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

No, I accept I was probably wrong to say that MOST nurses lack compassion. That was just my experience of being in hospital for a month recently. I'm a bit bitter and not at all objective. I can understand why some nurses suffer from "compassion fatigue" as they have an incredibly tough job to do, and are always so short staffed. But even when I was a hospital social worker 20 years ago when the NHS wasn't as bad as it is now, there was a common lacking in compassion theme amongst nurses who could be quite cruel regarding some of the frail dementia patients which was so sad to see.

My issue isn’t with the nursing staff who, in my dad’s case, were fantastic. The consultant was a sadist. And the main issue was the inflexible and inappropriate pathway.

My dad passed away in hospital 4 weeks ago, he was admitted 9 days before he died with kidney failure. We always tried to be there fore at least one mealtime each day as he couldn't feed himself & nobody bothered to make sure he had help at meal times, nobody helped him to have a drink when we weren't there, we arrived one morning to find him sat in diarrhoea, nobody had cleaned him up or changed the bed. We had to argue to get him a ripple mattress to prevent bed sores, he didn't get one until 4 days before he died. My mum was distressed 2 days before he died when we arrived that he Las laid in a pool of blood, the toxins in his blood were causing severe itching, he had scratched his arms raw & he was bleeding everywhere because his blood wouldn't clot. We had to argue to get his bed changed & his arms bandaged up to prevent him scratching. The day before he passed away they called us in because they thought he was going to die, he was very agitated & frightened, we asked for him to be sedated, it took 6 hours for a doctor to come to prescribe the drugs & syringe driver to sedate him, he was screaming in pain. The bay that he was in was designed for 4 beds, but due to cuts & ward closures had 6 beds in with less than 3 feet between the beds. There was no privacy or dignity for a dying man of 83 years old. That was what upset me almost as much as losing my dad, on the morning that he died, they called us in but by the time we arrived he had passed, they hadn't even had the manners to close the curtains, the other patients spent 8 hours in a ward with a dead patient, this wasn't the first death during my dad's stay, another patient died & was left in his bed for most of the day.

in most cases it's chronic systems failure, isn't it? Like when I was on the maternity ward but DC was in NICU and kept missing meals because I was with him, but no-one on the ward seemed to grasp that I still needed to eat even if I wasn't there at the precise moment that the food trolley came round. As if I was the first new mother to be with their poorly baby

At the moment our ward, Which is equipped / stocked and staffed for 10 patients. 4 Coronary care beds and 6 direct step down coronary beds. We are currently doing our upmost to care for TWENTY NINE mixed specialty patients. Our patients are generally mobile so our staffing is 2 nurses and 1 HCA. I have stopped taking food to work on my 7am - 8pm (in reality 10-11pm) shift as I was never getting the chance to go and eat it.

I have been nursing for 15 years. I don’t want to be anything else and I don’t know how to be anything else. I want to go home at the end of a shift feeling that I have made a positive difference to people. Mostly I spend my days trying to prevent harm. I am often solely responsible for 15 patients who may be on 20-30 meds each, may need help washing / eating / toileting. My colleagues are frequently breaking down in tears. I have collapsed on shift twice purely down to exhaustion / dehydration. In the first two weeks of January our ward put in over 20 reports about unsafe staffing. Higher ups don’t have the answers. We are trying to do more and more with less and less. The stories on this thread are simultaneously making my heart break and blood boil

In order to fit 29 patients onto our ward they have opened the fire doors to the day surgery unit next door and filled it with beds. There aren’t enough side rooms, toilets, tables or chairs. The only thing we aren’t short of is patients. Catering is run by a private company who often don’t fill rota gaps with servers so we are frequently responsible for dishing out and serving dinners while giving out meds and nursing our patients.

I cared for my mum when she was terminally ill and the 2 weeks she spent in hospital were awful. I quickly realised that either myself or another close family member/friend needed to be there all day, every day ideally. No staff were around most of the time. Those I did meet were uncaring and arrogant. It felt hurtful and cruel and my mum deserved kindness (she was lovely, 64, terminal cancer and very, very scared). In the end, we managed to persuade the hospital that we could care for her at home. She passed away at home with support from family, her GP and the local hospice.

My children were toddlers at the time so a lot of juggling was required to enable us to care for my mum but knowing that we did everything possible and that a family member or close friend was with her most - eventually all of the time - comforts me now.

Could you recruit some other family members and close friends and draw up rota so that someone’s with your dad as much as possible? That worked out for us. Good luck, OP it’s a difficult time for you. x

I have left ward nursing now, but I can say I gave much better care when I had 7 patients to look after (with the help of one healthcare assistant), as opposed to when we had 8 - 16 patients, or a few awful times when we had 28.

I am ashamed of the levels of care that I could sometimes provide when I had too many patients. I used to turn up early, skip breaks, leave late, but it was very rare that I left work thinking I had done everything. Quite often I would be struggling to figure out who had eaten breakfast or not by 10am; the morning drug round alone would take me between 1.5 - 3 hours. Some of my colleagues were absolutey brilliant, and others obviously didn't want to be there.

Someone said upthread that nurses "need to step up" and "don't give a shit". I gave a shit, I tried, the job broke me and I left. Maybe you do need to not give a shit to stay in some places.

For an insight into wards from a nurses point of view, this blog is interesting reading:

militantmedicalnurse.blogspot.com/?m=1

The author relocated from the UK to America a few years ago, and where she works has a maximum patient ratio of 6 patients to one nurse.

My mother in law fell at new year broke hip,shoulder and arm,she lay on floor for four hours waiting for ambulance once admitted to hospital she waited two days for them to operate and put a plate in her shoulder,2 days later they rolled her onto broken side and pushed the plate out of her shoulder through the skin so she waited two more days for that to be sorted she is still in hospital six weeks on

I work in a hospital, mainly on dementia friendly wards,and have to agree to an extent. Some wards staff are rushed off their feet as it can be very demanding and there really should be more staff. There are some nurses, however, who really do not have a caring attitude and I have to say I've seen one HCA get narked with an elderly patient pressing her call button and removing it from her so she couldn't press it again. She was later seen storming out in tears after it was noted what she had done. But the damage is already done to the patient then :(

It does anger me. I love the elderly patients and as demanding as they can be sometimes just a smile as you walk past can make the, um, 'lively' ones enough of a boost to settle down a bit and let staff get on.

It's largely about communication though and ensuring staff pass things over to others working on the ward.

Just to add to that though, do remember that working on wards with elderly patients can be incredibly demanding and emotionally tough too. Most staff do the best they can but with limited support, often ridiculous hours and constant demands, its not plain sailing for anyone who is constantly torn between so many people at once

@originalusernamefail
You’re working from 7am till 10 or 11pm without so much as a chance to eat or drink? how are staff supposed to cope in those conditions and why isn’t more of a fuss being made? Surely the staff turnover is high? Just wanted to acknowledge your post you sound like a caring nurse.. I want to go home at the end of a shift feeling that I have made a positive difference to people. Surely this is why most nurses actually go into nursing. It’s sad the policy side of it all is preventing nurses from doing the best job they can.

It does happen easily IME. I was in a hospital for 5weeks & one confused elderly patient regularly missed meals because she wandered off & no-one noticed so she'd misse a lot of meals. It got to the point I went & searched for her every meal time I was so worried. Nurses accused me of interfering & said 'leave it to the staff' when I mentioned it. Another patient who spoke no English & was much worse mentally was also just left for 2days, to wander or lie on the floor singing or crying. (Both should have been on geriatric ward but there was no room for them). I also got the wrong medication twice but was aware enough to notice . It was totally shambolic & the Nurses were openly dismissive to patients when relatives weren't around (at which times they would keep v low profile). I reported the whole lot of them to the Care Commission. Also, I don't know what their normal staffing level was, but one Nurse did say the Ward Manager "couldn't be bothered" getting 'bank' cover in if someone was off short term sick. In such a busy, large ward I think that had repercussions daily.

CherryPavlova I’m afraid your point about force feeding doesn’t stand up because many older people would eat or drink enough to keep comfortable with the right support. Lacking capacity to make a decision about nutrition does not mean they need to be NG fed. Often, it needs a member of staff to ensure they can reach their food, have food of the correct consistency and are encouraged to eat etc. I fully understand staffing pressures make this very, very challenging but I don’t think capacity is actually the main issue.

This can actually be ward specific. My DGM was in hospital for about 6 weeks before she died. When she was admitted was put into a side room and effectively forgotten. She was on the toilet when they came to take the food orders so no food was supplied that day. They tried to cobble something together (probably because we were there) but it was roast pork and she was Jewish. For some reason she moved to a different ward one floor up and it couldn't have been more different. A much happier and more supportive atmosphere probably due to the attitude of the Matron.

I think Cherrypavlova must be a senior health administrator or the Health Secretary to be so blinded by reports and so unaware of what is actually happening on the wards. IME anyone on a general ward is at risk of neglect and people won't complain as they are able to see what happens to anyone who is perceived as difficult. Not responding to buzzers/moving buzzers out of reach when patients have used them more than once is commonplace. Staff are too stretched to give appropriate care.

Ward rounds become problematic because staff have so little contact with patients that they can't give an accurate up-to-date briefing to the consultant. The last time I was on a general ward the verbal report given to the consultant bore no relationship to my actual condition and the consultant was directing my care based on erroneous information until I interrupted them (I hadn't been involved by them in the discussion). I was able to advocate for myself but anyone who couldn't would have received inappropriate care and probably stayed in hospital far longer than necessary.

I would suspect that complaints that are investigated create a lot of administration work and reduce still further contact time with patients, demoralize the staff still further and don't achieve anything.

My DD was in hospital for six weeks, three in intensive care in one hospital, then transferred for another three rehab at another. The first hospital were amazing, but the second... they left her in piss soaked sheets when her catheter leaked, left her in a wheelchair in a corner facing the wall, took her for a shower and left her sat in it after she’d finished, soaking wet for ages, and far, far more. Luckily she was a feisty 25 year old, and very able and willing to speak up for herself, not to mention ringing us and telling us what was going on. Hate to think what would have happened to someone more vulnerable.

I have no doubts at all.
My personal observation. I was in hospital and saw an elderly lady fall out of bed because she didn't have the sides up.
My dbil is blind. He was in hospital for a long time. On the third time I found him with hot food gone cold next to him I had to get really really angry. He had been asleep at lunch. No one woke him. And of course he couldn't see it. He had visual impairment written over his bed. I crossed it out and wrote blind.
In the end I had to ask other patients and their families to watch out for him

Not just elderly - anyone who is in a state where they cannot be totally on top of things themselves and don't have family members coming in regularly to check on them.
YANBU and it is a disgrace.
My experience of it (with my mum) was not that they were understaffed (although they may well have been) - they were undertrained and DID NOT GIVE A SHIT. Nobody took any responsibility, nobody was at all bothered. She had food in front of her that she was incapable of eating herself and it would get left there and then just taken away - not ONE SINGLE NURSE ever bothered to find out why she wasn't eating. My dad ended up going in and spoon feeding her and even washing her himself.
I wouldn't have believed it if I hadn't seen it myself.

You're right, it isn't just the elderly. My husband was taken in with suspected meningitis. While he was being admitted I went home to get some things for him.

I returned and had to track him down, eventually found in an end of corridor side room, no lights on, sheets still folded up on the bed and he was laying there shivering and hadn't been admitted (this was 4hrs later). I flat out refused to leave until I saw a wrist band on him. He got no food for tea because they didn't know he was there so therefore he didn't get a form to fill in for the next day. When I arrived at visiting time, he had missed three meals and a Dr still had't seen him.

Likewise when I was in with typhoid, the room was cleaner than me as there was a big push on MRSA. I laid there for 7hrs in blood soaked sheets after they had an issue with my drip despite me asking several times for new sheets and as I had no control over my bodily functions at one point for 48hrs, I laid there in my own mess for quite some time. Having said that, when I had a crash on the second night, the emergency care was quick and effective. Thinking back, the staff seemed a lot happier than recent experiences (2007).

I just find the whole system is fractured and departments don't talk to each other, the right hand doesn't know what the left hand is doing.

@ MrsCollinssettled. Health secretary? Absolutely not and definitely not blind to some of the challenges facing front line staff. Again. A few anecdotes do not make up the majority. There are mistakes, there is poor care but it I still the minority. Much is about poor communication rather than necessarily poor care.
It’s also about chronic underfunding where budgets have been decimated under this government. It’s about trashing the working conditions for junior doctors. It’s probably about 12 hour nursing shifts - although they were brought in and normalised at the behest of nurses.
Recruiting is a nightmare at all grades.
The FFT results are patient and relative opinion.
The NHS staff survey is the staff opinion.
PROMS are patient reported outcomes.

Even in lower performing trusts most payday they get good care and have good outcomes.

Professional experience of frontline care in many, many hospitals.

Direct personal experience? Yes a 94 year old mother whose been admitted five times in past year including surgery and day surgery. Not entirely perfect care (forgot to help her put hearing aids in and thought she was confused once and had incorrect weight setting on her pressure distribution mattress). Nothing that reasonable communication couldn’t sort. Getting angry afterwards does nothing. Most of her care was good. Some has been excellent.

Severely disabled sister? Generally excellent care too.

The real risk of taking individual stories as generalised fact is that it undermines the world class service that you get. It will allow the destruction of the NHS as people with no experience talk about the model in other nations.
The increase in NHS work to the independent sector (about 30% at moment) is worsening the situation overall although private rooms and better food is appreciated by individuals who can access this sell out. The overall impact makes recruiting harder, means nhs gets only harder to manage individuals with higher risk and the high payment surgery goes to venture capitalists.

There are people in the states awaiting transplants who can’t have them because their insurance won’t pay. Germans pay 8% of gross income on statutory health insurance. This compares to top band U.K. national insurance of 2% deductions on salary only. Other income isn’t included. Just imagine how fantastic our NHS could be with four or five times the funding! Yet people voted Tory.

I just wanted to say that the nurses (and former nurses) on here like originalusername fail and PopcOrn sound fab and I think most people understand that the system is at fault here and the under-funding, not (in the majority of cases) the individual staff who generally speaking are battling everyday to do a good job in an impossible situation.

People don’t seem to understand consent terribly well and assume that hospital staff can just make decisions without consent.
Bed rails deprive people of their liberty and cannot just be put up. There is actually an increased risk of more serious injuries where they are used for distressed patients. A fall from climbing over bedrails has a much more significant impact than a fall from a trolley without bed rails.
Of course nurse should ensure patients can reach food and have call bells in reach. Most hospitals now monitor call,bell response times.
If a person with full capacity (as person having suggestion of nasogastric feeding was), and they don’t want to drink, you cannot force them. Even if they choose to become dehydrated.

If a 96 year old has capacity and wants to go outside for a cigarette, refuses a coat despite the snow and isn’t well practiced in the use of acwalking frame after surgery, you simply can’t stop them. If they fall relatives might well shout negligence when in fact they should be shouting independence.

as a community carer it makes me very sad that the morning staff do not get clients get dressed, this particularly 97 year old apparently consistently refused to get dressed.
the family chose another care company in the end.