elderly in hospital

I am apalled by all these dreadful personal stories which confirm what we are hearing in the news. I myself am 83 and very much aware that this may be my fate in the not so distant future - though I plan to die at home if I possibly can - or perhaps ANYWHERE but in care! I do hope that Geraldine can find some way of turning all this heartfelt witness into an effective campaign, which I shall certainly support.

I am struck by gkal's mention of the 1970's as the time when things seem to have begun to go wrong. Wikipedia tells me that Matrons were abolished in the NHS in the late 1960s (although apparently they are being reintroduced in some areas now in the NHS, though their roles have changed.)

But also the 60s and 70s were the high time of the women's movement, and I do wonder if in our struggles for equality, we may have sacrificed some of the caring side of our natures, with which women could take pride in the hospitals run by the matrons in the 'old days'. Bending to Matron's rule must have been more satisfying than bending to the rule of the male managers who followed them. Sadly, gains are sometimes balanced by losses.

Interesting thoughts Judian. I think further up this thread I mentioned recruitment issues. If not, will return to theme later.

Getting equality may have been great for some women but as a stay at home mum and housewife I did not like having doors swung in my face or not getting offered a seat on a bus. The NHS really went down the pan in the late 60s and early 70s and I found a lot of women who trained at the same time as me left to work in other fields.

Do you think it improved at all after that date Harrigran? Was there a golden age?

I am not really sure that it did improve JessM. I could never see beyond the sloppy way of dressing, no caps and hair not pinned up. Admin was done by staff who had progressed through nursing but then it changed to managers who seemed to have little connection with care of people. I think perhaps the early 60s was the time when nursing was a vocation and they really cared about the people they nursed. Medically we have advanced enormously but tests and machines seem to take the place of a friendly face and a cool hand on the brow. One or two of the female nurses started pushing for us to join the union and became quite militant, I didn't like it.

I seem to recall there used to be volunteers who would visit people in hospital to help cheer them up. Does this still happen? If so, couldn't they be asked to look out for any mistreatment. This could also be extended to nursing homes and residential homes, volunteers could visit at any time and if they see anything which shouldn't be happening they could report it to the relevant authorities - who should then do something about it! Not sure how practical this is though!

Good point Barrow, we have prison visitors so why not hospital ones ? There are probably lots of old people who have few visitors and perhaps would appreciate a visit. My friend's father is in hospital and she said that she was the only visitor in the ward on one evening. She had a word with other patients so that they were included.

Sitting here waiting for the cardiology ward to discharge MIL. We are arguing about morphine patches that she has had for last 2 years. They have formed the opinion that she does not need them and that co-codamol is sufficient. I would like to see them cope with arthritis in neck, spine and hands on top of 2 hip replacements that have past their sell by date on just a few co-codamol.
Oh not to mention periodic bad gall stone pain every few days. Tra - la - at least the GPs are helpful. Or will be when she is back in their care.
Sitting in SIL's lovely garden, trying to stay calm. This "discharge " process has been going on for about 2 days now... Still in another 2 hours it will be nearly visiting time and perhaps at that point she might like to discharge herself...
OK - need to do some work and distract myself...

That's awful Jess. Surely she is the only one who can decide if she needs the patches. Be strong and fight her corner for her. (You can do it girl!)

Enjoy that garden.

We're sorted. She's home and knackered after a whole afternoon in the "discharge lounge" - sounds revolting but better than calling it the departure lounge I guess. Found her wanting the loo but not wanting to ask male nurse. He was fine when you got to talk to him but looked like the sort of guy you'd be wary of bumping into in the pub.
Communication stars again - she had a patch last night. Should last for a week and then GP presc. takes over. Hospital dr obviously wanted GP to pay. Nurse could not convey these simple facts on the phone. Gave completely wrong impression to me and to SIL in two phone calls.
We sang "show me the way to go home" in the car.
At least the cardiologists have done their stuff and given her some relief in the heart dept. Off to double check all prescriptions... anything left off that she was on before... Perils of being on about 15 drugs!

Jess - "departure lounge".

Naughty!

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.

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.

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.

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!!

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!

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.

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.

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

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 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.

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.

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.

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?

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.