To wonder how many elderly people in hospital die of neglect?

[Gone2far]

My poor elderly dad is in hospital. Whenever we visit, we're sorting out something. This morning, nobody had made sure he'd taken his medication and, when I pointed it out, they whisked it away. But then told my mother that he had had it.
The hospital is enormous, and you never seem to see the same member of staff twice.
I think it would be very easy for an elderly patient, who didn't have family or friends coming in, to be forgotten, apart from the absolute minimum of care.
Anyway,perhaps i'm feeling this because i'm worrying about my dad. But I know we can't be there all the time and feel helpless

Yes, Spanish nurses who I have worked with have been suprised at how little most families get involved here, apparently in Spain family members take it in turns to help care for their relatives whilst they are in hospital, so they do things like helping their relative to wash and eat, drink etc.

Hard to do when your family is scattered all over the place having had to move for work, can't get time off, have small kids themselves. And usually, this care is expected to be done by women.

I remember someone telling me that in europe the family have to come in and help, we need to have this attitude here. Family need to go in and feed their relatives.

No, we need better funding for social care. Plenty of people do not live near relatives as their relatives have had to relocate for work (how often do we hear this, a person states they live in a place where they cannot get decent work and the first thing they're told to do is move), have to work all hours to keep the wolf from their door (that will get worse as employee rights are removed more and more) or have toxic or even abusive relatives.

It's like all that guff about 'in other cultures' people all live together in multi-generational housing. Yes, and a lot of times in those cultures it's cheaper and easier to hire domestic help and/or the elderly don't live as long so you don't have such issues such as advanced dementia and of course, the women in the family are expected to provide most of the care.

What works in other cultures isn't necessarily what can be applied to another one.

I think they should bring back training on the wards

What do you mean bring it back? It never stopped.

I’m currently very dependant. In hospital Happy. For HQ. To give real name.

When certain nurses. Are in charge I get cold shiver although they’re. Busy with some they’re busy but kind otherrs not so much

I could write a book on the things I've seen on adult wards that shouldn't be happening but are. My severely disabled daughter (sadly no longer with us) was a frequent visitor to hospital wards. Having stayed with her all the time when on childrens's wards, we continued the practice when she became an adult (although we were not always welcomed). If we hadn't have stayed with her on each admission she would have died many years before she did. The staffing levels are atrocious. There is a very high ratio of dependent patients on some wards and not enough staff to care for them. As someone else said, the care received on ITU is fantastic, only for patients to be transferrred up to other wards and deteriorate again due to lack of care. When DD was in ITU they admitted this happened frequently.

My own DM basically died from hospital neglect. She went in with a simple infection but was not helped to move around when she recovered and became immobile. It was not possible for her to go home and whilst they faffed around deciding what they should do with her she caught another infection which eventually finished her off.

Sorry for your loss Megabat . Your mother was blessed to have you there.

@Sweepingcalamity thanks so much. It's just horrible right now but what can you do? It's nice to have a stranger send wishes

I know it's not much help to say it right now but things will get a little easier for you I hope Megabat. I've been through it with three parents/in-laws (the fourth died at home) so I have a small inkling of how you must be feeling. It's very hard.

What you said in your post about the small things that "comfort" a medical patient (rather then the strict medical need stuff) is so important and can make all the difference I think , especially to an elderly patient. Sadly, it's those things go first in a system that is so badly under-resourced.

I think some anecdotes are fine but it doesn’t really give an accurate picture. Undoubtedly there are small pockets of poor care - children in East Kent, Maternity services in Newham etc.

However, the Friends and Family test consistently shows around 92% of people using hospitals in England would recommend that particular hospital to others.

There aren’t hoards of elderly dying from neglect. That’s a scaremongering and s Daily Mailism. Elderly people die. The statistics show 94% of people admitted to a nursing home die within a year. Not from neglect, not from treatable conditions but from age and complex comorbidities. They usually die peacefully and cared for with compassion and dignity.

Unfortunately, some very frail elderly people are taken inappropriately to an acute hospital because they don’t have an end of life plan in place. Nobody has thought to,ask them whether they’d prefer a natural death at home or an undignified death in an emergency department. Nobody has explained that resuscitation rarely works, particularly outside a hospital setting and hardly ever for the elderly.

Most hospitals provide reasonable care in challenged circumstances. Some continue to provide exceptional end of life care. There are Trust’s where 90% of patient’s are discharged to their preferred place of care in their last few days. Most trusts bed management policies prioritise patients receiving end of life care and offer them side rooms. Occasionally, very occasionally , in very poor buildings that are no longer fit for purpose, there are insufficient side rooms. Most do have a side room as life closes though.

All deaths in hospitals are now subject to review. All trusts have to run learning from death panels. Statistics around deaths are closely monitored and any trust with a mortality outlier for any particular patient group or illness is closely interrogated.
The way deaths are reviewed is subject to review itself. It is a national initiative. The Standard Hospital Mortality Indicator is benchmarked against similar trusts and variance considered. Trusts are expected to maintain mortality ratio within a tight band.
Deaths of patients with learning difficulties are subject to very specific scrutiny.

Cherry, I agree with you about end-of-life planning. I see a lot of Respect forms and PACE forms locally but I also see a lot of families overriding these because they can't make the hard choice between keeping Mum who has dementia warm comfortable and safe in her nursing home with a bit of a chest infection (which might result in her death) vs dragging her into A&E and a stay on a hospital ward with poor care and strangers with an IV drip (which might keep her alive this time for a few more months). I've already written and logged my Advance Decision.

CherryPavlova you raise many interesting points (especially about resusitation and the elderly dying in a&e (something about which we all need further education) and your post does indeed all sound very encouraging but surely it is a little complacent to largely dismiss the anecdotal evidence on here as it demonstrates the considerable gap that exists between the care aspirations laid out in national strategies and what is actually happening on over-stretched wards. Otherwise, wouldn't the majority be posting about the excellent care they have received (which I am sure they have in many cases)?

The only time I’ve seen good care within the nhs is peads, homebirth Midwife’s and when I have been treated by military doctors. Walk in centre doctors have regularly misdiagnosed care on wards after surgery from the misdiagnosed problem which was then found in a&e was a shambles. Maternity care once given birth or any care actually in the hospital/maternity unit is shocking.

It’s no surprise if those that are able to speak up receive such bad care that those unable to speak up are left neglected by the those supposed to save us.

Lots.
We visited mil after a stroke and we took her a flask of soup because her chew/swallow reflex wasn't right.
She couldn't have eaten hospital food so God knows how she would have eaten otherwise.
There was a very elderly lady at the other end of the ward who didn't eat. She was bed bound and couldn't get to the trolley, let alone eat.
Our hospital used to invite volunteer feeders in, but that stopped and I don't know why.

I remember someone telling me that in europe the family have to come in and help, we need to have this attitude here. Family need to go in and feed their relatives

Presumably these family members have to work in order to feed themselves though? Not many employers are going to give someone paid time off to spend weeks feeding their relatives in hospital. And who would care for the relatives families/children when they’re in hospital feeding their relative?

SweepingCalamity No, not necessarily. People tend to post about negative experience because it’s outside the norm and they need the catharsis of sharing. It’s a few stories. There are thousands and thousands of good stories too. You just have to look for those.
The people’s voice is important but is best gathered through planned user engagement such as dine by Healthwatch. That’s allows more objectivity. It certainly shouldn’t be ignored but a few posts on a public website do not constitute a norm.

Hiddenaspie1973 Many Hospitals do still have volunteers assisting people at mealtimes. The very elderly lady not eating may not have wanted or been able to eat. As death approaches, he body shuts down and in the last few days/week people generally don’t eat. It’s a normal physiological process. I assume you didn’t see her medical records?

It’s not just the elderly. DH has been in twice in the last year, first time for a month, second for 10 days. AMU and HDU before being classified and transferred to specialist wards. While he was unconscious for the first week (sepsis, encephalitis and renal failure, from perfectly well to gibberish, then unconsciousness and fitting in 5 hours: it took specialists 10days to find out why because of an extremely rare disorder) I didn’t leave. My elderly mother came to supervise at home, from over 300 miles away bless her soul. When he regained consciousness, though not memory initially, she had to leave and I had to go home for 7 hours each night for the kids and animals. Most consultants, doctors, nurses and care workers were fantastic. Some were just plain incompetent or worse indifferent. Especially at weekends, I frequently had to chase his medication (mostly intravenous), drinking water (I was told not to bring anything onto the unit, infection control) and take care of his personal needs. When I arrived on the units first thing, he was usually lying in a caked, soiled nappy which clearly had not been changed for hours. The choice was sit and wait for up to another hour or clean and change him myself. I did, I love him, I didn’t mind. What about the patients who don’t have a loved one to look out for them? Once he was aware of what was going on, he minded though, a lot. Would you enjoy your partner cleaning and changing you as you lay there completely helpless? (please don’t tell me if you would, TMI 😁). I was shouted at one very tired Sunday morning by a nursing sister who told me I should not be doing it, it was a health and safety matter and if I injured myself in the process the hospital would be held liable: he was immobile and I was having to lift 18 stone, I wright 9 1/2. She had the grace to apologise when I showed her what I had just peeled off of him. Apologies for the graphics, and we can laugh about it now, he’s recovered to a large extent though unfortunately they discovered an extremely rare and hitherto unknown (by us) genetic disorder so we’re just waiting for the next episode.
Once he was on the specialist wards, what a turnaround. Excellent care by every single member of staff, no exceptions. And a huge shout out to the lovely army of volunteers who bring cups of tea! We experienced though some of the very worst care on the high dependency and acute units, ironically where the very sickest people are. We’re dreading the next event. I don’t know what the answer is, better pay for a start probably. I understand it must be very hard to be motivated on minimum wage, but if people’s lives are often literally in your hands (it’s the neglect in basic care that often causes infections and complications which doctors then have to expend huge energy and resources dealing with) and you’re not prepared to do your very best, then you need to find another job. Desperate, worried, frightened normally kind and decent people shouldn’t have to be driven to crying and shouting at indifferent staff to make sure their loved one’s life saving IVs are being changed.

My mother died from dehydration.
The fluid balance charts were all filled in.
Nobody actually looked at them or considered giving her a drink.
We all visited as much as possible and gave her drinks while we were there, but it wasn't enough.
When she was admitted she was fully mobile, but they wouldn't help her up to go to the toilet.
Even the nurse in A&E warned us that the ward staff wouldn't help her to get out of bed.
We wanted to take her home and they wouldn't let us.
Threatened us with "safeguarding" - whatever that meant.
If a dog had been treated the way she was the RSPCA would have been called.

@Cherrypavlova, I'm guessing you work in a health related field at a remove from patient care just as I did. I believed all the evidence, statistics and theory too until my parents became extremely old and frail. First hand experience of the health system when I had to fight like a tigress to get them halfway decent care was a real eye opener.

The ward my dad was on was so appalling the nursing staff implored me to complain so disgusted were they with the consultant who ran it. Thanks to a very senior nurse we managed to spring him. He died ten days later, I will always think the week he spent on that dreadful ward shortened his life.

I bow to your greater experience in these things Cherry but at the same time, I'm still not entirely convinced. Mnsnet HQ started a post-natal care campaign based on all the dreadful and distressing reports received here. The posts did (generally speaking) reflect a national picture. And although I agree about people (understandably) needing to vent I also think people are generally fair, understand the pressures the NHS are under and do give credit where credit is due. In fact I I think this is symptomatic of the overall problem ie management dismissing RL experiences of patients as "a few anecdotes".

And I'm sure we are in agreement that an under- resourced system - with fewer staff on wards (and a recruitment problem!) - impacts directly on patient care both withstanding national strategies.

And that is aside from the point that from a strictly medical pov the last days or hours of an elderly person's life is not necessarily a high priority, whereas from the pov of the family and the elderly person themselves, it is vitally important.

Most people being happy with the care they receive doesn't mean that there are not significant problems in the care of certain vulnerable groups.
My son with autism and complex needs, needs the care of very young child ( and more) but I'm pretty sure he won't get it on any adult ward when he gets to his late teens. We will have to stay with him full time and who knows what will happen when we are too old/ dead to do that.

This is a truely awful read, I’ve mostly just skim read so far but will catch up now. I honestly can’t imagine this happening here in Australia but I suspect I am dreadfully naive.

On a very sad and rather random note.. Quite a few months ago now I met a woman at softplay and we got chatting. Her older DD (5ish?) was playing with mine who was probably 10 or so months at the time. Her DD told me she loved babies and had a baby sister. So anyway chatting to her Mum and for some reason I mention the baby sister. Mum looks puzzled and then realises she’s talking about what would actually be her older sister. She died as a baby due to gross misconduct at the UK hospital she was in. Of course the family kept her memory alive and this little girl thought of her as her baby sister

Mum is writing a book about the ordeal so I hope that means she doesn’t mind me sharing this anecdote. I still think about it months on, just beyond sad.

Gross negligence that should read

My Mum died in Nov and I truly believe neglect in hospital was a major factor. It was not she was not being fed just no one was taking any notice of what she needed to get out of hospital and come home.

She had a fall that left her shaken but uninjured but was taken to hospital - she was admitted just to check her over. She did not see a Doctor for 4 days by which time she felt really ill and almost died from hospital acquired pneumonia. This left her frail and it was suggested she went to rehab for a while - it was two weeks before she was assessed by which time she had a pressure sore which prevented her from being weight bearing so unable to be assessed for rehab - she had to wait until this had gone before they could look at her again.

Two weeks later she had hospital acquired pneumonia again and died.

A week before she had her fall she went shopping in Ikea and out for lunch - one fall - causing no injury and she never got out of bed again. If she had been seen and assessed properly she could have been home within 24/48hrs and would still be alive today. She did not need a care package - my daughter had been her carer for 2 years and went in every day. The rest of the family helped out daily when needed.

My job involves me working extensively with consultants in hospitals - and I speak their language and understand working practices and I could do nothing despite ringing everyone and trying to sort things out.

My daughter is a firefighter well used to dealing with difficult situations and being strong and assertive when needed and she could get nothing improved for my Mum.

Each individual was polite and caring - but it appeared they simply never had a conversation with each other or even looked at what others had written in her notes. It was the entire systems and working practices at the hospital that failed my Mum.

Basecamp65
I could have written your post.

Can we copy and post this thread to someone important it's shocking and we thought treatment was bad with our Grandpa. It's showing also that it is basically about if you've got people coming in to look after you or bothering the nurses to step up. Otherwise they don't give a shit if they're not going to be called upon it.