Monday, 29 October 2012

Liverpool Care Pathway – True Compassion Is Heart-felt, Not Death Dealt

It should be a no-brainer, but a recent study actually does confirm this to be the case - Better care means better outcomes.

The study, published in the Lancet, says 
Doctors concede that there is simply not the money to provide such a level of care for all patients.
But they say hospitals need to improve care for “high risk” patients, such as the very old

Doctors say hospitals need to improve care for “high risk” patients, such as the very old.

Here follows an article published in the Mirror that is shameful to relate. Is this really 'our' NHS so loudly lauded at the London Olympics?

An elderly gentleman is admitted to hospital following several falls at home. What then proceeds is, unfortunately, not at all extraordinary or anomalous. A similar story of elderly neglect is related in these pages -
She told me that one ‘old girl’ had fallen out of bed. Mum had kept calling for someone to come but no-one came. They were “all stuck in their cubby hole,” she said. I looked across and, by my own observation, they were. Eventually, a nurse had come, apparently, not shocked or concerned, but offended by the nuisance of it.
The neglect this elderly gentleman suffered demonstrates a lack of even the most basic sense of compassion.

The suffering this gentleman endured demonstrates a lack of even the most basic care.

Actually, it is the very absence of any kind of care!

The elderly, the frail and the fragile, those without wit, without sense, are judged not to possess the required 'quality of life' to grant them the due respect they deserve.These are our old ones and it is our duty to care for them as they have cared for us.

All else apart, they have paid their dues all their lives. However, when it comes to clawing back what they have paid in to pay for some care for themselves, the care they receive is stinted, reluctant, resented and begrudged.

Here is the Mirror –

"They're killing me.. get me out of here": Scandal of death of a 90-year-old dementia patient due to NHS failings

When dementia sufferer Robin Melville was admitted to hospital after several falls at home his family hoped he would be nursed back to health.But two weeks later the 90-year-old died after falling from his bed, which had been raised 4ft off the ground and left with the guard rail down
Failed: Robin Melville, who died aged 90, on his 85th birthday
Failed: Robin Melville, who died aged 90, on his 
85th birthday
Queen Alexandra Hospital in Portsmouth
Queen Alexandra Hospital in Portsmouth

March 30
Dad admitted to Queen Alexandra Hospital in Portsmouth. He’s not been himself for a few days now. He’s lost weight in past few weeks, has difficulty moving around and is increasingly confused. He’d fallen on the carpet at home, and mum isn’t able to cope on her own. As a family we hope some time in hospital will make him feel much better.
April 1
Dad moved to St Mary’s Hospital. It’s two days since he was admitted and I am worried about things. When I arrived today I noticed his saline drip, which is supposed to keep his fluids at a safe level, had RUN OUT. And his urine bag was bursting, meaning he was in pain. There are only two or three nurses here and the ward is full. It is chaotic and staff seem over-stretched. Worse still the bed is way too high off the floor and there are no bed rails.Dad’s confused and is trying to get out of bed on his own. We’re all petrified he’ll suffer a fall. At one point dad says to me “They’re killing me in here – get me out!” Feeling frightened when it’s time to leave him.
April 2
Arrived first thing in the morning to find dad in a coma, his saline drip empty and his medical notes claiming he’d only just eaten breakfast – impossible!
Told ward consultant that can’t be true and challenged him to show me how anyone could feed him in that state. He agreed and started spooning yoghurt into dad’s mouth but it just ran down his chin.
Doc said “he’s resting” but no amount of shaking him or shouting his name could rouse him.
Told doc he’s eaten nothing, his drip’s run out, he’s starving and dehydrated and all the nurses are doing is ticking boxes. Told doc they’re killing him and I wanted him transferred out today! He refused. Told him I’m making an official ­complaint.
His only response was to coldly reply: “OK. That’s your prerogative.”
Dad moved to a single room out of sight off a corridor. Worried he can’t be properly monitored in there. Can only hope he will receive better care.
April 3
Received a phone call early in the morning to say dad has fallen on his head. Feel so angry as I race to see him.
When I get there I can’t believe my eyes. There’s a cut on his temple and lots of swelling and bruising on his chest. He doesn’t respond when I talk to him.
By midday his saline drip is empty again and I have to find a nurse to sort it out. Meet the consultant in charge again who finally recommends a lower bed for dad. Bizarrely, a ward nurse informs us that it is hospital policy to leave bed safety rails down, even for falls risks like dad. How can that be right?
April 4
Dad’s fall has led to major health problems. A scan shows bleeding on the brain where he fell. None of this would have happened if there had been enough nurses to monitor him properly.
Even now his treatment just isn’t adequate. His bed’s still propped up high with the bed rail down ready for the next fall. Complained to nurses.
Lunchtime and nurses shake him gently to wake him. He seems in excruciating pain tears rolling down  his cheeks (we later discovered he’d also cracked four ribs but had no treatment).
A ward nurse suggested that the bed be permanently placed against the wall with a mattress on the floor to cushion dad’s fall. It’s ridiculous it has had to come to this but anything that makes him safer would be some improvement.
April 5
Arrive to find the mattress – which was supposed to be on the floor – leaning against the wall. I guess no one thought to put it back after cleaning. A pump assisting dad’s circulation is not working due to a loose electrical connection. He’s left in agony again because his catheter tube is obstructed and blocked. He keeps saying how he has to leave and catch a train, and made several concerted ­attempts to get out of bed – I’m very worried.
After I complain, nurses promise to keep a continuous watch over him, but it doesn’t happen – it can be 15-20 minutes before you see anyone. I check his records that evening and there is no record he had lunch or dinner.
I demand to see the doctor in charge again who seemed visibly shocked at my observations and the lack of care. He recommends a 24-hour watch, but after he’s gone the ward sister said this would not be possible and suggests the family can provide our own private staff at our own cost or watch over him ourselves day and night.
Also told we can bring in our own food and feed him ourselves as that’s the only way he’ll be able to eat. Can’t believe my ears.
My dad’s at serious risk and they’re refusing him basic care.
April 6
Dad’s been moved to a specialist neuro unit at Southampton to monitor brain damage from the fall. Over the next few days he is more aware of his surroundings.
He is eating and drinking most meal times the family are present. Hopefully things are finally improving.
April 10
Dad readmitted back to Queen Alexandra Hospital in Portsmouth at 8.23am. We arrive at 1pm and find him alone in a single room distressed, sitting alone in a chair – unsupervised, weak and confused.
Staff on the ward tell me they can’t give me any update until tomorrow when the consultant will visit.
It’s just unacceptable.
Found dad’s lunch left on his bedside which was later removed uneaten – they’re not helping him. Medical records about eating left blank.
Despite our constant warnings about his bed, dad is still being left in an elevated position with no safety rails. It’s only a matter of time before he falls again.
April 14
Got early morning call telling us dad died in the night.
He had pneumonia, a fractured skull, brain damage and four fractured ribs despite arriving at the hospital with none of these.
I just wish we could have nursed him at home.

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