my 16 year old was treated by specialist in "elderly care"

[teenma]

My son was refused treatment by the peadiatric department at my local hosp. because he had just turned 16. Instead he had to spend a week in the company of 5 very elderly men, 2 of whom died when he was there. One kept him awake all night screaming "kill me, kill me I want to die" and my son was so traumatised we had to discharge him early, before he got the results of his tests. The consultant he was under was a specialist in "elderly care". His condition was something that is fairly common in adolescents so there must be a gap in care provision for young adults here if he ends up on a geriatric ward! AIBU? Any similar experiences?

I work in health care and this is not uncommon. If it was a small hospital then they do not have the ability to move patients. Staff will often do their best to not have this happen when dealing with a young person who will be upset and further stressed by what is happening on the ward. But we do not have wards which only cater for 'high care needs patients' so the staff are put in a position were they have to mix patients or they would not cope with the ward.

Because peadiatric medicine is different 16 year olds often cannot be treated in a childrens hospital, the drugs needed may not be available.

Larger hospitals are not the answer as they would not be as assessable. It depends on the population where you live. The census is supposed to address issues such as this but i doubt it.

It is a matter of how much we are willing to spend, which is not on the increase.

It sounds like a horrible experience - it's very unfortunate two people died and that your son had to witness the outburst, but that isn't the hospital's fault. He could have witnessed something similarly as horrible on any ward. A specialist in elderly care is still a doctor, and would have been perfectly suitable to treat any adult, so I don't think his quality of care was affected.

My sister spent a significant proportion of every year in hospital from the age of 20. She often wound up in geriatic wards - simply because a large number of those hospitalised for medical reasons are the elderly. It wasn't ideal, but there was nothing that could be done about it.

YANBU, there has always been a problem with what to do with teens, they are too old for childrens ward so are put on to adult wards, where they have little or no interaction with their peers, medical staff that have no undrstanding of how to relate to teens, visiting hours that are restrictive etc.

It is a problem and needs to be addressed, maybe a teen wing attached to the end of childrens ward? this problem exists in Major city hospitals as well.

Personal experience, LOTS

Not uncommon, which is why our local hospital is trying to fund a teenage ward.

My one day of voluntary work in a local hospital involved going into a geriatric ward, which had 2 women of 18-21. One of whom had tried to commit suicide, being on that ward would have made me suicidal.

Please complain, including to your MP; maybe somethign will change.

Thank you for the comments, I think I will write to the CE, and my MP about adolescent care provision in general hospitals. I am in no way blaming the staff or the doctors themselves who did their best to help him. I was also very impressed by the respect and care the staff showed towards the geriatric patients. My son's condition is one which is common in adolescents and is difficult to distinguish from serious disease so needs careful diagnosis and a peadiatric/adolescent specialist would have been more experienced at this sort of thing. I just thought this would be the best place to sound out my concerns, so thanks for replies

As a doctor working with unwell adults in hospital I see this fairly often. I hope your son is recovering well at home now. It sounds like a difficult time for you all.

I suspect your son was placed on a general medical ward rather than a geriatric ward as such. In practice there is often almost no difference between the two as most poorly adults in hospital are old. If it was a designated geriatric ward then this is NOT appropriate. In some hospitals 16-18 yr olds still in full time education have some element of choice regarding whether they go to paeds or adults. It is a shame that this option wasn't available to you.

The doctor looking after your son may have specialised in care of the elderly but all hospital doctors looking after sick adults will have a good grounding in all areas and should be able to look after general medical patients. If you say his problem is fairly common in teenagers then it sounds fine for him to be looked after by any medical team.

I am so sorry that your son had to witness the deaths of two patients in his bay. However, other patients of any age may have found this equally distressing.

So many things about this situation are less than ideal. Dying patients should really be placed in side rooms to allow them & their family the space & dignity they deserve. Aggressive or confused patients should also ideally be placed in side rooms or quieter areas.

In an ideal world a 'teenage ward' would be lovely but with the exception of teenage cancer units etc I personally do not think this should be a priority for NHS funds. Better, would be the creation of more side rooms for patients who need them such as those with infections, the dying and perhaps younger patients such as your son.

My best wishes to him for a speedy recovery.

Sorry about your son, hope he's on the mend.

I don't know if the NHS funds ANY teenage cancer wards - those I know about are funded by a charity. Deplorable state of affairs. The chief execs and board directors earn enough, if they can't sort it out for young people with cancer, they should take a pay cut and donate the savings to the teenage cancer trust.

This happened to me when I was 13. It was not a geriatric ward but an orthopaedic one which had mainly elderly patients. I was being treated privately (under my Dad's works policy) but they had no private beds available. Some of the nurses treated me like shit because I was private (this is 40 years ago) and the old ladies depressed me so much. I used to help out with serving the food and one of the old ladies grabbed hold of my wrist and told me to make the most of my life as too soon you find yourself like her. I howled .

many of these "geriatric wards" are not actually geriatric wards, they are medical wards who take any patient from teenager on upwards who have a "medical problem" i.e. pnuemonia, heart problems, infections, overdoses.

Naturally most patients on these wards are geriatric because older people tend to have more problems with their heart and lungs etc. I had to have a 20 year old overdose in liver failure in a bay with 5 older ladies the other day. There was literally no where else.

In the old days they had geriatric wards. In addition to those they had medical wards which treated acute medical patients age 65 and UNDER.

Now both those types of patients get dumped on large general medical wards. My hospital no longer has "geriatric" wards and neither do many others.

The shitty thing on a medical ward is that not only might you have in your bay (as a Nurse):

a 45 year old mother dying of cancer,

a 20 year old who overdosed,

a 75 year old with pnuemonia and Cardiac failure who is disorientated and pulling out his IV lines and 02 and constantly getting up and falling, refusing meds and demanding that we call his mother (!)

a violent herion addict who is in for detox from alcohol who likes to smash the place up and shout abuse and demand morphine constantly

a 36 year old with diabetic ketoacidosis who needs frequent monitoring

but you will also have patients that have been dumped in hospital because no one can manage their dementia. As if we can with everything else we are dealing with. And they tend to shout, pee on the floor near other patients, fall, refuse food and water etc etc.

As a Nurse you will probably be the only RN for 2 or 3 bays like that with 6-8 patients in each bay.

Medical wards are shit for both Nurses and patients. They suck.

I am not surprised that your son was traumatised. I have had patients that were 35 years old who discharged themselves because they were traumatised by the state and behaviour of the elderly patients.

Nurses and doctors do tell management that these wards are set up very badly and are very tough on patients. They don't listen.

when i was 17 i had to go in for an op on my jaw

i was put on a geriatric ward, there were admissions and deaths almost every night, i was in a private room but i found it incredibly depressing

This is very interesting, thanks. Lots of issues: Do we treat dementia cases separately? Is it appropriate to differentiate elderly patients as geriatrics in the same way we do children as peadiatrics? should all wards have more single rooms (dream on!) Dare I mention the effects of any cuts...

The thing is this: If a nursing home resident with dementia gets a gastic ulcer and starts bleeding from it their GP has to send them into hospital to get treated. They will need an endoscopy and possibly a blood transfusion. Therefore they need treatment on a medical ward.

The old fashioned geriatric wards didn't treat patients with high tech anything. It was just comfort care. Nowadays they really have to treat everyone and do blood tests, IV meds, diagnostic tests etc etc.

They cannot just say "oh well she is 98 years old, immobile, incontinant and has dementia so lets not put her through all this treatment". Not right away anyway. The liability is too great. I know people think that we are neglecting and killing the elderly in hospitals but actually they are getting more intense treatment than ever.

The interesting thing about patients with dementia and blood transfusions is that they will often pull out the IV line spraying blood on other patients or they might actually chew through the IV tubing and drink the blood. There is no way to make them understand. We might try 4 or 5 times before the family and the doctor meet and say "okay enough is enough, lets let nature take its course here and not put her through anymore needlesticks and tests, she is 101 and bedbound for christs sake".

But often the family want everything done for a 101 year old with no quality of life even though they never visit. In that case we have to keep putting lines etc in over and over which the patient then proceeds to bite through or pull out. Over and over again. And over again. Put them on a ventilator, put feeding tubes in that they pull out over and over. They keep climbing over the siderails and falling over and finally a head injury does them in. We cannot make them understand, restrain them (its illlegal), and I know my hospital will not pay for a one to one carer to sit with them. They sure as hell won't eat or drink anything even with encouragement. And they pull out their IV lines put in for re hydration so they often end up in renal failure.

They did not intensively treat the elderly like this 20 or 30 years ago. Once they got to this point it was tender loving care.

YANBU OP that sounds horrendous and I would complain. Maybe if enough people do, things will eventually change for the better?

newjobthankgod you have given me a lot to think about wrt my own grandparents' care. The things you describe sound awful and they're probably far, far worse to actually witness. I hope my mum and her sister never put either my 87 year old gran or 91 year old grandpa through any of that treatment. We wouldn't let dogs suffer that way

I am amazed that your poor son wasn't treated as a child. DS had surgery in Great Ormond Street at 18, and although there were various jokes about the beds not being big enough, it was the perfect place for him.

I know how hard hospital is for teenage boys, and for him to have to cope with stuff like that is dreadful. I do hope he gets over it all soon - and you too.

newjobthankgod - that is really sobering stuff. I don't know how you do it. I know I couldn't.

newjob, that sounds incredibly stressful and distressing. Would just like to mention, though, that it's not always like that everywhere. My 96-year-old Great-Aunt had exemplary care when she was dying. The nurses were caring and did everything correctly (my sister's a nurse so knew what to look for). They/the doctors (I dunno who) had also made sure she was able to make a decision about resuscitation in advance - she declined. Her last few days were as calm and comfortable as possible when you are dying. I saw her the day before she died - in fact less than 12 hours beforehand - and she was at peace with the world and with leaving it, once she'd passed on some family messages (bit of a struggle as she was very short of breath and on oxygen - but she was very happy once she'd managed it).

The ward was exceptionally well managed and had enough staff to provide good care for all the patients. I can highly recommend the Countess of Chester hospital for elderly people at the end of their lives (assuming it hasn't gone rapidly downhill in the past year).

not being funny but you might well also be compaling that he was stuck on a ward with babies screaming all night in pain or with parents crying beside their child's cot the whole day .

their is no specific provision for teens so its either children's ward or old peoples ward

nether is much fun i am sure he would not of wanted to be stuck with a bunch of babies or old people but i am sure he is fine and no lasting damage has been dine as for the old people dying that could easily happen on the children's ward which would have been far more distressing as i am sure a lad of 16 understands old people die