elderly in hospital

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Yes Stansgran - it is interesting that when I looked my problem up on the net afterwards (as you do) there were endless references to the fact that the second fracture I had is "easily missed", "can cause long term problems if overlooked" and that radiologists need to be "vigilant" to spot this when presented with an injury like mine. So clearly the radiologist who looked at mine had not been on the net!!

But worse still the so-called foot specialist in my home hospital could not identify it on both CT and MRI scans, in spite of the fact that another local consultant had seen it and reported on it.

We are in their hands and can do so little - we just have to trust that they know what they are doing.

The results of an X-Ray tend to be only as clear as the eyesight and experience of the radiologist who reports on them. It is a brave patient who asks for them to be reviewed.

Maybe doctor needs eyes tested - but if no complaint then may carry on thinking they can see!

Mishap, if patients don't complain, the hospital won't have the incentive to make the necessary improvements.

After my father died and when the dust had settled a bit, I did make a complaint to the hospital where they failed to diagnose two infections and allowed him to fall twice, the second time resulting in a fractured hip that required surgery. This was basically a terminal event as he never fully recovered from the surgery and died slowly over the next few months.

They replied that they were starting an investigation and would get back to me by a certain date, which, to my amazement, they did! There do seem to have been some good results, including changes of policies and the employment of a nurse whose job is to go round the hospital checking on the strategies for falls prevention and also providing training and recommending equipment. So....a result!

I do not know whether to start the process in my local hospital, where I received very poor treatment for a broken foot - not only did they miss one of the two fracture, but that fracture is malunited and I still cannot walk without crutches after year. The fact that I was in plaster for 17 weeks has caused all manner of problems, including the joint that is now misaligned. I am to have surgery in a specialist orthopaedic unit some miles away from my home.

The original hospital's foot specialist could not even see the second fracture at all! - I have been shown this fracture on the scans and it is perfectly clear. The biggest problem was that none of the doctors would listen to me - when I said it was so painful to walk I was told that it was "just where the plaster had been." I knew this was rubbish, but could not get anyone to listen.

Reviving this thread in light of Ann Clwyd's report today. Sounds like she has been making some headway. She was on radio 4 World at One earlier if anyone wants to listen

www.bbc.co.uk/news/health-24669382

I did take Social Services through the complaints procedure over the way they handled the whole period from my aunt's stroke until she and her husband were admitted into a care home, mainly because I and another relative who was a hospital consultant warned the hospital and Social Services in advance that what did happen when she was discharged would happen. I went through several levels of complaining but knew that the best I could hope for would be an expression of regret and the great let out mantra 'Lessons will be learnt' but stopped when I had caused them about 10 per cent of the hassle they caused me mainly because I realised that evry £ spent dealing with my complaint was a £ not spent on caring for people who needed care.

You can lodge a complaint against a medical professional up to three years from the time the adverse outcome became apparent, which could be several years later. This applies whether the treatment was NHS or private.
And I can tell you that you enter a nightmare world of delays, lies and secret filming. The Medical Defence Union dragged out my daughter's case for seven years and finally settled out of court one week before the trial date was set. The surgeon had admitted liability seventeen months after the operation, so the only dispute was about the extent of her injuries.

It's not just a modern trend. In 1975 I brought a 2-year-old with a temporary colostomy home from hospital. Did I get a visit from a doctor or a district nurse? What do you think?

They reckoned I could cope on my own being in plaster and no weight bearing. Fortunately I have the knowledge and facilities to organise paid help for myself!
But what would have happened if I hadn't? My GP didn't even bother to call or phone!

We didnt complain because it was only a year later that we really realised how bad things had been. At the time we were so in shock from the accident, and concentrating on caring for DD who was in a pschologically fragile state as well as having the serious injury she had that the ability to stand back and say 'This is treatment is unacceptable' completely left us.

Also having between 2000 and 2010 been responsible for the wellbeing and care of three different elderly households in my family and been in and out of hospitals with them in places as diverse as Margate, Swindon, Portsmouth and Oxford, I knew that the hospital care DD was getting was good and when the discharge decision was made the consultant didnt threaten me that if I didnt take immediate responsibility for the care of her he would just dump her outside her home and leave her there, and that happened with one of my uncles.

Another hospital refused to undertake the mental assessment needed to confirm that another relative had dementia because if they had they could not have discharged her as they did back home to live with her husband who did have a diagnosis of dementia, both had physical disabilities and Social Services saw no need to visit the home as part of the discharge assessment.

The hospital 'forgot' to ring me to tell me when she would arrive back home and I arrived at the house to find she had been home for two hours stuck in a chair she couldnt get out of, with no walking frame to help her get to the toilet or get a drink. I managed to get the instant loan of walking frames and elephants feet to raise the height of my aunts chair from the local Red Cross but Social Service considered that two disabled people both with dementia could manage at home with carers coming in three times a day for 30 minutes. Needless to say that lasted for about three days with GPs, Paramedics and Community Psychiatric nurses being called out at a rate of about three a day. They then moved into a care home but by then they were so traumatised it was six months before they had fully recovered.

It is not just the care in hospitals that is so poor it is the premature discharges to grossly inadequate home care that is just as bad.

Flickety B - yes, your bum barely hits the bed and you are on your way out. This is how waiting lists are kept down - never mind good patient care.

Conditions that resulted in a week in hospital are now day cases.

Some of this is good - people like to be in their home surroundings and often recover better there - but the speed with which people leave hospital now borders on negligence. And the complete lack of interest in how you are going to manage when you get home is now the norm and reflects blinkered thinking - we've done our acute bit; now go away and sink or swim.

On a more trivial note I was was sent home from A&E in October with leg in plaster and crutches only to get home and find I could not get into the house, on or off toilet etc. No-one asked any of these questions or offered help to get equipment etc.

If Ann Clwyd MP can't get what she thinks is satisfactory care for her husband as he lay dying, what hope for the rest of us. I (and all my family) have had wonderful care in hospitals in different parts of the country. Some of us have received neglect t and carelessness and what can only be described as total lack of compassion, sometimes in the same hospital on a different occasion or on a different ward. The key seems to be not long lists to check about maintaining patient dignity etc but a recognition on the part of all staff that the patient is what the job is about.

I stopped reading at the end of page one as my tears were preventing me from seeing the print. This is all so appalling, what can we do?

Flickety, I do hope your DD has recovered well by now. I have to go into hospital next year to have a kidney operation, and I am really worried and scared about it. It's not as if I haven't been in hospital before but the older I have become I have noticed the caring bynursing staff has become less and less., I think this is partly down to the nurses being so short staffed, they simply don't have time to do their jobs to the best that they should. But it doesn't help your own confidence when it comes round to your turn to need treatment.

That's truly shocking, Flickety. Words fail me - I'd complain to the highest level. It's unacceptable that all the good work which is undoubtedly done in hospitals by the surgeons and nursing staff is being compromised by the indecent haste with which patients are discharged.

Your story is appalling Flickety Could you now write to your MP and the hospital to complain. If the patient isn't at the hospital to receive the treatment they need, any improvements won't make an iota of difference.

But the care of young patients isnt that brilliant either. DD was seriously injured in a car accident last year. She was in hospital 10 days and had 3 operations. The care she had in hospital was excellent but she was discharged from hospital only hours after recovering consciousness from her third operation, a very large (6in x 9in) skin graft on her arm plus an equally large wound on her leg, the source site for the graft. She was on massive doses of antibiotics and pain killers.

For the first fortnight at home DH and I were providing 24 hour nursing care as she needed help at night as well as during the day. The dressing on her leg often came off in bed at night so we would have to re-dress it, and change all the soiled bedding and her nightware. She was very unwell just from the effects of the accident and her injuries on her system and being in theatre for nearly 12 hours over 10 days and couldnt get to the loo or wash and dress unaided yet every day we had to take her to the hospital or GP for some form of after care.

The constant need to keep getting her up and dressed and into cars to sit in crowded waiting rooms when she was still unwell hindered her recovery and we had a constant worry that this travelling around and sitting in crowded public places could lead to her wounds being accidentally damaged or that they would pick up infections. On one occasion we had to take her to A&E, to have a side effect of her drugs treated which wouldn't have arisen if she had been in hospital. It was appalling, she should really have been kept in hospital another week if not two.

I am still amazed how we managed to protect her wounds from further injury and avoided picking up any infection. Neither DH nor I have any medical experience and DH has medical problems of his own that were exacerbated by the worry of caring for DD.

What would have happened if we hadnt been able to drop everything to stay at her house and care for her I do not know.

As an retired nurse, I think the best way to bring care back into nursing is to reinstate the SEN role. They were often down-to-earth, caring, hands-on nurses who always knew their patients well.

Sadly, the changes came about from the time of Margaret Thatcher, who brought in internal markets. All emphasis then switched to saving money, so where you would get one Sister over a ward, instead you would have a staff nurse and one a sister over several wards.

I too, like everyone else, dread having to go into an NHS hospital. I have very modest private health insurance fom Saga.

Good article from the Kings Fund here: www.kingsfund.org.uk/time-to-think-differently/blog/how-must-we-change-care-systems-meet-needs-future-patient

I hate to harp back to yesteryear , because not everything was good . The one good thing I can remember was the way the wards were set out --- Long wards with beds down each side , a Sister's desk at one end from which she could see exactly what was happening on the ward . She would notice which patient needed help and just as importantly which nurses were not pulling their weight !! . On hospital visits in recent years I have been appalled at the way nurses are always to be found chatting and laughing at the nurses station , on several occasions asking the whereabouts and the progress of a particular patient and no seemed to know !! .So yes I would like to see some kind of action from gransnet and/or members , I wish I had the know how to do it .

Sorry, bit of a rant there. I agree that something needs to change.

Perhaps we could concentrate on one thing that needs to be improved. For example demand that the quota of nurses to patients be increased in geriatric wards and battle for that.

Though the money to do that would have to come from somewhere. Does anyone have any suggestions as to where this might come from.

I worked in the NHS (not a nurse), trained in the early 70s. Also occasionally in 2003-5.

I think all this stuff about bringing back matron is silly. And the tales that nurses cared so much more then. Staff now are brilliant and believe me get to treat probably 100 times the patients they did 30-40 years ago. It is a totally different ball game.

I was a radiographer and I can remember in the 70s an old chap being wheeled in, he was 93 or something, we all were oooing and ahhhing 'poor old soul' 'hasn't he done well'. It was so unusual to get someone of that age through the door!!! Yes, really. So nurses didn't have a ward full of confused and often incontinent elderly they had wards full of young people with broken legs, people recovering from ops (but these people would be 40s 50s and completely composmentis) so didnt' need someone to comb their hair or etc etc etc etc. The nurses could chat and joke with their patients. The patients could clearly describe their problems and were (usually) made well and after a couple of weeks sent home to a fulfilling life.

Now in Xray there is a non-stop conveyor belt of confused oldies on trolleys (they might not have been confused before being brought in but by the time they have had a fall/ infection/ long term ilness and are whisked in by ambulance they are confused and frightened). What they then need is a full time one-to-one carer to stay with them and make sure their every need is met. Needless to say that is not going to happen. The staff work at a v fast rate - they have to to get through the work - and ime are more considerate and kind than in the 70s. I can particularly remember a snooty doctor's wife who would never sully her hands by touching a patient. Also patients were very deferential to staff, we were thanked constantly, patients werein awe of doctors and didn't expect to know what was going to be done to them or why.

My mother was a nurse so I am v aware of what nursing was like in the past. As stated above the patients are totally different from the old days, healthcare is more sophisticated, that is why the oldies are in hospital, they have been kept alive by modern medicine, previously they died in their 70s.

I don't dispute that there are bad nurses and it is infuriating that this isn't dealt with (we could all put our complaints into writing naming hospitals AND staff for a start) but our aged population is a new scenario and blaming the poor care staff who have to do the very heavy and exhausting work of looking after them isn't going to get us anywhere.

I remember feeling put out a few years back when my DM was in hospital and wasn't aided to have a shower (which didn't seem too much to ask).

Well, afterwards I worked out that there were about 30-40 patients, and one senior staff nurse and maybe two other trained nurses. Probably 3/4 of patients would need assistance to shower or bed bath. Say 30 mins to do that (though as my DM was over 80 probably more). Sooooooo say 25 patients at half an hour each would take a nurse 12 and a half hours!!!!!!!!!!!!

So really 2 of the staff would be taken up wholly with this work in a day.

Leaving 1-2 trained staff to do medicines, consutlants wardrounds, answer phone to enquiring family, filing, writing up reports etc etc etc.

There were care assistants but still there wasn't nearly enough hours in the day to do all the work required.

The problem is more the lack of staff than their standards of care imo.