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Is the Liverpool Pathway still being used in our Hospitals

(37 Posts)
Tina3120 Thu 17-Aug-17 14:20:24

Further to our Care of the elderly in hospital which I must add is so true and having witnessed first hand the dreadful treatment of my Mum who we lost on the 31st October last year I believe that ageism in the NHS is so prevalent as to be a concern for all of us who have elderly relatives. Until 2013 elderly patients were placed on the Liverpool Care Pathway which basically meant the withdrawal of all but the basic needs in order to hasten death and now it is termed "Passive or Palliative Care" which actually means the same thing in practice but leads to an inevitably hastened death in their elderly patients. This whole scenario is an abomination to a generation of people like my Mum who was machining Army Lorry Covers as part of the War effort at the tender age of 13 its disgusting a cherished Mother, Grandmother and Great Grandmother taken away unnecessarily as she was treated for her date of birth and not her condition.

SueDonim Thu 17-Aug-17 14:39:51

I'm sorry you lost your mother is such difficult circumstances. flowers

I have to say, that's not been my family's experience at all, they've been very well treated.

devongirl Thu 17-Aug-17 14:45:13

According to

www.compassionindying.org.uk/wp-content/uploads/2015/02/IN05-What-happened-to-the-Liverpool-Care-Pathway.pdf

there should now be (point 5)

"An individual plan of care, which includes food and drink, symptom control and psychological, social and spiritual support, is agreed, coordinated and delivered with compassion.
Each individual must have a plan of care. This plan should include any wishes for care and any treatment preferences that the dying person may have. It should also include information on symptom control, such as pain relief, and detail the individual’s emotional, social, spiritual, cultural and religious needs. The plan needs to be documented so that any information shared with those involved in their care is consistent. The care plans should be regularly reviewed and any change in the person’s preferences should be noted."

It's so sad that this was not your experience.

snowhound15 Fri 18-Aug-17 21:01:22

Hi, my mum has been admitted to hospital 12 times in 18 months for UTI related issues. I have never seen a care plan in that time. An admittance can be for 1 night to 10 nights. No physio, no treatment other than in one out of area hospital. I used to get my mum up and exercised till it was used to discharge her. Discharge process shambolic, sometimes you may have 12 hours notice, sometimes just 30 minutes with medicines sent by taxi.
A DNR written on her latest discharge letter. After enquiries this appears to have been created 5 admittances previously but no mention on discharge letters, neither does my mum recall the conversation.
My bigger concern is local GP services. For example previous 14 days mum has been exhibiting signs of UTI but she had been given a daily dose of trimethoprim. It has been difficult to obtain a urine sample, she managed to produce one on Friday and passed to GP. Monday I telephoned for result, informed needed to be reviewed by GP. GP eventually telephoned Tuesday to say no growth identified. She suggested another sample which mum provided Thursday. GP telephoned later that day to say growth detected and Trimethoprim ineffective. Nitrofurantoin to be supplied for 7 day course.
If it is not called Liverpool Pathway the withdrawal of treatment my leads to the same thing, early death.

RuthMCA Mon 14-May-18 12:08:43

Hi. Just new on gransnet. Want help or advice. My dad died on 17th February this year and i think he was on the 'Liverpool care pathway '. Even though they say its not used anymore. Dad went in with pneumonia and lasted just short of three weeks. The first week he was doing well but then he was placed in a room where 2 people had already died. When he was in the room, he wasnt getting cleaned, shaved, mask and mattress were wrong. Only when we complained they made changes. They stopped his antibiotics for pneumonia even though thats what he died from. They had him on high doses of morphine saying he was agitated. They said about palliative care which he shouldn't have been on. They wanted to put him on syringe driver but as carers we knew what that was. When nurses and doctors were asked what tablets my dad was on, they refused to answer and when asked about the LCP, the doctor said no. There was no signs dad was eating (eg: salt, napkins) and a sticker had been put over the first number of his restricted fluids on the wall, instead of 1200 ml it showed 200 mls. He died 4 days before his 69th birthday. Doctors and care staff should not have authority to 'kill' off people and thats what they did to my dad.

gillybob Mon 14-May-18 12:12:42

When I read your harrowing post RuthMCA I expected to reach the end and learn that your dad was perhaps 89. No way did I expect you would say he was 69 and I am rather shocked. I wonder did your dad have several other serious health issues? Surely there has to be more to this other than what seems like sheer neglect.

silverlining48 Mon 14-May-18 12:53:58

Ruth so very sorry, that sounds just awful. Have you contacted PALS (patient liaison service) at the hospital or sought an appointment with the doctors to discuss what happened. I think you need answers and an explanation about the treatment of your dad.

silverlining48 Mon 14-May-18 13:19:14

Tina and Snowhound flowers

Alexa Mon 14-May-18 15:44:20

Ruth, like Gillybob I was surprised and worried when I read he was only 69. I also expected he'd be at least in his 80s. You do need answers. Make a list of all your questions and go to the Patient Liaison Service until you are satisfied. I am sure you have the moral support of all of us grans.

Panache Mon 14-May-18 17:02:16

To hear these situations are worsening and not improving is very distressing to read,let alone have this actual happen to your own kith and kin....Tina,Ruth & Snowbound.My heartfelt sympathies.

As someone approaching 80 with some very serious on going problems plus a very complicated `op planned as soon as the 29th it certainly does not fill me with confidence ..........in fact it fills me with dread.

What on earth is happening to the care of the generation that worked through and after the last war,rebuilding the country.
Utterly shameful to say the least.

BlueBelle Mon 14-May-18 18:26:11

My experience with both my parents and the NHS. Could not be faulted My Dad was a fairly healthy nearl.y 92 year old when we found out he was terminally ill The kindness support and help in the hospital I got then as he wanted to go home I was given everything we needed to care for him at home nurses doctors on call and every type of equipment to help him and me in his last days
My mum at 90 + had a heart attack rushed to Aand E where we spent 24 hours the doctors and nurses were kindness itself and did their very best to make my mums last hours as comfortable and pain free as possible they found me a comfy chair blankets simple food and drink offered me a bed if she lasted longer than 24 hours and were so kind as I was really in shock
At the moment I have a close friend of 81 with the most complex and multiple health problems ( heart, kidney she’s only got one, leisions plus blood clots) in hospital although she has talked clearly with the doctors as not wanting resussitating if anything happens in surgery they have gone out of the way to do really complex ops and procedures to get to the root of her problems she has said she can’t fault them so Panache it isn’t all bad news please take heart

janeainsworth Mon 14-May-18 19:25:42

Thank you Bluebelle, I too do not believe that doctors and nurses within the NHS ‘have the authority to kill people off’ as Ruth puts it.
Killing people off and ‘hastening death’ which Tina refers to is actually illegal in this country.
It might be as well to remember that for everyone who complains that their relative died too soon, there will be at least as many concerned that their relative suffered for longer than necessary
and that doctors should have given more medication, even if the side-effect would have been to shorten life.
It seems clear that both of you have unresolved issues and I agree with a previous poster that the best way forward is to seek the help of PALS to obtain an explanation for your relatives’ treatment.
I feel sure there is one.

Iam64 Mon 14-May-18 21:25:27

My experience of the care given to my mother (aged 87) and mum in law (93), like that outlined by Blue Belle, could not be faulted.
Physical and emotional care was excellent. I saw no evidence that the doctors or nurses wanted to do anything other than provide good care for our loved ones in what we all knew, would be their final weeks of life.
The side effect of some medications that ease life in those final days and hours, can be to shorten life. When life is full of pain and is coming to its end, I find no fault with that.

Tina3120 Tue 15-May-18 11:05:37

Like all matters not all hospitals practice this form of money saving but I have spoken now to many professionals who left the NHS simply because of this practice PALS forget it the only thing you need to get to the truth unfortumately is a very large Bank balance my hearfelt sympathy to Ruth and her family when you feel up to it once the hospital responds with the normal rubbish take it to the Health Ombudsman xx

starbird Tue 15-May-18 11:33:15

My heartfelt sympathies for those who have experienced what they feel is needless suffering and death. According to the news there has been an unexplained increase of 20,000 deaths so far this year. I imagine a large part of the reason is the shortage of properly trained staff and resources. It would also be interesting to have the figures broken down by area/hospitals. I live on the border between two counties and friends receive very different treatment in the different areas.

It is frightening to think about what happens to people who have no one to look out for them.

Tina3120 Tue 15-May-18 13:32:54

Yes It would be good but that would bring all to light and if this is a training thing whats gone wrong? Many years ago no one worked on a ward until they were qualified to do so no responsibility and no supervision is the biggest problem

notanan2 Tue 15-May-18 19:34:13

According to the news there has been an unexplained increase of 20,000 deaths so far this year

if you remember the news from earlier in the year there was a massive surge in hospital admissions and a national bed shortage so a higher death toll this year is to be expected this year.

And vaccine uptake is down. Antibiotic resistance is up.

Tina3120 Wed 16-May-18 13:43:18

Understandable but not the kind of deaths we are talking about its when Treatment is with held or delayed long enough to cause secondary problems or no treatments given at all for diagnosed issues with no explanation other than "theres no point in it" which is what my family was told my Mum was having a cut and blow dry in the hairdressers on the Sunday and DNR placed on her by the Wednesday!

gillybob Wed 16-May-18 13:51:01

PALS forget it the only thing you need to get to the truth unfortumately is a very large Bank balance

I agree with you about PALS Tina3120

I had an occasion to complain about the ambulance service when my late mum was on dialysis and was directed to PALS. They were completely unsympathetic, useless even and I felt that we were being patronised and read to from a previously prepared speech.

gillybob Wed 16-May-18 13:51:43

Meant to add, not the ambulance personnel themselves but the service coordinators.

Tina3120 Wed 16-May-18 17:18:52

Yes unfortunately they are part of the circle of conspiricy to silence so for that matter is the Ombudsman unless your rich you have no recourse to these people we all pay to care for others!

janeainsworth Wed 16-May-18 19:18:09

Sweeping generalisation there, Tina.
You sound very bitter.

Tina3120 Thu 17-May-18 17:06:57

Lived it now for the past 18 months with proof in Black and White - Bitter? -no just experienced!

Iam64 Thu 17-May-18 19:35:12

I disagree with your words and your views Tina. My experience and that of so many loved ones has been a million miles away from the one you describe.

notanan2 Fri 18-May-18 12:43:01

anything can be missmanaged, that doesnt mean the thing itself is bad/wrong.

Surgeries can be inappropriate & missmanaged: that doesnt mean that hospitals are wrong to perform surgeries in general.

Same for end of life care plans.

It's a good thing that there are best practice standards for the care if dying people.

If anything I think there are a lot of people in the UK who feel that we dont consider that option until too late: often missing the window for a "good" calm death at home or in another place of choice.