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

I think many of them do give a shit. The systems and processes have a lot to answer for. My dad was put on a pathway that was completely unsuited to his needs. Numerous capacity tests were carried out which he passed with flying colours, the results were ignored. A lot of the problems are caused by people's individuality not being taken into account. And, despite claims of bed blocking, it seems many people are kept in hospital when they simply don't need to be there.

We need to be less reserved and afraid of the ward staff perhaps

I do think there is a feeling of 'if I cause too much fuss will the patient suffer?' When DM was in (effectively most of the 5 months before she died) we met a range of people. Some could not have done more; others - well she was clearly an inconvenience and so were we for daring to ask what was happening. On one occasion DB and I went off to demand some info (we had to demand as nothing was forthcoming from anyone and Staff Nurse was as incontractable as could be), and when we got back to DM she was lying across her bed, crying from pain/discomfort, unable to move or reach the call bell. I found Staff Nurse and demanded to know how long she'd been like that - SN didnt know and 'she could have rung her bell' - except that it was out of reach and I suspect possibly deliberately so. Sorry, a bit ranty there. I have 11 pages of notes about DM treatment which form the basis of our complaint...

It tends to make you ranty, doesn't it? My (heavily edited) letter of complaint ran to three pages, the response addressed none of the points I made. The meeting when I complained again was cosmetic. The medical director told me off the record afterwards that she'd never allow her 94 year old dad to go into hospital.

I agree about being less reserved with ward staff although with one exception the nurses and HCAs were brilliant when I was last in hospital.

The exception was a nurse who never smiled, always had a scowl on her face and you couldn't find someone less caring. She virtually snarled at us patients if we needed anything. Why would you choose nursing if you so obviously hate people? I asked her if she would kindly help me get into bed (already disabled before falling and breaking bone in knee) and her response was 'why can't you do it yourself, you get in bed by yourself at home.' I explained I slept in a reclining chair, unable to use a bed and she grabbed my leg and flung it onto the bed - all the other patients in the ward were all making faces and rolling eyes behind her back.I'm due to go back in for an op in the next few months and hope she's moved on to somewhere more suitable, like a prison hospital

Neglect is only part of it. The 'neglect' is wilful. The intention is to bring the lives of the elderly to an end, as quickly as possible. The doctors (usually in their twenties, not an ounce of feeling in their bodies and no souls to speak of) are quite open about it.

There are also 'convenience' practices. For example, if your elder has had a visit in the afternoon, arrive for evening visiting hours and you will find them drugged up to the eyeballs, and everyone else who had an afternoon visit will be the same. Staff don't expect families to visit twice in a day.

you absolutely legally cannot force a patient to eat their food if they decline it, nor take their medication, not drink their water (all of this would be consider abuse) - and you have a situation where issues such as malnutrition & dehydration are entirely possible.

You can encourage someone to eat or drink, give them food that is easier to eat and swallow, drinks in easy to drink cups. Doing what some staff do - plonking food down and taking it away uneaten because "Mrs X does not want to eat" is total neglect.

You can't force people to eat and drink but you can encourage them. My mum would eat if I fed her. So I did.

"Add to this the fact that no - you absolutely legally cannot force a patient to eat their food if they decline it, nor take their medication, not drink their water (all of this would be consider abuse) - and you have a situation where issues such as malnutrition & dehydration are entirely possible."

Err, have you heard of the Mental Capacity Act, and making Best Interest decisions when a person lacks capacity? Of course you can legally force a patient if they lack the mental capacity to be able to make the decision themselves.

Unfortunately, in my experience, staff are very quick to trot out the above bullshit, as it saves them a lot of time and effort.

There are, of course, exceptions to the rule and I have come across a few really caring nurses. But they are in the minority, and most seem to lack compassion.

Sorry to hear you are having a tough time OP. I'm sure some do

Also I'm sure a lot die following being discharged from hospital without a proper care package

HiddenAspie I have been in hospital and only able to eat very soft food. Surely the hospital menu had these choices? I know in my local hospital every menu had a very soft choice.

My granny died in hospital from kidney failure due to dehydration. She was fully aware and alert, she was in for ongoing cancer treatment and would come home to us at the weekends. She wasn’t very thirsty due to how she felt, and the nurses didn’t notice she wasn’t drinking enough or peeing and her kidneys gave way. We had to watch her slowly slip away over days and there was no way to help her, she was hooked to fluids and morphine but it was just too late, her body couldn’t process them. We know it wasn’t intentional, the staff were lovely and caring and kind, and I don’t think anyone had the strength afterwards to make a complaint to stop it happening again. It was terrifying that she had cancer and was coping with treatment, and it was dehydration that took her.

Ginandsimicboom if course a doctor can decide that a patient can be force fed via an ng tube and then the patient would have to have their hands in mittens do they can’t pull it out. This does happen but often doctors do not believe but to be in the patients best interest. You say most nurses lack compassion. All I can say is why don’t you have a go yourself, plenty of job opportunities and more becoming available everyday. Most nursing and care staff do things everyday that the general public wouldn’t dream of doing in a million years.

stairway If nursing and care staff are not up to the job, they should not be doing it. And there are lots of jobs where people do really tough things every day. Try being a child protection social worker for example.

I’m not saying people who are not up to the job should do it, but most of the problems are coursed by lack of staff. The hospitals are full of foreign workers ( who are mainly excellent). I just hate it when people generalise and say most nurses lack compassion. It’s not fair.

Caused

It’s interesting how many people are saying dehydration is a massive issue. I get there’s no money for anything but after honspital aquited infections/antibiotic resistance was flagged up massive changes were made. It’s that’s what’s needed with drinking.
I could not believe how bad dehydration/uti/kidney problems could be.

No it is not fair to say that most nurses lack compassion, but some do.
And I think HCAs are under trained.

I think nurses and HCAs are totally overwhelmed - understaffed, rushed off their feet, stressed - which probably leaves to compassion fatigue for some. I do also think that lack of good English doesnt help - my DM, 88, deaf as a post even with hearing aids, found it very hard to understand non-native English speakers. Sometimes when we called the ward on the phone the person on the other end couldn't understand us nor we them.
My solution: return the bursary for nursing students and provide one for HCAs and look at caring qualities as well as academic ones. Oh yes, and pay people adequately and provide decent staff:patient rations. In my dreams.

stairway no, it’s not as simple as that. A doctor cannot decide to ’force feed’ or sanction the use of mittens. That is covered by the Deprivation of Liberty Safeguard law and requires a DoLS application to the local authority.
If a patient has capacity for a specific decision (no such thing as ‘no capacity’) then they cannot be overruled even if it’s a seemingly unwise decision. Able to refuse food? Absolutely.
If they lack capacity to make a specific decision there must be a recorded best interest decision involving discussion with the next of kin (although next of kin cannot give or withhold consent) and usually an independent advocate.
Complex cases are referred to the Court of Protection.
Force feeding. is very rarely used - became obsolete with the Cat and Mouse Act.
Plastic Patty you are so wrong. There is no intention to bring lives to an end. There is generally intention to ensure a dignified death free from painful and degrading interventions. Why would anyone want to force feed a very sick elderly person with dementia just to keep them on this planet a few days longer? Why would you put them through the distress of having a tube inserted, a sore nose, ulcers in their throat where they’ve pulled it out? We can’t cheat death. Elderly people die from (mainly) old age.

Nighttimenope. It’s sad your granny died. It doesn’t feel like it was from dehydration as you say she was ‘hooked up to fluids’ which rather suggests active steps were being taken to manage her fluid balance and reduce the impact of an acute kidney injury. In truth, it’s more likely that kidney failure secondary to cancer treatment was the key factor. Intravenous fluids hydrate more efficiently than oral fluids.

I've been nursing for 30 years, mostly in care homes due to my autism. From what I've experienced, many people who are in the job are not cognitively capable of doing it. They simply can't grasp that A will lead to B and result in C. Some people are more switched on than others, but many are just plain stupid.

Also, empathy. The times I've had to fight for pain control for people. I actually find it frightening.

Agree with up thread poster. Why don't you all go and have a go?? Loads of jobs available in nursing and health care. Show us how it's done!

@Cherry- she was hooked up to the fluids only after it was noticed that she was dehydrated with kidney failure.

And it was the hospital themselves that said it was triggered by her not drinking enough.

I think compassion fatigue is a thing but I think one facet is overlooked: that HC staff increasingly feel unsupported themselves.

The Red Top papers encourage a combative attitude towards the NHS, while expecting the fictitious version of Florence Nightingale in nurses; they have lead the drive for Brexit which is resulting in more non-European, sometimes dubiously trained and sometimes with poor English skilled individuals to take the place of EU staff.

NHS middle management's attitude to coal-face staff is a shrug, as 8 hour shifts get changed into 13 hour shifts; 'normal office hours' are 6.45am to 10pm; training budgets disappear, failing equipment gets that same shrug; local pay arrangements, designed to incentivise staff- get swept away overnight; and 'loyalty' is questioned if someone refuses to cover another absentee's night-shift. Qualified positions are replaced with HCAs. Posts are deliberately left empty to save money.

General wards with general ward staffing numbers are filled with over 80s with endless complex co-morbidities.

With all this as a backdrop, it is unfortunately true that once you get to the point you know you cannot do your job anything like as well as you'd like, and you know your managers just don't care, and given that you still have a mortgage to pay, I think some staff do 'shut down' to a greater or lesser extent.