Tuesday, 22 February 2011

Poor treatment of older people in the NHS is an attitude problem | Society | guardian.co.uk

Poor treatment of older people in the NHS is an attitude problem

Health service ombudsman report reveals shocking treatment of the over-65s, who are being failed again and again

older people NHS care Some patients were not offered help with eating or bathing, and one was left in urine-soaked clothes held together with paper clips. Photograph: Alamy

Mrs H was an independent woman who lived on her own until the age of 88 and loved literature and crosswords. This picture of this strong, dignified woman contrasts with the appalling treatment she suffered at the hands of the NHS. After a spell in hospital following a fall, she arrived at a care home with numerous injuries, soaked with urine and dressed in clothing that did not belong to her held up with paper clips. She had several bags of dirty clothing with her, much of which did not belong to her and just a few possessions left of her own. She was highly distressed, dishevelled and confused and had lost 5kg (11lb) since her admission to hospital. She died in August 2010.

This is just one of 10 shocking stories of people aged over 65 documented in a new report by the health service ombudsman . It highlights a range of clinical and operational failures; people at the end of life being discharged from hospital without correct pain relief, failure to deal with infection properly, malnutrition and dehydration. These are by no means isolated cases – 18% of complaints to the ombudsman last year were about care of older people and they investigated more than twice as many as for all other age groups put together.

Yet, as the ombudsman, Ann Abraham, reflects, this report reveals that at the heart of the problem is an attitude – both personal and institutional – which fails to treat older patients compassionately or respond to their individual emotional and social needs. One family was not informed when their father's life support machine was switched off; a husband was left in a waiting room, forgotten about while his wife lay dying in the ward next door; a man with advanced stomach cancer was left behind a drawn curtains desperate to go to the toilet and unable to ask for help because he was so dehydrated he could not speak properly or swallow.

It's difficult to imagine us allowing any other group of people to suffer this indignity and neglect, yet when it comes to older people it's commonplace; as a society we often fail to value or treat older people equally. History shows fundamentally shifting people's attitudes to overcome discrimination isn't easy – it takes time and concerted effort – but nowhere is this more important than in the NHS where people over 65 make up 60% of all admissions. Only by casting these prejudices aside can we start seeing older people like Mrs H as individuals and respond properly to their needs.

Equality legislation outlawing age discrimination – due to come into force in 2012 – will certainly help. But in a period of huge reorganisation, support needs to be given to translate this into action on the ground. We also need better training of health professionals to care for growing numbers of people living with multiple health conditions and frailty. To end the scandal of malnutrition, we are calling for a commission to bring renewed focus to this issue and a strategy for change.

But this report also demands answers to some difficult questions to those leading the NHS through the proposed set of reforms. Will this huge shakeup reduce the risk of older people receiving this sort of treatment? Do they promise any positive change for vulnerable, frail patients?

I remain unconvinced that, as the reforms stand, they will deliver the improvements to the health outcomes and care of older people that are so urgently needed. For the sake of all the people featured in this report and all of us who need NHS care now and in the future, the secretary of state needs to answer these questions.

• Michelle Mitchell is charity director at Age UK

's comment

Comments in chronological order (Total 91 comments)

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  • Juliasammy

    15 February 2011 9:22AM

    This is also my experience with my 75 year old father who has advanced dementia. Since going into an assessment ward 6 weeks ago where he is being assessed for treatment we have seen him never dressed in his own clothes, so thirsty his mouth was stuck together, covered in urine and I could go on. He was never like this when he lived at home with my 76 year old mother. Dementia is a dehumanising condition but unfortunately very often so is the care that people receive.

  • Bullitt

    15 February 2011 9:27AM

    Indeed a nation is judged on how it treats it's children, it's elderly and it's animals.

    NOT by how well it treats terror suspects, prisoners, criminals, illegal immigrants and bankers.

    On this basis alone Britain is clearly under judgement.

    But look, don't be surprised at what you read about our hospitals. This is not about buildings i.e. hospitals. It's about people.

    People in the UK are essentially heathenistic and atheistic in outlook. We live in a secular, hedonistic society that has a low or nil moral code. Therefore we must expect base attitudes from people in all walks of life who live 'unto themselves'. That is the nature of secularism.

    A Government that forces the teaching of Evolution as a root of our existence will reap what it sows. It's here already.........

    Having said all this, there are some really caring people in hospitals. But overall, I'm sad to say, we are a godless people in a godless nation. And that's a crying shame.

  • SEJ016

    15 February 2011 9:32AM

    Nursing used to be a caring profession. I saw little evidence of caring when my mother died in hospital. Everything seemed to be too much bother for them.

    "Care" was perfunctory, at best.

  • ALARICUS

    15 February 2011 9:37AM

    'We also need better training of health professionals to care for growing numbers of people living with multiple health conditions and frailty.'

    It's not a question of training, it's a question of numbers. An average Ward of 25 elderly, demented, patients may have 5 nurses (if they are lucky) on duty at any one time. One will be giving out treatments, one will be attending to an acutely sick patient, another will, no doubt, be answering the telephone, which leaves two to simultaneously feed all the demented patients-and that is manifestly impossible!
    There was a time when we had 'Auxillary Nurses' who would supplement the Nursing Staff, but these went long ago to save money.
    Many of these patients are barely coping at home anyway and may require 'one to one' 12-24 hour continuous care when they become ill-and that applies in Hospital as well as in the Community.
    It often surprises me how often a patient's relatives are very keen to see a 'loved one' admitted to Hospital, only for them to be rarely seen or heard from again, until the complaints come rolling in.
    Maybe Cameron's 'Big Society' could start on these types of Wards-with an army of Volunteers coming in to help the Nurses.

  • scrounge

    15 February 2011 9:38AM

    (I doubt you'll hear this but, hey, I'll have a go) There are lots of people who are neglected and it weakens your argument to exceptionalise the elderly. In my experience, the salient quality is not age but its correlative: lack of worth. We don't value people equally and individually in our society. People who are judged as past it, non-contributors, goners - the very ill, the mad, the broken, the weak - their lives are not respected and their survival is not pursued. Anyone in the NHS who cannot be cured is neglected because there is no success incentive in caring for them.

    There are numerous stories here: http://www.guardian.co.uk/society/2011/feb/15/nhs-report-elderly and not all those people are old.

    I understand you are a pressure group for one particular group (and a huge and hugely important group) and so make your points from that perspective, but, may we ride on your coattails? Can it be as wrong that my (quadraplegic) partner is neglected and abused in hospital as that his elderly neighbour is?

  • Bagwhan

    15 February 2011 9:41AM

    "Equality legislation outlawing age discrimination, due to come into force in 2012, will certainly help..."

    No it won't!! It will just be yet another box to tick on yet another form.

    When will people realise that one of the NHS's biggest problems is bureaucracy coupled with the lack of accountability endemic throughout the public sector. Those responsible for this lady's care should be identified and sacked. But unfortunately, as the NHS's prime function long since became the welfare of the people who work in it, rather than care of its clients, any such move would be seen as a "witch hunt" of "hard-working and dedicated staff".

  • WelshBluebird

    15 February 2011 9:41AM

    Not surprising at all.
    My gran had alzheimer's until she passed away last year.
    Everytime we needed help, or she was in hospital, it seemed to us as if she was just being seen as a nuisance, someone taking up recources and room. It was disgraceful really, and something NEEDS to be done about it.

  • Valdie

    15 February 2011 9:42AM

    Your story *
    Poor treatment of older people in the NHS is an attitude problem says a lot about UK!
    Please Tell openly to the Government via the Media outlets that they should not critizise other nations of human right violations when they do it right here at home everyday!
    Shame on Bitain.
    Britain should also no longer confess and proclaim to others, that they are a Christian Nation based on LOVE!
    Let the world know that Britain is working sucessfully towards being a loveless society where money and external appearance, lies, cheat and violence is now an everyday way of life in large areas of the nation.
    Does UK aim to become a second Guatemala or Mexico? The actions clearly are saying YES!

  • catherinethegreat

    15 February 2011 9:49AM

    I trained as a nurse 40 years ago and there was never a problem meeting the needs of the elderly in acute hospitals because there were hardly any there! they were all in so called geriatric hospitals the old workhouses usually hidden away in the most hideous circumstances.
    Nurses these days have had to harden themselves to the demands of vast numbers of elderly needing treatment that is totally inappropriate for their age and prognosis with relatives demanding life saving procedures without any hope of a better quality of life .
    When I was a ward sister every patient was offered an opportunity for a bath or thorough wash every day, every relative was consulted and kept informed and every nurse stayed on over the lunchtime at shift changeover to make sure that patients were given time and encouragement to eat their food. These basic standards have been abandoned as each patient is so sick and having so may observations and treatment and the medical staff so involved in their care ( quite rightly) that there is no time to get to know patients before they are whisked off to the next stage in there treatment As a society we need to be clearer what we want from our hospitals and patients will be offered care at home more often ,with the likelihood that they may die at home with dignity and support of their family but maybe 2-3 months than if they had gone to hospital. Relatives need courage to be advocates for their relatives and try to keep them out of hospitals. But remembering the old Geriatric hospitals where people were hidden things have not necessarily got worse!!

  • amandawaring

    15 February 2011 9:55AM

    My name is AMANDA WARING, actress and dignity in care campaigning filmmaker and I am the daughter of the late great actress Dame Dorothy Tutin . My mother was treated like a caged animal when she had leukemia with an appalling lack of dignity and when she died I sold my flat to make my dignity film WHAT DO YOU SEE? starring VIRGINIA MCKENNA . I talk on this topic around the world and Sir Michael Parkinson when he interviewed me urged everyone to see ,my film as it has the greatest impact at changing attitudes.I speak around the uk with my films and I am on the dignity in care partnership board and have been the leading light for saying we need to see the person inside and to care with love.The past five years of my life has been about promoting dignity and my re- inspiring the humanity of staff, we will all be old one day.Last month I gave my film to Paul Berstow and have urged the government to ensure that this topic does not lose momentum .my films are on amandawaring.com

  • linuxman

    15 February 2011 9:58AM

    It's not confined to the elderly although they do suffer they are not alone , I am 55 and recently had cause to be hospitalised the treatment i received was to say the least abbismal .
    The attitude of staff was well 3 nights i had to create merry hell to get my medication the 4th night i had enough called in the night manager and got things sorted but that is only because i have the balls to stand and be counted .

    We need to go back about 35 years for hospital standards when there was a Matron that ruled the roost when wards were cleaned top to bottom none of this only to shoulder height rubbish when people cared ( PS Bulltit , it has nothing to do with imaginary beings that have never will never and can never exist)

    Where our problem does lie is two fold the first is we are too busy by far trying to emulate the American failed system of super hospitals where we know from past experience that smaller hospitals work far better.

    And the second is a product of society as a whole where there is no respect for others at all there is a third issue as well but i will not bring that up here people will only get all upperty i know here i am coming from i am still suffering 31 years later thanks to them

  • WelshBluebird

    15 February 2011 10:02AM

    @catherinethegreat
    What about those of us who do try to care for our relatives at home, but are badly let down by the system?

    There is no way you can expect someone to care for a relative 24/7. I helped my parents look after my Gran, and we NEEDED the respite care we were entitled to.

    And we were only able to do that because my mother worked part time, I was in sixth form (so not away at uni) and we lived in the next street. Most people are not in a situation where they can do what we did.

  • SpamManager

    15 February 2011 10:06AM

    Bullitt
    15 February 2011 9:27AM
    Indeed a nation is judged on how it treats it's children, it's elderly and it's animals.

    NOT by how well it treats terror suspects, prisoners, criminals, illegal immigrants and bankers.

    No, Bullitt. A nation is judged on all those things.

    A Government that forces the teaching of Evolution as a root of our existence will reap what it sows. It's here already.........

    No, Bullitt. It sounds as if you want to force the clearly incorrect teaching of Creationism. That would be a crying shame.

    Being a secular society does not mean being an immoral one.

  • LuminaLondon

    15 February 2011 10:10AM

    Ageism always suprises me because the perpetrators will become the age they diminish and they may well find themselves in that hospital bed when they are frail, being treated with the same disregard. Ideas:the name of one person be listed on display at the ward who is responsible for care and a monthly care list be publicly available and a complaints proceedure be listed; nelegence in a ward be an imprisonable offence; visitors to a patient be recorded. Any patient not receiving a visitor within 7 days be asigned by the hospital a care/visitor monitor that has some independance from that hospital. A levy be paid into the charity or organisation to assist in this by the NHS. An administrator at the hospital visit wards regularly without any warning whatsoever with due attention to geriatics. The information be gathered mostly by physical observation and reference to data eg weight information, cleanliness. Once an individual case is identified proceedures be escalated so that resentment in the form of further mistreatment by the ward staff not be inflicted on the patient.

  • handsonhips

    15 February 2011 10:14AM

    Here we go. Let's blame the nurses.

    Yeah, we go into this profession as uncaring souls who are intent on just getting a degree. We sit around eating choccies and not caring two ounces about wherever Mr Jones has fouled himself. We are lazy, spiteful with no respect for the elder generations.

    Not looking for sympathy,

    Let me tell you some truthful facts;

    A. My feet and my colleagues feet never touch the floor in 13 hour shifts, most days I dont even have a pee.
    B. I have one pair of hands to 16 patients at times, I'm not an octopus.
    C. My patients get a drink and mouthcare whenever possible.
    D. We don't leave people intentionally lying in filth.
    E. While you lot fail to go to work in the bad snow, we are sliding sideways down the bypass or walking miles in snow to little gratitude. It's called duty of care.
    F. The relatives who complain the most are the ones who never come to see thier family. When they do they spend most of the visiting time scrutinizing us and watching what we do as opposed to talking to mum.
    G. We can't do washing, we cant cut nails, we are even expected not to catch people if they are falling.
    H. Being threatened with physical violence isn't nice.
    I. Being sexually molested isn't nice.
    J. I spend more time doing paperwork than at the bedside, this is to prevent te hospital being sued. If it ain't documented it didn't happen.

    I could go on. I've not met one "uncaring" nurse. Stressed yes, but not uncaring. Maybe before you pick fault try to see what we actually do correctly, then perhaps consider blaming the management and government.

  • richard1234

    15 February 2011 10:17AM

    Taking a theological approach:

    It is possible for a secular society to be a caring society. But don't expect a secular society to be a caring one of individuals resist the spiritual endowment given to every man and woman - the Light of Christ. You go read the Bible where it specifically states that the Light of Christ is given to every man.

    That spiritual Light strives with the mind of every man and woman. But, I expect the time when that Light will cease to strive, and then the world will lose it completely.

  • WelshBluebird

    15 February 2011 10:18AM

    @handsonhips
    I don't think most people will blame the nurses themselves.
    The problem is that there just aren't enough staff to properly care for the paitents there. Or at least that was my experience when my Gran was in hospital.

  • amandawaring

    15 February 2011 10:24AM

    I believe that People's / staff's emotions need to be engaged before change can happen, then people are motivated to change behaviour,- that's why I use the medium of film to involve staff in understanding and empathising with an older person, this so often has more of an effect than white paper of legislation can. One hospital even has my film on a continuous loop in a dedicated room as a reminder to all.for the need for respect. Emotional intelligence and caring from the heart is a vital part of good medical practice. Tommorrow I am filming for Aged care TV as their dignity expert and there is a live phone in in April and I will not stop campaigning for dignity for all no matter what age race colour or creed www.amandawaring.com

  • luxuryplayer

    15 February 2011 10:29AM

    This is just one of ten shocking stories of people aged over 65

    Just the tip of the iceberg - and it's certainly not about resources. I heard that this report was to be compiled some time ago, but my experiences were still too upsetting to relate.

    My mother (75) died in 2005, my mother-in-law (83) died in 2006. Both of them were in hospital for several weeks, and suffered dreadfully through misdiagnosis and the arrogance of clinical staff, but that wasn't the worst of it.

    Plenty of nurses and care assistants bustling about (always in pairs/groups) but all of them "too busy" to care. "Handover meetings" at the nurses station which would last all afternoon and for some reason involved long conversations about their personal lives and what they did on their days off.

    Enquiries met with defensiveness and hostility from nurses and care assistants who didn't even pretend they gave a damn. Wrong medication. No medication. Water, food and medication left out of reach. No help with toileting when it was needed. Accusatory questions such as "Why didn't you walk to the toilet?" when they were left to soil their beds.

    The worst thing was when my mother sobbed on the phone to me after she was victimised and bullied after we made complaints about her care. Three days later she was dead, and the attitude was "Ooh, we didn't realise she was that ill..." despite her being (finally, correctly) diagnosed with secondary liver tumours.

    My mother-in-law fared no better. Inadequate treatment for leg ulcers leading to blood infections, then CDiff, kept alive for four weeks while the doctors tried various different antibiotics, way too late in the day.

    Believe me, it is a heartbreaking experience, one which I will never forget or forgive. We didn't pursue complaints because like most people we were just too wiped out, paralysed by grief and anger at the unfairness of it all. They know you are unlikely to complain because of this, and that's how they get away with it.

    If animals were treated the same way, their carers would be jailed or banned for life.

    I just hope I die under a bus or something, I am petrified of having to spend my last days in hospital, dying in my own shit and yesterday's meal which I never managed to get into my mouth, too weak and feeble to end my own suffering.

  • LynW

    15 February 2011 10:31AM

    Hospitals generally are not terribly caring places: anyone who is incapable of making a fuss may not get the care they need. But then, over at least two decades, the focus of policy makers, managers and to some extent clinicians has been on making hospitals centres for emergency and acute medicine, through which patients move very quickly, without spending much time on wards. In that context, the shift of emphasis on medical rather than caring skills for nurses has probably been appropriate.

    What has been lost are the wards on which people can simply recuperate or wait to die in some dignity and comfort. However, few people would now choose six weeks in hospital over keyhole surgery. And as the poster above points out, the old geriatric hospitals had very little to recommend them. Indeed, while most hospital closure proposals attract huge opposition, these hospitals vanished from communities ten or so years back with hardly a murmur, because they were widely feared.

    The alternative was meant to be community care. But it's failing. The fact that so many of these patients end up, inappropriately, in acute hospitals in crisis is evidence of that; and a report on how community nursing and social services treat vulnerable reading would probably make reading every bit as grim as this investigation.

    So we urgently need an alternative. With the cuts for NHS and council funding and the shift towards lowest price commissioning in the NHS, however, it's hard to see where it's going to come from.

  • TheLastWord

    15 February 2011 10:39AM

    What can we expect...? Most people in this threadbare patchwork quilt of a country are far too busy spending every minute of every waking day dreaming up more and more ways of making their own lives vastly comfortable at the total expense of everyone else...! Britain's "me-me-me" culture can only mean one thing...!! - namely, "A-COULDN'T-CARE-LESS-FOR-ANYONE-ELSE-BUT-ME" society...!!!

    Only the rich are immune...! Until the damn of self-obsessed greed finally bursts and the have-nots (that's the overwhelming majority, folks...!!) have their day...!!!

  • MrEdge

    15 February 2011 10:40AM

    My brother contrasted the NHS attitude to the elderly people in hospital to their attitude towards children, after our mother was sent to a rehab ward after having had a stroke. When children are ill, it's as though there's nothing they won't do to help. But with old people it's like with old cars. If there's something goes wrong, it's just because they're old.

    There is good practice on NHS wards, but it often tends to be individual rather than systematic, particularly with UK staff, with some men and women able to make a ward a safe and nurturing place to be, just by their presence. Overseas staff have been criticised here but, in my experience, the most competent and committed group of nursing staff have been south east asian.

  • luxuryplayer

    15 February 2011 10:51AM

    Typical attitude from handsonhips. We're so busy! We go to work in the snow! How dare you criticse us!

    The relatives who complain the most are the ones who never come to see thier family. When they do they spend most of the visiting time scrutinizing us and watching what we do as opposed to talking to mum.


    You really give yourself away with this statement, handsonhips. How do you know what pressures families are under, or how far away from the hospital they live, or what caring responsibilities they may already have?

    And your comment "spend most of the visiting time scrutinising us" - well that's because their relative is complaining bitterly to them about you, but they are too frightened to tackle you about it because they fear your retribution the minute their back is turned.

    Disgraceful.

  • MrEdge

    15 February 2011 10:54AM

    luxuryplayer

    Absolutely right. I went through equally bad experiences with both parents in 2004 and 2007. You may occasionally forget, but you will never forgive. And nor should you. They don't deserve it. This report coming out now brings it all back. And I have to say, I really hope someone can be publicly shamed for it.

    What we need is the kind of scrutiny applied when there are failures in child protection.

  • LuminaLondon

    15 February 2011 10:56AM

    Dear Handsonhips

    You say you are overworked and no one is intentionally left unclean. Your comments don’t make the complaints in the report incorrect and the report is not criticising all nursing.
    Indeed you confirm that the fact that you are overworked may mean that patients are unintentionally neglected. What you do is highlight the face that patients can both be intentionally and unintentionally neglected. I hope that you are not saying :’ hospitals overwork their staff, this may mean that patient care is affected as a result, but that’s ok because its unintentional’?
    If you happen to reread these postings I would say this: a) nurses are appreciated and that it’s only the wrong that people complain about, that is understood, yes, in England we have lost the sense of the extended family and that relatives could take a greater care responsibility but there are thousands sacrificing their lives as carers. Does your hospital benchmark ward workloads with other hospitals, does it have a culture of short staffing, do you have meetings to voice your concerns, what does your union say, do you have a culture of reporting wrong-doing. How do you deal with abusive patients? Do you collectively voice the problems of overwork?

  • thesnufkin

    15 February 2011 11:00AM

    @handsonhips

    I agree with you.

    When I visit a hospital ward I see two dozen or more elderly patients whose care needs the staff team would struggle to meet even if the patients were well and the staff had no medical procedures or paperwork they needed to complete.

    @luxuryplayer

    Nurses are busy, they do go to work in the snow. If a patient has a heart attack they drop everything and attend to them. Hand overs take ages because patient care is complicated. Yes, nurses at work do talk about their holidays and personal life - but that's because they're human like you and me. They make mistakes under pressure for the same reason.

  • MrEdge

    15 February 2011 11:16AM

    Let's look at handsonhips's truthful 'facts':

    A. Self-serving exaggeration
    B. You're understaffed.
    C. Drinks and mouthcare are not the main points of contention
    D. You should be leaving them lying in filth at all - intentionally or unintentionally
    E. Denial - my parents were mistreated in hospital whatever the weather
    F. Self-serving drivel. The people who complain are like me - in every day talking to their mum or dad and trying to find someone who can give them a remotely truthful fact about their parent's treament.
    G. Oh yes?
    H. Being threatened with physical violence isn't nice - and neither is enduring the night shift staff when the senior ward nurse isn't around.
    I. Being sexually molested isn't routine either - neglect of elderly patients is institutional
    J. So if the hospital did it's job properly you'd be at the bedside more. Well that's the answer then. Hang on a moment, you are the hospital.

  • luxuryplayer

    15 February 2011 11:19AM

    thesnufkin
    I'm afraid I do not accept your excuses, or those of handsonhips for the unnecessarily cruel remarks made by nursing staff to my dying mother, the unnecessary victimisation and bullying she experienced, or the failure of nursing staff to give the basic care to both my mother and mother-in-law which would have allowed them to die with dignity.

    It sounds like you and handsonhips think the NHS is there for the benefit of staff, not patients. Bloody patients! If there weren't so many of them, needing so much care, the job would be so much easier...

    Well done, you have illustrated exactly what the problem is.

  • MrEdge

    15 February 2011 11:20AM

    Of course 'fact' 4 was meant to read:

    D. You shouldn't be leaving them lying in filth at all - intentionally or unintentionally

  • WelshBluebird

    15 February 2011 11:29AM

    Just thought I would post this here too (I just posted it in the comments of the actual news article about it).:

    Not a suprise at all.

    I experienced pretty much all that was descriped when I was helping my parents look after my Gran (who had alzheimer's).

    Falls were not recorded and ignored, water was placed out of reach, food was just left there even though she could not feed herself, she was left in soiled clothes, not washed for ages, hugely sedated so she couldn't complain, clothes went missing, etc etc.

    The same was true in the nursing home she went into for respite care (which is something that is badly needed by people who care for relatives).

    To top it all off, when we went to the GP's because she was coughing quite a lot, we were told there was nothing wrong with her. We decided not to take that for an answer, took her to the "local" hospital ("local" because it takes 2 hours to get to) and was eventually told that we were lucky we brought her in when we did as she had severe pneumonia. She died 4 weeks or so later.

    Of course on the otherhand, she had a heartattack about a year or so before she died, and the care she recieved then was amazing. Personally I think that shows the difference in attitudes between departments.

  • dotmegsam

    15 February 2011 11:32AM

    I have never spent a night in a hospital, but have many relatives who have, including some who died there. From my own observation the NHS has a crisis on its hands. I don't know whether it is caused by understaffing, changing roles or management. There can be clinical excellence, short waiting times, state of the art treatment, but these seem to coincide with a loss of basic care functions; kindliness, empathy, respect and concern for dignity. I have seen this every time I have visited a sick person, in relation to them or to other patients in the same ward. It is not isolated and is not confined to the elderly. I have stories like other contributors have, but won't take up the space by telling them, but I have worked in Special Schools with severely disabled children who required personal care and many of the things I have witnessed in hospitals would not be tolerated there. I dread the day when I might have to go into hospital, and wish I could afford to pay for a carer to accompany me if I ever have to do so.

  • MrEdge

    15 February 2011 11:34AM

    to thesnufkin

    When I visit a hospital ward I see two dozen or more elderly patients whose care needs the staff team would struggle to meet even if the patients were well and the staff had no medical procedures or paperwork they needed to complete.

    If the patients were well, they wouldn't be in hospital, silly. And if the patients were all well and not in hospital, then all the nurses could go tobogganing when it snows, chat about their holidays and personal life, forget about paperwork, and never have to make mistakes under pressure again. And you, snuffy, wouldn't have fluffy little posts to discussion blogs like this to set the record straight for nasty people like me whose parents were treated appallingly in hospital before they died.

  • rburns

    15 February 2011 11:57AM

    While it's absolutely unacceptable for anyone to be treated in the ways described in the case studies and in the reports here, to put it in context, there are about 15 million hospital admissions per year, and 1.3 million people working in the NHS so that some dreadful cases are almost inevitable. The causes are surely complex and extend into social attitudes generally, but if we are going to reorganise the service yet again, it's a pity that the central focus is not the improvement of the patient experience rather than the "business plan" or spurious "choice".

  • Wyndley1857

    15 February 2011 11:57AM

    Well, Mrs T, you got the 'society' you worked so hard to get: damn near sociopathic.

    Those who believe that privatising health care will improve the situation are deluding themselves.

    The central problem is that Mrs T's 'society' has marginalised whole groups of people who are now seen to be useless.

    Read Bauman's 'Wasted Lives' on the plight of the redundant, by which he means not people who just got their P45, but all those who will never work again.

    We are the useless in the neoliberal dystopia, and we get the care we 'deserve'

    I am coming to the view that Hitler's Aktion T4 programme might have been kinder.

    What a truly dreadful conclusion that is! Thank you Mrs T.

    Social Darwinism was always the name of your game.

  • zavaell

    15 February 2011 12:02PM

    Bullitt - this has nothing to do with a god, if it did, I'm sure he/she would have sorted it out. It is to do with our values as a society. We have chosen as a society to value our private pleasure over contributing to care (and other things that need funding): for as long as we are prepared to pay some people inordinately more money (increasingly so) than others without taxing more we display what it is we value. That is a political issue not a religious one. Our politics has failed us because we are voting for the money.

  • WRVScommunity

    15 February 2011 12:03PM

    It's so sad to hear that older people aren't valued in society after all they contribute throughout their lives. It seems like attitudes need to be changed and more attention needs to be given to all the excellent things older people achieve.

  • Lerryn

    15 February 2011 12:18PM

    So the health service ombudsman’s report reveals shocking treatment of the over-65s, who are being failed again and again and that at the heart of the matter is an attitude problem, both personal and institutional.
    This revelation is nothing new as I have observed that some treatments made available by the NHS to the younger members of society are not made available to those past retirement age. Also known treatments are often not made available to some disabled persons.
    Moreover, poor treatment and lack of respect abounds within care and nursing homes as witnessed by my wife who worked in several such homes.
    Several factors are at the root of the problem, firstly the perception that the old and disabled are of little more than nuisance value and do not contribute to society so should not receive more than minimal care: in this context it is unclear whether this view has been covertly fostered by government or its servants over concerns about rising pension and welfare costs. Secondly the medical profession and pharmaceutical companies do not perceive the elderly, and disabled, as great sources of profit: greater potential being seen in cosmetic surgery, fertility enhancement, sales of Prozac and Viagra. Lastly it appears that a stock response from GP’s to those elderly experiencing problems is to enter a care or nursing home: here motivation is unclear but could be commission driven, or to lessen personal workload.

  • thesnufkin

    15 February 2011 12:24PM

    @MrEdge

    You have spectacularly missed my point.

    The majority of elderly hospital patients have high care needs even when they are 'well'. Many have been admitted from residential and nursing home, the majority have a degree of dementia.

    Do you see what I mean?

    I'm not justifying poor care, I'm explaining it in the hope of getting a solution.

  • luxuryplayer

    15 February 2011 12:40PM

    snufkin

    The majority of elderly hospital patients have high care needs even when they are 'well'. Many have been admitted from residential and nursing home, the majority have a degree of dementia.


    I would like to stress that both this was not so in my mother's case. My mother-in-law had mobility problems, but neither of them were suffering dementia.

    They were old, but that isn't why they were in hospital. They were in hospital because they were ill and needed medical treatment.

    I very much doubt they would have been subjected to such cruelty and neglect had they been younger.

    Do you see what I mean?
    That's the point.

  • WelshBluebird

    15 February 2011 12:46PM

    The majority of elderly hospital patients have high care needs even when they are 'well'. Many have been admitted from residential and nursing home, the majority have a degree of dementia

    If someone has dementia, then they are not "well".

  • europe

    15 February 2011 12:57PM

    I work in an NHS hospital and am shocked at how British people dump their elderly relatives in hospital and expect the state to look after them when they clearly don't . This is a big problem of course there is no excuse for not looking after them in hospital but the elderly are not looked after by their families in UK

  • handsonhips

    15 February 2011 12:58PM

    Mr edge, luxaryplayer, shall I attempt to defend myself?

    My grandfather dies in the hospital where i work. i thought his care was quite lacking in some parts. I see care of others quite lacking in the workplace as well. they may say the same of me.

    You have both obviously had bad experiences of care in the nhs. piss poor care cannot be excused but let me answer some of your comments:

    Hydration/mouthcare is a point of contention: dehydration hampers the healing process, lengthens hospital stays, causes confusion, constipation, skin breakdown. so making sure your patients have a drink is very important, especially amongst the elderly who tend to drink less. but you knew that.

    My comment on not leaving patients intentionally lying in filth:

    I take it in your jobs you can meet all demands by clients easily whilst working within the boundaries set by you management.

    Scenario: Mr Jones has fallen out of bed, Mrs bright needs the commode, Mr Davies wants a hand after spilling a cuppa down his front, Mrs smith has been incontinent of urine and faeces........ Who do you go to first?


    As I am "the hospital” being at the bedside I/we should be able to do it. but I/we cant.

    There is no excuse for people to be withering in poo and wee, its super frustrating. but it does happen. of course you could say that if I wasn’t chatting shit, shoving sweets into are mouths we could prevent all that, but then you know all about hospital/care home care.

    I had to leave a lady on the commode for half an hour once while trying to find help to get her off. She was in tears. You’d probably say I felt nothing for her, wrong of course; I was disgusted with the system, she was let down. I wasn’t however upset with myself.

    "And your comment "spend most of the visiting time scrutinising us" - well that's because their relative is complaining bitterly to them about you, but they are too frightened to tackle you about it because they fear your retribution the minute their back is turned. Disgraceful"

    This one made me laugh. I thought the idea of part of my job role was to advocate the patients needs. speak up for them when nobody will, I find patients will question their care, fair cop, so would I. those who don’t get asked or prompted to express needs/anxieties.

    "How dare you ask me for pain relief Mr Jones! you’ll get yours!" don’t be stupid. I heard of one staff member speak horribly to a patient, she was suspended then dismissed. Rightfully so.

    You want to know what would make it better? put more staff on the floor simple, I’ve just left a job because I couldn’t cope with the lack of care fundamentals (unfortunately I do have a conscience) Floor based staff cant change things without managerial support. It’s proven that with more staff and better training the elderly can have fantastic experiences of stays in care.

    I just find it frustrating when people lay the blame on floor staff without think why such poor experiences happen.

    PS I will add some self indulgence: sexual harassment is very common, as is being bitten, scratched, hit etc, but I’ll believe you when you say it isn’t Mr Edge.

    Right I’m off to kill cats, spit on kids and generally not give a damn about my fellow man.

  • WelshBluebird

    15 February 2011 1:00PM

    @europe
    As I have said, what about those of us who do try to look after our reletives, but are badly let down by the system?

    There is no way someone can care for an elderly relative 24/7, they need help in form of respite care.

    Plus, its not just hospitals. The amount of fighting my parents had to go through to get NHS funded care for my Gran was disgraceful really. If we had just given up (as most people probably would have), my Gran would have had to be "dumped" into a care home, as we wouldn't have been able to afford her care without selling her house.

  • SgtApone

    15 February 2011 1:01PM

    handsonhips

    Don't listen to this lot. I'd like to thank you for your dedication and only wish you were more highly prized and rewarded. No one in my family would leave my mum alone for 5 minutes, let alone a day or two. When she passed the nurses were amazing.

  • sparclear

    15 February 2011 1:04PM

    To add to this discussion we need comparisons. Here we're thinking and writing about a system with nothing to compare it against.

    Some people report a high standard in their local hospitals, but are these individual experiences, or is this particular hospital doing things spectacularly better all round? If so, which things?
    What part does nursing leadership play? What of the trainee doctors & consultants?
    How mechanistic is the medical practice underlying decisions made in the hospital environment? What helps very vulnerable patients (of every age group and social background) to give their consent to treatments with proper awareness?
    What best protects psychological welfare in noisy, dirt-prone hospital environments?
    Do good diets, pleasant washing facilities and peaceful sleep make the same difference to wellbeing as they would everywhere else, and if so - what are hospitals going to do to rectify these health aspects?

  • babyzoomer

    15 February 2011 1:20PM

    Approximately 8 years ago the quality of care my elderly mother (whom has since deceased) received was exactly as described here - both meals and medication were placed in front of her. My mother by this time was severely disabled due to strokes and could not feed herself. this would have been obvious to anyone (with or without any health care knowledge and experience) from her visually physical appearance. In a bid to feed / medicate herself one day, she had only managed to spill food all down herself and the bedding. When I came in to see her at the start of visiting hours, the state I saw her in was very emotionally distressing. Food was all over the place and one pill was among the bed clothes and another on the floor. When I mentioned this to a nurse, the attitude I received was one of disdain and I was treated as if I was being a nuisance. But what was more worrying, however, was when I asked if the nurses had made sure my mother had taken her medication, I was assured that she had and it had been recorded that she had. This clearly was not the case. And if anyone thinks that this situation arose due to not enough funding for a higher number of nurses, when I came in that day there were a number of nurses gathered around the station laughing and joking and generally having a social chat. Attitude is defiantly a significant factor for such slack care standards - not funding.

  • luxuryplayer

    15 February 2011 1:38PM

    handsonhips

    Scenario: Mr Jones has fallen out of bed, Mrs bright needs the commode, Mr Davies wants a hand after spilling a cuppa down his front, Mrs smith has been incontinent of urine and faeces........ Who do you go to first?


    Yeah, right, there's only every one of you on duty per ward...

    This one made me laugh.


    No surprise there.

    You poor things! You are not ill, you are not dying, you are not neglected, your pay is better than ever before, and there are more of you than ever before in the history of the NHS...but still you feel sorry for yourselves.

    Having made my point in a lengthy earlier post I can't be bothered to respond to the rest of your "me me me" self-regard, your pathetic "blame everybody else" excuses, your obvious lack of empathy, and your patronising attitude towards patients and their relatives.

    You've done a better job at trashing yourself and your profession than I ever could.

  • babyzoomer

    15 February 2011 1:38PM

    handsonhips - from reading your comments, and the underlying attitudes that you seem to be displaying, if you are a nurse - I would suggest you seek a career change. You clearly are fustrated by the system in which you work and I feel that this may be impacting on the attitude you bring to your work. Patients lashing out can sometimes be done out of fustration - they are reasons to all behaviour. I have worked in very challenging situations and had to deal with behaviour which most would deem 'aggressive' but I simply deem 'challenging'. My job was firstly, to have patience, resilience, empathy and understanding when dealing with this behaviour. It was then to secondly, have the knowledge and skills in reflecting on effective strategies and interpersonal skills I could implement to difuse the situation. Teachers do it in schools everyday, the police do in in sometimes lifethreatening situations, mental health workers come across it as routine - it takes an intelligent, well informed and professional approach from staff. Nurses are paid well compared to many office and contact centre workers (whom have their own pressures to deal with, so you are not the only ones). Would you rather be unemployed?? Be grateful for the job you have and change your attitude.

  • carried1980

    15 February 2011 1:48PM

    @luxury player why are you so bitter? Handsonhips may have said things you dont agree with but they have stated them well. You on the otherhand have just come across as sarcastic and nasty, which undermines any valid point you think you may have had.

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