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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Worried about the care mum is getting in hospital

18 replies

greeneyedlulu · 11/05/2019 12:50

First off I'll say I have the utmost respect for the nhs and the staff and this hospital saved my life when I lost a lot of blood after giving birth!
However mum is in hospital we think with the onset of dementia relating to Parkinson's. Nurses say they need a urine sample to test for any urinary infections as this can cause old ladies to go dolally.
It's now Saturday and she been in since Wednesday and all they've done is put her in incontinence pants. They say she fought them off when they tried to get a sample by using a catheter.
Mum needs a lot of help as she is disable and mumbles when she speaks but when at home she lets us know she needs a wee and we get her up and she goes, upstairs, wees and sorts herself out and comes back down and then we may just need to help to pull her pants back up over her bum. Nurses are telling me she is incontinent but she isn't.
I feel like we are not getting any answers and that mum is actually getting worse there and it's frustrating. A doctor mentioned having a brain scan but nothing has happened.
I've never had to deal with this before so I have no idea if this is normal. I know the nhs is under strain but it's the lack of answers or communication!
Any advice would be appreciated!

OP posts:
Clockwatchers · 11/05/2019 13:05

DAILY MAIL/SUN ARE SCUM

I think they expect you the family to provide personal care. My DH has just come out of hospital and been in a few times recently. Everyone else is elderly, many have carers (who are expected to be in all day) and the rest have family who care for them all day. There is restricted ward visiting for other patients.

It did strike me that the NHS today is it rather like the pre NHS or SE Asia (where we have lived) when you are basically expected provide all the basic care for your family whilst in hospital.

So can you take over the personal care?

I would say that on my DHs ward there are people with early dementia who manage ok at home in familiar circumstance but they struggle in unfamiliar surroundings.

LucindaCowper · 11/05/2019 13:08

You are right to be concerned. In my experience with various relatives the elderly are routinely catheterised for no good reason other than nursing convenience because they are so short staffed. It's heartbreaking. Catheters are renowned for causing UTIs (google CAUTIs) and should only be used as a last resort and according to a strict set of published critera, but these are ignored.

Someone I know, in her 80s, was in hospital after a minor fall last year. She didn't break any bones and was still able to potter about. She was not incontinent when she went in. They lied to her relations and said the doctor ordered a catheter but this was not in her notes and the doctor denied it. She was catheterised and bedbound for no good reason for 4 weeks. She developed a UTI in week 2. They gave her anti-biotics for it but otherwise she was basically ignored her and there was no diagnosis of anything apart from the CAUTI. Despite pressures, they didn't seem to need the bed at the time. She is incontinent now for sure, as a result of not controlling her bladder for 4 weeks, plus her muscles wasted and her mobility is worse. She is so upset and embarrassed about the incontinence that she won't leave the house.

I learned from a doctor friend that staff shortages mean the only alternative to catheters is incontinence pads as there is simply no time for staff to take people to the loo when they need it. Sad

OldAndWornOut · 11/05/2019 13:11

I think you need to be very proactive with regard to getting things moving.
Ask when it would be possible to see a doctor to have a chat about your mum.

Wingedharpy · 11/05/2019 13:13

She may well have become incontinent OP, as a result of a urine infection.
Any chance one of you who normally assists her at home, could stay with her to get the urine sample so it can be sent off for testing and they can then ensure she is on the appropriate treatment?
Not saying you should have to do this but it may be one way to help facilitate her recovery.

NicoAndTheNiners · 11/05/2019 13:14

I learned from a doctor friend that staff shortages mean the only alternative to catheters is incontinence pads as there is simply no time for staff to take people to the loo when they need it.

This, it's common practice. I'm sorry. I know it doesn't help with dignity, etc and you could try arguing with the ward sister from this POV but that's the bottom line. If they take the pants/pads away and promise to get her to the loo there will be times they won't get her there in time and will then need bathing and changing.

TheSandgroper · 11/05/2019 13:16

OP. Ask to be transferred to the Elderly Parents forum. There is a wealth of experience to draw on there.

MintyCedric · 11/05/2019 13:19

There is a massive risk of infection with catheters which is a real problem for elderly especially if they already are showing signs of dementia.

Like you, I have always had the utmost respect for our NHS staff. I also work in the public sector and understand only too well the impact of financial cuts and the knock on effect of staffing levels, but...when it come to your own loved ones unfortunately sometimes you have to shelf that notion and kick arse.

My elderly dad was very seriously injured in a fall at the beginning of the year. After 10 days of miscommunications and complete lack of organisation they had still failed to achieve a concrete diagnosis of the extent of his injuries or any idea of exactly how they were going to treat him. He was initially nearly sent home (with 4 broken vertebrae) and aspirated twice causing chest infections and ended up nil by mouth during this time.

I tried to involve PALS, who did eventually come through for us after my mum put a complaint in writing, but to actually get anything done it took me physically going from ward to x-ray and back to ward, demanding to speak to a senior member of staff and telling them very publicly that if he wasn't dealt with with x time frame I would be going to my local MP and the nation press.

I am really not 'that' person at all, but he'd been waiting for a back x-ray for nearly 4 days at that point and I spectacularly lost my shit.

It worked, and tbh if that's what you need to do, I think you need just resign yourself and give them hell.

hatgirl · 11/05/2019 13:20

It's unlikely you will get any answers over the weekend.

If you are visiting and think you might be able to encourage her to go to the loo do you think you could ask for one of the cardboard sample loo tray things and a sample yourself?

MyNameIsFartacus · 11/05/2019 13:20

I work on an acute urology ward and can say hands down that we do not catheterise for convenience. Sometimes we do if a patient is so incontinent that their skin integrity is at risk. Often patients with UTI's are confused and only pass urine in tiny amounts at a time, it would be physically impossible to take them to the toilet every 5 minutes throughout the day and they are often not aware that they need to go/have been. Pads are changed on a very regular basis and we use barrier creams to protect the skin. It is a tricky situation for sure.

MintyCedric · 11/05/2019 13:21

Sorry - I realised that may sound a bit bonkers.

I'm coming more from the point of view of them needing to get a sample but presumably being unable to do so because of the incontinence pants issue.

From an overall care POV, I don't know what to say that hasn't been said already. I know I never envisaged a day when I'd helping my dad to use a portable urinal, but hey ho...!

greeneyedlulu · 11/05/2019 13:21

Dad tried to move mum as she was all slumped over in the bed and the nurses told him off! I don't think they want to put a catheter for a while but just to go in and out to get the sample.
I have spoken to the nurses every day but always have the feeling I'm being fobbed off but will get someone to answer me today as I'm just on my way there now.
Dad is spending most of the day there but I work ft and have a ds and am 3 months pregnant so I can't be there all day.

OP posts:
MintyCedric · 11/05/2019 13:25

Flowers lulu

I hope you and your dad are able to take a little time to look after yourselves too.

Do you have any other local family who could help out?

OldAndWornOut · 11/05/2019 13:25

I would second that.
My mum was transferred to a ward to await her discharge.
From using the toilet with help, and sitting out in a chair each day, I found her in a bed with cot sides, wearing a pad and drinking from a plastic beaker.

I had to find someone to ask why, and it was obvious she didn't know.
The next day I visited and things were the same, so the next day my daughter tackled the ward manager.

After saying she wouldn't listen to my daughter shouting (she wasn't) she admitted that they had on handover notes on my mum, and knew nothing about her, her issues, or her time on the ward before.

LucindaCowper · 11/05/2019 13:28

It's crazy though, why would they put in a catheter to test for infection when even if she hasn't got an infection the catheter is very likely to cause one.

SnowyAlpsandPeaks · 11/05/2019 13:50

(Sorry this is long I didn’t realise until I finished!!Blush)

Dad was taken in via ambulance last year, he’d taken triple morphine tablets when they’d been stopped- I only noticed as I picked up his meds and they were out- put two and two together and he managed to say he took three purple tablets, so I knew what he’d taken. Ambulance gave him two reversals it done nothing. In A&E they done the same, and I said to the Dr it was something else, not just this, was told I did not understand the drug and this was what happened and he was being discharged. I lost my shit- I do understand, I deliver medication training, I am myself on morphine tablets, and dad was on 3 morphine tablets for several years until they stopped them 7 days prior. It was something else. So she said she would order bloods ‘just to give you peace of mind or else you won’t leave will you?!’ 🤔she’s right I wouldn’t have left! An hour later a nurse came to say they were moving dad to the ward as he had a severe infection and his kidneys were failing amongst other things. I asked why the Dr had not come to explain, she smiled looked around and said ‘because you were right and she was totally wrong’. As I left to go to my car and get dads things (I packed as I knew he’d be staying) I seen the paramedics who asked after him, I explain what had happened and they said ‘we knew it was more than that in the ambulance after he didn’t respond the reversal and we told them that when we handed him over’. 🤷🏻‍♀️.

I know they are stretched, I know they are working short staffed etc etc. I’ve worked in this environment my whole life. I get it, I really do! But so many times I think ‘listen to what the family are telling you’. Yes there are times that families say stuff that make people go 🙄, but then there are so many times that that ‘little bit of information’ makes a big difference to how they are cared for.

One example that springs to mind- Mr j capable of going to the toilet by himself, is able to adjust his clothes, clean himself etc. Mr J just needs help to swing his legs around off the bed to the floor, but he is then able to get up off the bed himself and with his sticks make his way to the bathroom. Mr J will call for assistance as soon as he needs to go, as by the time he gets there the need is more urgent. Mr J rings for assistance and is told someone will come shortly, he rings again and again. Finally assistance comes and Mr J has lost control of his bladder. After this happening several times they decide that a catheter is best. It’s best for the nursing staff, however Mr J has now lost his independence and is likely to get a UTI as he’s had them previously when having a catheter in the past.

Mr J is not a family member, but a service user that was in a residential care facility that I used to deliver training too. Every time Mr J went into hospital the same scenario happened, and this was with qualified nurses at the care facility telling the ward don’t put a catheter in just sit him up on the side of the bed and he can do the rest himself. Yet they still wouldn’t listen. So what hope to ‘families’ have of convincing them????

greeneyedlulu · 11/05/2019 17:40

Thanks for the responses! So today we found out they got a small sample of urine and it's not showing any signs of an infection. The doctor finally spoke to us after lots of chasing and he said they are now waiting til Monday to get things moving as they want mum to be seen by others, physio and Neuro, and of course that's not going to happen on a Sunday.
We do feel better about things as that really all you need isn't it? Communication!

OP posts:
OldAndWornOut · 11/05/2019 17:50

My daughter and I used to phone every day too.
I know it probably got on their nerves but it was my mum, so I politely (always) wasn't going to let things slide (and they still did, but at least I could deal with it there and then, mostly)

greeneyedlulu · 11/05/2019 17:50

Thanks minty, we are doing ok for now, if it comes to it, I'll just take leave from work if I need to, my boss knows everything and is understanding as he went through something similar when his father passed away so I have his support.

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