Very worried about elderly dad and geriatric hospital ward

Or compassionate leave, surely?

I was in hospital for nearly 3 weeks not long ago,,for pneumonia followed swiftly by pleurisy, and for at least part of that time I was in wards with patients who had dementia. I have to say I thought the staff were unfailingly kind and patient with them - one of them was constantly wandering and needed a 1 to 1 healthcare assistant with her, day and night. TBH I really felt for the staff.

Another old lady who said she was 91 had a very loud, imperious voice, and at one point called at piercing full volume to me across the ward, ’I’m afraid I’m going to have to ask you to leave, because I didn’t invite you and I wasn’t expecting you!’ 😂
It certainly livened up my day!

Serious think or ask him about a DNR.. Its not a nice thing to go through especially as an elderly patient.
Both my sister and I are Health care professionals, (she was a Intensive care sister, I'm a Cardiac Physiologist both of us still working ) when out dear mum was really poorly the GP commented there was no DNR in placed, prior to her deteriorating she was able to make up her own mind but she became very ill, no way would we put mum through that.

I've helped during Arrests many times it's a very low % that make it, it's brutal.

Visgir1

Serious think or ask him about a DNR.. Its not a nice thing to go through especially as an elderly patient.
Both my sister and I are Health care professionals, (she was a Intensive care sister, I'm a Cardiac Physiologist both of us still working ) when out dear mum was really poorly the GP commented there was no DNR in placed, prior to her deteriorating she was able to make up her own mind but she became very ill, no way would we put mum through that.

I've helped during Arrests many times it's a very low % that make it, it's brutal.

I’d echo that. Our next door neighbour of 80 odd, was resuscitated after a 2nd heart attack. He told me the after -effects were so painful, he wished they’d just let him die. He did in fact die a few months later anyway.

I certainly put a DNR in place for my mother, from the time she moved to a care home at 89, with already pretty bad dementia.

My very elderly mother was taken ill at home and it was only because she had filled in a form for the GP saying DNR and that she wanted to die at home that we were able to physically stop the paramedics from putting her on a stretcher. As it was, she was put in her own bed and died at home, peacefully and with family round her, a few days later. However, I was told that one should have the DNR form stuck up on your kitchen wall for all to see, just in case.

I have taken all your kind comments on board - thank you for taking the time to do so and offer support.

Have spoken to the GP surgery today and outlined the concerns which the doctor fully understood. Had a very useful conversation on cardiac med regimes which did clarify some issues. He has assured me that as soon as dad is discharged to home and his records delivered to the surgery that they and the district nursing team will assess for a revised regime to suit my dad's current status.

Have advised my mum accordingly and the discharge team have got on the case ... finally ... through my intervention with the Integrated Care Board.

Some of you were concerned that my mum is all alone in my absence, but my brother and his wife, are liaising with the discharge teams and will be on hand when my mum reaches home. He is retired and I am not ... yet... have to move around with my job. Adjustments in my schedule to follow to accommodate the current situation. Between the three of us (4 including my mum) we will handle it. My mum has agreed to the intrusion of the care teams provided it is done under her supervision!

I am just angry that the whole experience with this hospital has yet again been so bad ... my mum and dad have done their best not to have recourse to admittance there for good reason based on past experiences. Lets hope that the new chapter is better handled away from that wretched place in the comfort of their home. It is their 69th wedding anniversary this coming weekend ....

Umm.

Hithere

DNR =/ follow nature or believers of the Almighty

DNR = do not extend life without proper quality of life
This is letting the Almighty decide when it is your time

It is a compasionate measure to do for your loved ones when the inevitable is going to happen anyway - are you aware how brutal CPR can be?

You are under a lot of stress - beware of making decisions that are not in the benefit of the patient

Patients here have been made to agree to DNR when they are not compos mentis, are practically in a coma and without any consultation with relatives.

We have experience of this.
The problem is, the medical staff do not see the patient before they are admitted and assume the way they present in hospital is how they normally live.

It is disgraceful the way older people are made to agree to DNRs when they would have a good chance of recovery with the right treatment.

It is a sad fact that care standards in different hospitals vary so widely. My family know that I have told them that on no account will I go to the nearest one, and to bribe the ambulance staff if necessary to take me to the one which is one mile further away!

The geriatric wards in that place are filthy, I have seen friends admitted to beds where the blood from the previous patient has remained on the floor during the whole of their stay. Nurses ignore calls for help, patients who cannot feed themselves get no help and go hungry. Bad news is given abruptly to patients in an open ward with everyone else hearing. I have watched them burst into tears, and the team just moves on and leaves them sobbing. My 89 year old father was admitted after having a very mild heart attack. I gave the doctors the right hand side of his prescription so they could see what drugs he was on, including heart support drugs. This was completely ignored, in the ten days he was there none of them were given. I noticed he had been put on a new drug, and asked why. Apparently he had gone up to the nurses desk to ask three times in one afternoon when he was going to see a doctor, and they decided he was being a nuisance, so sedated him with a drug that caused jumpy movements as a side effect.

He developed a urinary infection which made him need a bottle frequently. The staff would not bring him one, on one occasion my daughter was visiting, he asked her if she could get him a bottle. The staff said they would come when they had time. He was getting more and more uncomfortable, my daughter went to ask where the sluice was and she would get him one, the staff rudely told her she was not allowed in there and to go away. After about 45 minutes the inevitable happened and he was forced to wet himself in front of his granddaughter. He was then catheterised, no antibiotics given, and left sitting beside his bed in just a pyjama top, with his groin and catheter on display to everyone.

No-one on that ward went home, they were all told at some point that they would have to go into a nursing home. My father had been fully independent before going in, shopping, cooking and cleaning for himself. When he was told the same thing, he pleaded with them for a trial at home. This was arranged, but he still had the jerky movements from the sedation, which I had finally persuaded them to stop - but not before they had put him on Parkinson's drugs. I asked why, and they said 'because he has Parkinsons'. I pointed out the side effects of the sedation they were giving him, and they agreed to stop them, but it was only the next day he had his trial at home.

He was really nervous, knowing how much rested on this, they told him to make a cup of tea. The physio got the milk out of the fridge and put it on the worktop. My father filled the kettle, put it on and went to the fridge as he had not seen her get the milk out. She shouted at him 'why have you done that, you can see the milk is out already', which further stressed him. His hand was shaking a bit as he lifted the kettle, she grabbed it from him and said 'It's no good, you are not safe'.

Back on the ward, he pleaded with me to help him get home, and I told the staff he deserved to go home with carers coming in. They protested that it would be cheaper for the NHS if he went into a care home that care be provided at his home. I insisted I be given the chance to try and organise this, and they agreed he was ready for discharge and I could try and set something up. As I left the ward he said to me 'I am so glad you are here, I feel safe when you are here'.

At 2.00 am I received a call that he had taken an unexpected turn for the worse. As an ex-nurse I knew what that meant. I said I would come in and had just got as far as the bathroom when they rang again to say that he had died. On arriving at the hospital I was told that he had been found in respiratory arrest and that the team had been performing CPR. There had been no discussion on a DNACPR form, and so they said they had to do it. They had no idea why he had arrested, there was no reason for it - except that they had failed to give him any of his heart support drugs from the minute he was admitted, and given him a sedative which had cardiac arrest as a side effect.

I am so sorry to have posted all this, but it just touched a nerve, there are hospitals where care of the elderly is as great as the over stretched staff can provide. And then there are ones like our local one...

i'm so sorry, B9exchange.
i have seen many wrong things over the years in different settings, all kinds of wrongness.
and some good humane practice too.
often from the most lowly members of staff.
those who glibly say, leave it to the professionals, they know what they are doing,
how do you know. you don't. you can't.

Callistemon21

Hithere

DNR =/ follow nature or believers of the Almighty

DNR = do not extend life without proper quality of life
This is letting the Almighty decide when it is your time

It is a compasionate measure to do for your loved ones when the inevitable is going to happen anyway - are you aware how brutal CPR can be?

You are under a lot of stress - beware of making decisions that are not in the benefit of the patient

Patients here have been made to agree to DNR when they are not compos mentis, are practically in a coma and without any consultation with relatives.

We have experience of this.
The problem is, the medical staff do not see the patient before they are admitted and assume the way they present in hospital is how they normally live.

It is disgraceful the way older people are made to agree to DNRs when they would have a good chance of recovery with the right treatment.

Callistemon21 - that is precisely the reason why mu mum and dad have always refused to be put under such an order. Too often it is inappropriately used by medical personnel 'playing God' as my mum calls it. One one occasion when my dad was admitted for surgery my mum had to fight off 7 doctors and consultants who kept at her and my dad on the very morning he was due to go into theatre. She refused to back down and told them that they were doctors and not there to play God... and promptly reminded them of their Hippocratic Oath!

B9exchange

It is a sad fact that care standards in different hospitals vary so widely. My family know that I have told them that on no account will I go to the nearest one, and to bribe the ambulance staff if necessary to take me to the one which is one mile further away!

The geriatric wards in that place are filthy, I have seen friends admitted to beds where the blood from the previous patient has remained on the floor during the whole of their stay. Nurses ignore calls for help, patients who cannot feed themselves get no help and go hungry. Bad news is given abruptly to patients in an open ward with everyone else hearing. I have watched them burst into tears, and the team just moves on and leaves them sobbing. My 89 year old father was admitted after having a very mild heart attack. I gave the doctors the right hand side of his prescription so they could see what drugs he was on, including heart support drugs. This was completely ignored, in the ten days he was there none of them were given. I noticed he had been put on a new drug, and asked why. Apparently he had gone up to the nurses desk to ask three times in one afternoon when he was going to see a doctor, and they decided he was being a nuisance, so sedated him with a drug that caused jumpy movements as a side effect.

He developed a urinary infection which made him need a bottle frequently. The staff would not bring him one, on one occasion my daughter was visiting, he asked her if she could get him a bottle. The staff said they would come when they had time. He was getting more and more uncomfortable, my daughter went to ask where the sluice was and she would get him one, the staff rudely told her she was not allowed in there and to go away. After about 45 minutes the inevitable happened and he was forced to wet himself in front of his granddaughter. He was then catheterised, no antibiotics given, and left sitting beside his bed in just a pyjama top, with his groin and catheter on display to everyone.

No-one on that ward went home, they were all told at some point that they would have to go into a nursing home. My father had been fully independent before going in, shopping, cooking and cleaning for himself. When he was told the same thing, he pleaded with them for a trial at home. This was arranged, but he still had the jerky movements from the sedation, which I had finally persuaded them to stop - but not before they had put him on Parkinson's drugs. I asked why, and they said 'because he has Parkinsons'. I pointed out the side effects of the sedation they were giving him, and they agreed to stop them, but it was only the next day he had his trial at home.

He was really nervous, knowing how much rested on this, they told him to make a cup of tea. The physio got the milk out of the fridge and put it on the worktop. My father filled the kettle, put it on and went to the fridge as he had not seen her get the milk out. She shouted at him 'why have you done that, you can see the milk is out already', which further stressed him. His hand was shaking a bit as he lifted the kettle, she grabbed it from him and said 'It's no good, you are not safe'.

Back on the ward, he pleaded with me to help him get home, and I told the staff he deserved to go home with carers coming in. They protested that it would be cheaper for the NHS if he went into a care home that care be provided at his home. I insisted I be given the chance to try and organise this, and they agreed he was ready for discharge and I could try and set something up. As I left the ward he said to me 'I am so glad you are here, I feel safe when you are here'.

At 2.00 am I received a call that he had taken an unexpected turn for the worse. As an ex-nurse I knew what that meant. I said I would come in and had just got as far as the bathroom when they rang again to say that he had died. On arriving at the hospital I was told that he had been found in respiratory arrest and that the team had been performing CPR. There had been no discussion on a DNACPR form, and so they said they had to do it. They had no idea why he had arrested, there was no reason for it - except that they had failed to give him any of his heart support drugs from the minute he was admitted, and given him a sedative which had cardiac arrest as a side effect.

I am so sorry to have posted all this, but it just touched a nerve, there are hospitals where care of the elderly is as great as the over stretched staff can provide. And then there are ones like our local one...

I know exactly what you are referring to ... saw evidence of this on the ward myself. All elderly males left exposed on their beds waiting for nurses to attend to them. No dignity for those poor souls. Had to avert my eyes as I walked out of the ward out of respect for their privacy.

My mum has been quite verbal with some of the staff who have spoken to her like an idiot. She will not tolerate it and they can't handle patients or their carers who won't buckle under the nonsense.

Sorry to hear about what happened to your dad - unforgiveable treatment. Even if staff are overworked and stressed out there is no excuse for this. I know that nerve that it touched.

Macmillan nurses now support people with various illnesses, not just cancer.

At least you have a Health P of A in place. We didn't for my father and had a huge battle getting the hospital to agree to discharge him back to his care home. They argued that they needed to continue to try to make him better and even submitted him to a pointless kidney scan. He was 95 with advanced heart and kidney failure (and with absolutely no desire to continue living)

the awful thing is that the nurses/doctors only see the frail person before them and if they are over 85 they decide that is their lot,

............. a neighbour of 86 had a hernia , they wouldn't operate as they said he was too frail and sent him home with carers as he lived alone.. he had a fall and went in again and was told ' he had two days left ' and only fed him jelly /ice cream .. he told them he was hungry so they fed him again and sent him home where he was okay again for a few months..

I think the 'pathway' is still in existence.

My mother was getting worse and worse at home and when we called the doctor he gave her some antibiotics. My daughter asked him why he was not taking bloods and she is quite forceful. He took bloods and we had an emergency x ray booked for us. They discovered she had terminal cancer! She was dead within five weeks. The family or spouse really need to fight the patient's corner and keep on fighting for the best treatment for their loved one. It is no longer speaking to the dragon matron at the hospital, it is being the dragon matron yourself!

B9exchange. So sorry to hear about your awful time. What you’ve said brought everything back for me about my dad. He sadly passed away in hospital ten years ago. We experienced, very similar things to you unfortunately.
It is truly awful to think that their are thousands of patients in hospitals at this very moment being treated without respect and care, especially if you have anyone to advocate for you which many don’t.
The best of luck to the OP it is a minefield . I hope your dad makes a good recovery.

drbledu23 Just a thought. My mum aged 92 has recently been in hospital with a mild heart attack. Her medications have been changed to suit her new conditions, they were done in hospital.
The consultant rang me to say there’s was nothing else they would be able to do for her now. Her condition should be managed at home, he didn’t want to see her back in hospital again. He prescribed morphine to be administered at home in case she had more chest pain.
After much thought and discussion with me and mums GP we have decided we’re going to ignore that advice. An ambulance will be called.

Really? Would you want to put her through an ambulance trip, waits potentially outside the hospital then again inside. Once assessed they may still refuse to admit her. We're all animals really and parts wear out and malfunction. Medics aren't magicians. Sounds like your hospital consultant was actually being kind Katyj.

Katyj

drbledu23 Just a thought. My mum aged 92 has recently been in hospital with a mild heart attack. Her medications have been changed to suit her new conditions, they were done in hospital.
The consultant rang me to say there’s was nothing else they would be able to do for her now. Her condition should be managed at home, he didn’t want to see her back in hospital again. He prescribed morphine to be administered at home in case she had more chest pain.
After much thought and discussion with me and mums GP we have decided we’re going to ignore that advice. An ambulance will be called.

I hope you’ve worded ambiguously and meant that your mum was the person making the decision katyj, not you and her GP. If there’s nothing more the hospital can do for her, she should be able decide if she prefers to die at home or in hospital.

Hi yes mum decided that she would rather go into hospital if the pain was as severe as last time, plus she was very frightened. Her GP agreed that liquid morphine alone wouldn’t help the pain much anyway. And if I was away, who would sit with her and administer the morphine ?

Please listen to Visgirl and Hithere (are you aware how brutal CPR can be?). The Almighty gave you the gift of reason----Use it!

Katyj

Hi yes mum decided that she would rather go into hospital if the pain was as severe as last time, plus she was very frightened. Her GP agreed that liquid morphine alone wouldn’t help the pain much anyway. And if I was away, who would sit with her and administer the morphine ?

Thanks for replying, I can understand her reasoning, and I guessed that’s what you probably meant to say. I hope she stays well for as long as possible.

Thank you casdon. It’s a difficult one. Nobody wants to go into hospital, but when frightened and in pain it seems the only option.
If she was in a care home, maybe it would be easier to manage with lots of people around. But she lives alone, and needed an ambulance eleven times in the last three years, I’ve managed to be there every time so far 🤞 She wouldn’t cope alone with a bottle of medicine, and no support.

Caleo

Please listen to Visgirl and Hithere (are you aware how brutal CPR can be?). The Almighty gave you the gift of reason----Use it!

Not always good advice.