To not comply with my dad's paranoid request?

[Xley90]

For years my dad has been interested in some things others may find strange such as certain conspiracies but to be fair he's always given a good debate on them and has never gone as far as flat earth so I've just put it down to him having too much time on his hands. He's currently in hospital from complications of a recent surgery, he's had a positive covid test now he's in hospital but has no covid symptoms luckily.

He's only been texting me sporadically while in hospital, initially he would reply to me when I asked if he's ok but since his positive test he is mostly was not replying - totally ignoring my messages asking if he's ok, so I've been checking in with the hospital for updates.

Yesterday he started saying that the ward he was in was awful, that he could tell me stories that would make my hair stand on end and that he wanted me to contact his old nurse who was looking after him (from a few years back, at the same hospital) and ask this nurse to 'check it out'??!! He's suggesting the hospital don't want to let him go and want him to die there.

My question is, am I being unreasonable if I won't 'ask the question' of this nurse? He's obviously scared and anxious, when i've replied to him that another department won't get involved he just begs me please to ask the question. I obviously don't want to ring this department and sound crazy myself but don't want my dad (even if he's in a deluded state) to think i don't care and make him more anxious.

I was thinking about just ringing the department and letting them know he's told me he has an appointment coming up with them (he claims he does) and he wanted me to let them know he's in hospital so can't be contacted (telephone appointment). That way I have kind of done part of the request which I think is reasonable but I feel uneasy about lying to my dad to say I've asked them his bizarre request. Torn between lying or refusing and him thinking I won't do a simple thing that he claims 'may save his life'.

I would note my concerns with the nurses on the ward (if that's the way to do it) and would say I'd try to contact this nurse he's talking about, but probably wouldn't.

I think asking to describe what's going on is key, he could be delirious or he could be being treated poorly.

I would not lie to my father or presume he had delirium

[quote Graciebobcat]OP, I wonder if PALS could help?

www.nhs.uk/common-health-questions/nhs-services-and-treatments/what-is-pals-patient-advice-and-liaison-service/[/quote]
I was going to suggest this. If someone from PALS goes to see him and listens to his concerns, that would cover all bases. If he has actually witnessed poor care, then they will investigate it. If he doesn't seem lucid to the PALS person, then you might be able to follow that up with the ward staff so that they can look into the reasons for his irrationality.

My dad went a bit crazy in hospital. , it was the combination if drugs

Yeap, my mum did too.

The trusts her in these issues (hospital care) and wants a bit if reassurance.

Or hes horny and wants a date with the nurse he used to flirt with

The ‘poor random nurse’ can deal with a random request and ignore if necessary. Your dad is your own dad and is helpless and could well have very legitimate fears. Like others, I have seen frightening ‘care’ on NHS wards. Of course most drs and nurses are excellent but equally of course, there is a percentage of people across every profession who are awful. I watched a friend dying, being ignored by the nurses, not fed or given water. Because he was dying. Please take your dad seriously, even if it does turn out he was being delusional, isn’t it better to err on the side of caring?

Have you asked his care team to review his meds and check for delirium?

Very common for patients to experience paranoia, particularly after an ITU/HDU experience. Ironically these are the ones with a good staff to patient ratio and generally a good level of care. Ironically people will sit for weeks on general/care of the elderly wards for weeks and say nothing when they see appalling practice going on around them.

“They want me to die here” sounds like delirium, but if he were saying he’d not been fed/given fresh water etc then he could well have a point.

Would the people from PALS be allowed on a covid ward ? I wonder if it might be as well to contact the ward manager and discuss your concerns with them to see if you can build a better picture of what is happening ?

@frumpety they wouldn’t be allowed on the ward but the ward would have to provide a way for the patient to speak with them. Video link or phone.

@Audreyseyebrows Could the ward organise something similar for the OP ?

It sounds like it could be delirium. My uncle had this when he was sick in hospital and hallucinated all sorts of weird things. He was also paranoid that the hospital were trying to keep him there and kept asking us repeatedly to take him home which was really upsetting. I would definitely mention this to the staff.

They could (we do!) although that doesn’t mean that they will.

This thread is making me really angry. It’s more bloody ageism.

Several of us have first hand experience of how bloody awful care can be in wards with a high percentage of elderly patients. It’s real and prevalent. Yet post after post appears bleating on about delirium.

If the standard of care was so poor when patients had their families on hand to advocate for them, I wonder how bad it is now when vulnerable people are abandoned with no recourse to support.

@VinylDetective it isn't ageist to suggest delirium as a possible cause of
paranoia in an older person in hospital. However if the OP is only able to communicate with her Father by text it can be very difficult to work out exactly what is going on, which is why I have also suggested contacting the ward manager and seeing if it is possible to have some sort of face to face call.

[quote frumpety]@VinylDetective it isn't ageist to suggest delirium as a possible cause of
paranoia in an older person in hospital. However if the OP is only able to communicate with her Father by text it can be very difficult to work out exactly what is going on, which is why I have also suggested contacting the ward manager and seeing if it is possible to have some sort of face to face call.[/quote]
It’s ageist to suggest paranoia. If the patient was in their 20s or 30s and complaining about sub standard care their mental state wouldn’t be questioned. There’s never any questioning of sanity in the numerous threads about poor postnatal care.

And good luck with complaining to the ward staff, they’re hardly going to be transparent if they’re delivering poor care, are they? They’re going to join the Greek chorus of delirium and delusion.

I didn't suggest the paranoia , the OP did ? If someone in their 20's or 30's starting exhibiting symptoms of delirium I would be looking at the same things as I would as someone in their 70's , medication, infection and electrolyte imbalance.

I didn't suggest the paranoia , the OP did

That’s funny because I’ve just read all her posts and she hasn’t mentioned it. Stop trying to defend the indefensible. Care for elderly patients in hospital is frequently shit and assuming those who complain are delusional just perpetuates it.

Thing is, delirium caused by a minor infection is not something you encounter in young people that often. Call it ageism but this kind of delirium is common for the elderlies. It's fair to call it, because few people know of it and as a relative it is bloody scary witnessing.

@VinylDetective
Try looking for paranoid in the heading .

@giantangryrooster

Thing is, delirium caused by a minor infection is not something you encounter in young people that often. Call it ageism but this kind of delirium is common for the elderlies. It's fair to call it, because few people know of it and as a relative it is bloody scary witnessing.

I know that perfectly well. Can you really not see that going there as a first option when someone is complaining about sub standard care is a very dangerous road to take? We don’t dismiss complaints about sub standard postnatal care because all the patients are hormonal, do we?

@VinylDetective
Of course, I can see it. I've witnessed both, I so wish someone had told me about delirium, that would have given me a chance to react appropriate from the start. Op has stated she will be contacting pals and with the current situation that will be her best bet of securing her father, sad as it is, there is no way op can visit her dad to check for herself.

Hailtomyteeth That is absolutely not true, patients can be DNR but having active treatment can have all the treatment available up until CPR is required or it could be for someone who is dying, the pathway is to offer food and drinks if the patient is 1 safe to swallow and 2 wanting it, when we are dying our body is shutting down, we may not feel thirst or hunger and giving food or drink can cause discomfort as their stomach or bowel is not working well. I know in the past people misunderstand DNR and end of life pathways but it’s not like that now, I can’t speak for every trust obviously but I can assure you most nurses do not want to see patients suffering, we often advocate to stop some tests/treatments when it’s futile as we cannot bare to see patients suffering and we fight for them if we see fit too, we treat patients as we would want our families to be treated.

I am sorry your dad is poorly it must be so distressing for everyone involved, he may well be suffering with delirium from the infection or he could be seeing poor care, it does happen unfortunately, but tbh the way he has said it makes me think he is quite poorly and not fully aware, call the ward to get a better view, if you struggle ask to speak with the sister and the medical staff.

My mum was going a bit confused whilst on the ward. She’d been in, 5 or 6 days at that point. She was talking about the lady opposite taking her eyes out and putter them in a box overnight and this lady was asking my mum to look after the box. When I spoke to the nursing staff they said my mum wasn’t confused 🤷🏻‍♀️ That staff had had perfectly coherent conversations with her and they thought she was “pulling your leg”. I did ask whether it were at all possible in that case, whether the lady had a false eye or special glasses which she was removing and placing in a box. They actually laughed at me.

Skip another 5 days. I walked into the ward at visiting time and the nurse took me to one side to tell me “your mum is confused. She may have a UTI. She’s talking about film sets and lights and cameras and wanted to know where Helen Mirren was”. I told the sister that that was possibly the most lucid she’d been then seeing how my parents company made television scenery and were often “on set”. My mum had met Helen Mirren whist they were working on Prime Suspect.

This is my point. We really do need to listen and not judge/pass off a conversation as confusion. Two days later, having been told my Mum really ought to be up and about and more self caring (she was 80 and the inference was that she was actually being a bit bone idle) we, the family, were called in at breakfast time. She died that day.

Having worked for the NHS in a clinical role for nearly 30 yrs, I’m sad to say, I have very little respect left for it and am appalled by what this Tory shitshow has reduced it to.