taken after a family gathering, whilst tucked up comfortably in my own bed, in my own home, surrounded by those people I loved, would be a huge comfort to me and cost the NHS very little. Alternatively, the thought of spending my final days alone, afraid, in an uncaring geriatric ward fills me with HORROR and UTTER DISMAY

Guess we all have defense mechanisms about the fact that we too will get old and die ... will take a look.

supernana

Yes please; I have been saying this for years to anyone who will listen to me.
My son was devastated that I should think this way until we had a long talk during which I put forward my own arguments including the one which says, "If I knew I could go today, I would probably put it off until tomorrow. My daughters understand where I'm coming from, having been much more aware of my own mother's wish to just die quietly instead of having to live without her own wishes being accede to for the years she had to be in a care home - all she wanted was to be allowed to be alone in her own room instead of always being PUT into the day room.

iloveroses...I very much doubt that there is anyone on earth who will be brave enough to attempt PUT me where I choose not to go. Although, if I should become so frail that I have no fight left in me...being PUT in a day room may be the answer, as for me, it would without doubt, be the LAST STRAW!