elderly in hospital

As an ex-nursing sister, who trained at the Royal London, I am ashamed to call myself a nurse today and I am thankfull I was able to nurse and care for my mother and father at home untill they died

I am afraid the pain and suffering on this thread is not primarily about money. It is about lazy or uncaring staff and managers who let them get away with it.
And maybe about the way hospital cultures develop if senior managers are being asked to focus on other things.

I have just posted this on another thread - apparently the NHS has been purposely delaying operations to save money on a routine basis.
www.huffingtonpost.co.uk/2011/07/29/nhs-bosses-delay-treatmen_n_912920.html?1311935044

Perhaps this problem is further up the hierarchy than the terrible stories on this thread, but I think it says something about the lack of care in the whole system when NHS bosses are systematically causing pain and suffering in order to save money.

Oh it takes energy to complain as well doesn't it... when there are so many calls upon it.
And I guess Zephrine that hospital managers have a lot of other problems beyond rude consultants. Still not good enough though, by a mile.

(I worked in a hospital HR office years ago and was astounded one day to get an angry call from a consultant who had left his diary in the board room the previous day and it was somehow the fault of "administration"...why had they not returned it!!??)

jessM My mum was her closest relative but she had terminal cancer and I was her next closest, I did complain to the chief exec and got a very vague reply, the consultant had already been complained about by someone else and it was being investigated, they would add mine to the list. I never heard anything else about it, Cis by that time was in another hospital and I was trying to get the best care I could there. I think the toileting problem is a widespread and major problem. When I was visiting Cis one day she needed the loo, I told a nurse who said " oh, she always says that and never does anything when we get her there, just tell her to go in the bed and we'll clean it up after" It didn't seem to occur to them that she was very constipated because of her condition and to do something about it. It was a modern, purpose built, geriatric hospital but I can't begin to tell you how badly I felt about the general uncaring, unthinking care that the patients recieved. I could go on but I think I've probably ranted enough for now.

Zephrine how rude of that pompous ass consultant. That makes me soooo angry! I think JessM's advice is good, I have complained before about a doctor at the large hospital where my daughter was a patient and something was done about it.
My 88 year old mother is now in hospital as I write this but I think its only going to be for a day or two. The best thing I believe is that she is in a smaller country hospital and my sister is also very good friends with the Director of Nursing for the hospital. I feel relieved that my sister has stepped in and we have finally gotten my mother to stay with my sister for the time being. Since Christmas I stayed at my mother's house four nights a week so that she wasn't on her own all week but she is getting so frail and ill that it was not enough. It does help when there are a few members of a family stepping in the make sure their elderly relatives are okay. I really hate to think of vulnerable old people battling on their own especially at the end of their lives.
People do really need to take responsibility for their elderly relatives and even elderly neighbours and not just trust nursing homes and hospitals with their care!

I think people don't complain for a number of reasons. Sometimes it is grief. Sometimes it is because you are so busy looking after or making arrangements for looking after. Sometimes it is because you think your loved one might get re-admitted to same place and might be victimised (there is not always a choice of hospitals). Sometimes it is a case of we are a meek blooming bunch of Brits who don't like complaining. It is one thing not complaining about an unpleasant meal (like the one i had in a brasserie blanc last week - my excuse was someone else was treating us) - we just tell people, and don't go there again. But poor care is different.
I did not complain to MIL hospitals because I am a mere DIL and my MIL is also still with us and hates fuss. So i just wrote a general letter to MP who forwarded to minister who wrote to me.
I think Carosanto you could legitimately complain without involving your mother. It does not have to be done immediately - and it might make you feel better.
Zephrine too - i think you could write a letter to the chief exec of the hospital and copy your MP. They would investigate your complaint fully. And I think that consultant was completely out of line, both rude and arrogant - unless he thought maybe you were not a close relative - in which case that is what he should have said.
Hospital Chief exec will take all complaints seriously and give them some time and attention. They have to. As will your MP. And if you write to both this will amplify the effect.
You have got me fired up to write the chief exec of Solihull about the poor responses to toileting requests witnessed. Not our relatives but elderly women who had no relatives around, which i witnessed recently.

Mermaid, I'm sure a lot of us did complain and it probably got us nowhere. After the frustration of trying to get proper care for a loved one the frustration of coming up against a brick wall from the medical profession and hospital administrators is just to much. I was told by a consultant at King George Hospital in London borough of Redbridge that he refused to discuss my aunts treatment with me unless I was medically qualified and then showed me the door. Also when you have just lost a loved one you are not in the best frame of mind to start a long and drawn out complaints procedure.

All these stories- why are none of you naming the places these things are happening? Could someone respond? What is the point otherwise, except to share sadder and sadder experiences. Then it stops.No one is able to take any action.

Can any one of you who have posted your experiences tell the rest of us where it happened, and what happened when you complained- or did you complain?

If not, what stopped you? Fear, exhaustion, it really matters. Posting stories is soothing and sharing, but ultimately wont change anything.

Thanks folks for your support. We all (my 3 brothers and I) wanted to complain but were stopped by the sheer grief of our Mum, who just could not cope with any more. We are all literate, articulate people, but honestly this situation reduced us one by one to silence.

Reading the posts in this thread has given me hope that we ca make a difference. Count me in to any campaign going, I am up for it!

Thanks again, Carosanto

carosanto my heart goes out to you, I looked after my mum and two aunts in the last years of their life and at times had to insist, complain, shout and at one point have a tantrum in the G.P.s waiting room. These ladies worked all their lives and served their country during the war why did they need a bolshie relative to get the care that they deserved and what about the poor souls that have no-one to shout for them?

Carosanto your story made me want to weep and I am so sorry for you and your family. This definitely has to do with the quality of nursing. With a strong ward sister the ward works but if the sister couldn't care then the nurses won't bother either.

My mother had good treatment when she was in hospital having suffered from several major strokes. The doctors and nurses all seemed to care about her. Mind you we were lucky enough to be able to visit daily so this probably kept them on their toes.

I was once in hospital and completely forgotten because I was pushed to the back 'awaiting tests' and this despite the fact I was able to speak for myself. It was the senior staff nurse who was in charge and she was pregnant and really couldn't have cared less for her patients. I discharged myself in desperation and got the tests done as an outpatient.

My recent visit to the orthopaedic ward could not have been more different, it was slick, efficient, happy and caring so full marks as far as I am concerned to Southmead Hospital in Bristol. Needless to say I recovered amazingly quickly.

OH Carosanto that is a heart rending story.
But unless we complain then nothing is going to happen. if you complain to the hospital and copy your MP, your MP will copy in the minister and write to the hospital as well. They will have to investigate and they will have to get back to the MP.
I think as his child you have the right to complain and not involve your mother.
I don't think it is necessarily a whole hospital that should have the finger pointed - sometimes it is a department or individual ward that is not managed well. We have to name wards and patients to get things changed.
Did anyone here a programme on R4 last week about poor nursing? I heard it referred to on Feedback while driving.What was it called?

Oh hell - what on earth are we going to do about this horrible, widespread situation? All these pages of input show that we are all in danger of being at the mercy of hard-nosed policies that put money before compassion, and ill-trained staff who will not or cannot offer proper care.

It is like a 'care lottery': you might end up with wonderful, compassionate care, or you might end up dehydrated, starving, dirty and neglected, especially if your family cannot be there every day.

My father had several TIA's (small strokes)then was admitted to hospital with a larger one. He recovered, but returned home diminished both physically and mentally. The hospital care though that he had received while he was relatively compos mentis was good.

From that time my 84 year old Mother nursed him. Getting help was a nightmare of the "you own you rown house, we can't do anything for you, you will have to pay" kind, and dealing with the bureaucracy from a distance, as I had to, was a nightmare. My parent did own their own house but had no disposal income over their pensions.

Then my father, by now blind and incontinent, was admitted with another stroke. He developed Cdiff, and was put into isolation. His food (which he could not see) was left to fester. He was also paralysed and had to be manually fed - obviously this did not happen. He was not being given liquids, and when I queried the treatment for Cdiff and was told that irrigation was important, I queried why he did not have a drip. They reluctantly gave him one, but every time we visited (daily) the drip was empty, until one day I refused to leave till it was replaced. And I had to repeat that request EVERY DAY for three weeks.

My mother and I took food and drinks into my father. He complained of pain, pain relief was requested but not given. He cried to come home. Our hearts broke. He was expected to die of the hospital infection, but did survive.

He was taken out of isolation into a general Geriatric Ward where social workers and the hospital decided he was 'fit enough to come home'. In fact we were by now searching for a nursing home.

Within a week of moving out of isolation he developed Cdiff again, was re-isolated and died within 3 days. Cause of death = heart stopped, liver damage, kidney damage, no mention of cdiff on the Death Certificate.

The hospital was, shortly after, blacklisted for unecessary deaths from hospital infections. The family wanted to make a formal complaint, but Mum, by now worn out with 3 years of caring and hospital visits could not face it.

My wonderful father was refused the good death he had earned over his lifetime of work and bringing up a large happy family. I grieve for that as much as I grieve for him, and fear that my own end of life will be as bleak, desolate and uncared for as his was. If so, let me go now.

I have always believed that nurses are in charge of a person's general well-being and care - Doctors treat the illness or injury, though they should also be aware of whether there is more than one medical problem of course.

For this reason I think the answer to many of the problems lies with nursing training, nurse supervision and nurses' work conditions. If young trainee nurses could simply be trained to treat all patients as if they were their own sibling, parent or grandparent it would help. Management always makes a huge difference to how people carry out their work, so good effective supervision is essential. As for working conditions, an overworked nurse on a double shift is going to lose out on efficiency and even compassion; we are all human and being overtired and overworked is a recipe for disaster.

My husband has been in hospital for knee replacements. He is in his mid sixties and most of the time he was treated well, but it is my experience that every patients needs family around them, or friends - someone who can ensure their needs are being met.

Hugely interested in the posts so far- but unles the Hospitals are identified by name, and are properly contacted and held to account how can such a campaign be really effective?

It needs to be evidence based, and there is penty of evidence around. I don't know what the legality of naming Hospitals is, but the sooner we have the equivalent of a Trip Advisor for Hospitals , defined by areas of care, the better. As we know from the Mid Staffs review, a hospital can just be very weak or failing in care in one particular aspect.

Come on Gransnet, and Mums Net- someone needs to start a Trip Advisor system...and its only the users and families of service users who can know what the actualexperiences are. Those of us in the Health care system know whats goimng on in our hospitals, but denial in the system is very very common. That was one of the Francis findings around Mid Staffs. We need to HELP the staff by holding the Hospitals to proper account in this way.

I'm sorry if someone has already suggested this – it's a long thread with many serious postings – but perhaps a goal to add to any campaign is that all nurse training should include a focused section on care of the elderly. As has been pointed out, elderly patients may be admitted to hospital with a particular problem, such as a broken hip, but may also be suffering from underlying conditions, from difficulty in hearing to arthritis. I don't think it's always lack of compassion that is at fault or even lack of time but a blinkered approach that sees only the immediate cause of hospitalisation and fails to recognise or even be aware of the bigger picture – seeing the symptoms and treating the disease but not seeing the patient

Poor management. If the ward sister set better standards...
What for instance would be the problem, during visiting, if instead of an unofficial social break the nurses popped round and had a 5 minute chat to make sure those without visitors were ok.
There are some fantastic nurses but there are some terrible ones and if leadership and management not good.
My star of a SIL ended up giving the sister a mega- roasting last week. (SIL is a lovely woman but manages a LOT of men in an industrial setting so, when riled, both barrels) The last straw was leaving MIL in pain for a day and then saying she was fine. And the pain relief patches weren't on the computer. (their mistake, their second one) Blah blah.
It bugs me that they make so little effort to explain things to relatives. Yes they explain things to patients but it would be good if they made sure those keeping an eye on them or caring for them understood things as well. Drawing teeth I tell you.
Anyway my dear MIL back out now, much benefitted from cardiologist attention and much better symptom control. Bless her she never complains. Just off back home now, leaving her in SIL care.

Have you ever had the nurse treatment in hospital when visiting an elderly relative?

You know, the one that goes from uninformative to unhelpful to officiousness to downright hostility?

It is that one has to face when attempting to get an elderly relative cared for.

I have had to face that kind of reception on several occasions when one of my parents was in hospital, and every time I was made to feel that I was the only one making a (completely unreasonable) fuss.

I think it may be caused by a combination of lack of concern plus lack of competence on the part of the nursing staff, but it is very hard to fight on in those circumstances.

Perhaps if the "nursing" strategies were to be more widely known, people would be more confident in trying to get information and care for their elderly relatives?

We should at least be able to go into the battle armed with the knowledge that there are hundreds of Gransnet participants who are there in spirit fighting alongside us.

An elderly relative was admitted to hospital with a broken wrist - a result of going out for her daily walk even in icy conditions. She was very bright and alert. Next day when we visited we were told that there were problems establishing her history as she was so confused. They hadn't given her her hearing aid and she simply couldn't hear. We inserted hearing aid and miracle of miracles - she was no longer confused!

My mother was in a care home suffering from dementia. She was admitted to hospital suffering from an infection. When I asked a nurse how she was progressing she replied 'She seems a little confused'. I nearly laughed! - Obviously hadn't read her notes. My dad had been in hospital for weeks. One evening when I went to visit I was told he had been transferred to our local
community hospital earlier that day. No one had told me and transfer him was all that they had done. All his possessions, notes and tablets were still there! They had literally picked him up out of bed, and had left everything else there. Then after weeks recovering at the community hospital the sister in charge told me that dad could not go home as he would not be able to cope even with a care package. We had to fight all the way, she even told the social worker that he could not weight bear and that he had short term memory loss. Lies! He has been at home now for 12 months and copes just fine! I could tell of so many more incidents too!!

This last encounter highlighted that communication is a big issue. People take it for granted, and therefore make little effort to get right.
Toileting - what is it they don't get about "nurse i need the toilet" . A woman in her 90s had to shout across a room full of strangers (the discharge lounge) at a male nurse. He was more focussed on getting people discharged (a difficult job...) and other nurse on break. Eventually. after about half an hour, he got to us and I suggested he take her to the toilet first...
Apparently one woman on MIL ward waited a whole hour, during a visiting time, when my SIL had spoken twice to nurses.
I'd like to get em on a training course for a day and then say, you have to put your hand up and ask me, in front of everyone else, if you want to go to the toilet and then keep I would keep them waiting 45 minutes or so before i give them the toilet key. Or maybe make them ask twice more. Can you imagine the riot?
Bedblocking? seemed to take nearly 2 days from the time they decided she could go home to actually getting her out of the door!
General elderly care - everyone focusses on one symptom at a time. Even the last cardiologist she saw, a professor, was focussing on angina and did not pick up that she was retaining fluid and that this was making her breathless. How are we supposed to pick these things up?
Anyway the good news is that the cardiologists did their bit this time, she has dramatically slimmed down! (fluid loss) and getting to the loo and back is much easier than it has been for months. But why did it not get picked up before - the one symptom at a time phenomenon. Her ex GP even had a notice on the wall that said you can only talk about one thing per appointment!
I think we should all practice being stroppy and demanding so that when this happens to us we will not sit there being patient. My sister once shouted in an A and E dept "IF SOMEONE DOESNT HELP ME GO TO THE TOILET NOW I AM GOING TO PEE ON THE FLOOR" It worked.

I believe you are doing the right thing JessM, you have to advocate for your MIL. If she is like my mother she may forget to take her tablets. My mother can barely move if she is in pain, she who was strong and barely ever sick when she was younger
I believe we all need to speak up and complain when we have to. When my youngest daughter was in hospital with an enlarged liver, she was in agony. It took them ten days to work out what was wrong with her. She was on morphine for the pain and the doctor came around with his students and said oh you are okay you can go home. My daughter was upset as no one knew why she was in so much pain and she was scared to go home not know what was wrong. I immediately phoned and got onto the complaints department and complained about this doctor. They in the end did a procedure where they put that thing down their throats (I don't know the medical term) and they found out what was wrong. I have to admit I have had other incidences with that very hospital and wished I had have complained immediately.

In this Wednesday's Daily Mail there was a story of a woman like us, horrified by the care being given in a care home she worked in. She exposed the home and has set up a small charity called Compassion in Care which she runs on a shoestring. She visits homes anonymously, usually having been alerted to poor care by the relatives of residents and then reports poor care to the relevant authority, who generally takeno notice. We need something like this for hospitals.

Having said that, the problem with hospitals is not confined to the elderly. On R4 today I heard, as a talk, an article that Christine Patterson, an Independent journalist published in that paper in February. In the last 10 years she has had 8 operations and her experiences are just as horrifying as those of the elderly and she was just as helpless and unable to help herself. The link is http://www.independent.co.uk/opinion/commentators/christina-patterson/christina-patterson-nasty-nurses-tell-me-something-new-2215918.html

However my father's care in hospital could not have been better, but he was in a cardiac ward and his designated nurses were both trained in their country of origin, which meant they were everything a nurse is meant to be. That was the cardiac ward.I went into the Surgical Assessment ward of the same hospital as a day patient, except I was there three days because my minor procedure kept being delayed. At one point I was described to my face as a bed blocker even though the only reason I was there was entirely their responsibilty. I said that in that case I would discharge myself and go back to see if my GP. I was in theatre within half an hour. However I was on 'nil by mouth' for two days and even after my operation I was not fed. I had been moved into another ward and they forgot I was there so nobody brought me any supper. The next day I did discharge myself because they had forgotten to tell the surgeon about my move so he did not do the discharge check in the morning and was now in theatre. He would see me the following morning. I said thank you and goodbye and my husband took me to our favourite pub and I had a large pie and chips. Now I was in my early 60s, fit, healthy, minor problem apart, and could survive three days with little or nothing to eat and drink, but if I had been old and frail, it could have killed me.