Shaking with rage, can't sleep, NHS treatment of elderly

[Krupkrups]

My Grandma (89) has finally come out of hospital tonight finally after nearly nearly 5 weeks.

There's been nothing wrong she had a fall nothing broken, nothing but they wouldn't let her go home my uncle has lived with her for past 8 months since his divorce and she had a career who comes on a lunchtime. They said because she didn't have anyone at home which is bullshit, then social services got involved who were a shower of shite, then the hospital 'forgot' to discharge her twice despite my parents, uncle and care team being at home twice waiting.

Before going into hospital she could;

Get herself and dressed nicely

Get Downstairs / upstairs

Get herself to toilet and wipe herself - no incontinence pants

Make herself food and drinks (hot drinks, kettle on etc.)

Do crosswords

Move around the house with, slowly and with the help of a stick and frame but she did

Her memory was clearly going and she has slowed down cognitively in conversations but she knew we all were still enjoyed face times from my children, still read the paper.

She's come out and frankly it's like she's come out of a Victorian asylum, I am heartbroken, she looks deranged when she's awake sunken eyes strange rolling eyes, has lost an absolute load of weight - she was always very slender possibly too slender before now she looks like a famine survivor.

She is incoherent most of the time when awake.

Can't get out of bed / apparently is imobile - well yes she is now

Can't feed herself isn't eating when being fed

Is wearing adult nappies which have to be changed and the carers are changing and wiping her mess

Is covered in bed sores

I am weeping and raging I feel like driving to the hospital and punching the nurses in that ward in the face!!!! What have they done to her.

If the bed sores were from home they'd be written in her initial assessment.

Unbelievably there are plenty of unemployed nurses, doctors and other HCPs in the UK. The problem is a decision by Boris in 2021 to get rid of the Resident Labour Market Test. Effectively no priority is given to those already here, and the NHS is obliged to treat all applicants, wherever they happen to be living at the moment, equally.

Applicants from overseas, encouraged by higher salaries in the UK and the chance to settle here with their family, are often more experienced and than new graduates from UK Universities, and will be supported in their applications by international employment agencies, some of which seem to be paid by both the potential employer and employee. It is therefore very difficult for new graduates to compete which is why there are increasing number of stories about unemployed doctors and newly qualified doctors leaving for jobs in Australia. Entry level doctor jobs can now expect to attract several hundreds of applicants.

DD is completing her second foundation year and only knows of one F2 in her Deanery (a collections of NHS Trusts) who has a place for specialist training. (To be a GP.) This year over half the training places have been allocated to doctors who did not graduate from UK medical schools, some of whom may never have visited the UK let alone worked for the NHS. It can be expected that many will then move on to private health hubs in Singapore or Dubai once their training is complete. Indeed some may never take up their post, especially if they are not offered a place in a London Teaching Hospital but in somewhere less attractive and out of the way. In DDs Deanery 50% of the training posts in an important speciality are vacant. Consultants there would clearly love to be able to appoint some of their more promising F2s into temporary roles, not least because they are having to carry the extra load, but they can't. Recruitment for temporary roles needs to be advertised worldwide, whilst eligibility to apply for training places is determined on a national basis.

The situation is just as bad for nurses.

Some doctors from overseas are very good, but not all. Improving the career path for doctors and nurses already in the UK, and with an education/employment history within the NHS would take out some of the risk that occurs in recruiting blind.

A rant, but the situation is mad and needs to be sorted quickly. Otherwise outcomes for patients will continue to deteriorate.

Something similar happened to my mum, but she actually had a chest infection.

She was finally allowed to eat and drink after about 6 days without sustenance. No one had discussed it with me - I was actually rebuked by a nurse for giving her water, which was how I found out.

I don't know how she survived, but of course she lost a great deal of weight in the time and you can imagine the overall effect. I was going in and taking in ice cream to feed her.

I can't remember all the details 10 yrs later, but it was a shitshow. I'd had to point out that she was coughing up mucus, a sample was sent to the lab, but there was a change of doctor and antibiotics weren't administered straight away.

Mum had a diagnosis of mixed dementia, but was only in the early stages - the hospital seemed to take it upon themselves to decide that she was end stage.

I got advice from the Alzheimer's Society and created merry hell.

Just about everything went wrong. I'd been with Mum all day when she was admitted, had explained that I had POA - told them that I didn't want them slapping on a DNR. (Bizarre thing to say? Yes...but that's exactly what they did with Dad 4 yrs previously. I found out the day after he died. I had POA and hadn't been informed.)

Had to go home at 9 o'clock at night, in the end, to look after DH. Told the nurse I'd bring in the POA in the morning.

Next morning, got to the ward. Spoke to the nurse on duty. Handed over the POA. She looked like she'd seen a ghost.

"You need to see this."

A DNR. Next of kin? Victoria Hospital A&E.

At best - utter incompetence and lack of communication.

The sad reality is, very old people are extremely vulnerable and at extra high risk when anything traumatic happens to them. They need, at that point, every possible resource to be mobilised around them, and this includes family. It's unrealistic to demand that the NHS be able to provide perfect care to every old patient, particularly in a country with so many people living into their 80s and 90s.
It may take a village to raise a child, but it also takes one to support an elderly person in their last years of life.
I do wonder what OP's uncle's role in this situation has been; he certainly doesn't sound very capable or helpful.

@WearyAuldWumman I’m sorry you had such an awful experience with your husband. The level of care is just dreadful in some instances.

It's unrealistic to demand that the NHS be able to provide perfect care to every old patient, particularly in a country with so many people living into their 80s and 90s.

When my friend was in hospital, she was the only one in her ward not extremely elderly. She, post-operative, wound up providing a lot of these women's care.

Not good enough. Of course we should expect that standards of nursing care are met. Honestly, expectations on so low they're in the earth's core at this point.

@BellissimoGecko have a word love why would we be feeling guilty!! Do you think I came on here at one in the morning and made it all up.....my uncle and my Mum when she arrived back were in every day My mum for visiting during the day and my uncle on an evening.....it is NOT their responsibility to make sure she is fed and cared for - do not try and gaslight me. But of course they were doing that! But they weren't and couldn't be there 24 hrs. My Mum has been calling me every other day pretty much and telling me exactly what has been going on and I have obviously spoken to my Uncle since arriving up here. What a spiteful comment to suggest those with only people to advocate should get any form of care!!!

I have not seen the bed sores but the care team called my Mum yesterday morning after they had washed my Grandma to say she has multiple bed sores and asking her to buy a particular type of barrier cream and then aqueos cream which my Mum obviously did yesterday! I doubt they are lying they are very experienced!

Your suggestion that anyone is entitled for expecting to receive care in hospital is frankly mad. Let's hope you don't end up needing to be entitled eh!

@Buitenlander yes that is what I kept saying to DM my Uncle no way he is quiet mild mannered would well be easily bullied.

My parents are of a generation where they trust the NHS is doing the right thing but with each. Passing day Mum was despairing. No one ever really gave them a straight answer until (as you will see from one of my updates) my DF spoke to what he says is the equivalent of the word sister, and being what he described as 'firm' that there was any actual movement on getting her discharged. But putting a care plan in place and ordering the hospital bed was like a farce - this more time. Neither of which she'd have needed if they had discharged when they had completed obs!

@BlueandWhitePorcelain Thanks for this how did you initiate? DM says social worker never mentioned. Would it be via them? We're in car now but DM will investigate when we get to Grandma's

Thank you @BriceNobeslovesMurielHeslop DM is on a triage list to speak with GP hopefully imenently so we will mention this. I have never heard of it before, I will Google now.

They are right not to let her out with adequate support surely? She was in hospital for a reason her health had deteriorated, and often the stress and disorientation of actually being in hospital exacerbates that determination. That isn't the fault of the NHS

It might be worth joining the elderly parents group on here op.

Absolutely this. The woman is nearly 90. Of course a fall and a hospital stay is going to affect her in a negative way. They are right not to let her home if she doesn’t have the proper care in place.

I agree. Animals would have got better care than my 83 year old MIL when she was blue lighted to A&E and abandoned for 48 hours with no "care" at all. The "caring profession" my arse!

@ElaineBurdock
My dad had Parkinson's, but was still doing okay. A few months before he'd fallen in the garden, in between a fence and a rock wall and my mum couldn't help him up because he was stuck. Mum told me a guy with the ambulance crew, who was talking to someone on his phone at the time, asked her if they had more than 24,000 pounds in the bank. WTH? She was indignant and said of course they did!

They were probably trying to see if he would be self funding if he needed to go into residential care.

I'm rushing to get somewhere, so haven't read the full thread, but has she been checked for a UTI?

All of you who are so disgusted with the NHS, why don't you all train as doctors and nurses and be the change you wish to see? Or become hospital volunteers or HCAs. Even one person can make a difference. Or is it easier to moan about "third world" (rather a derogatory term but never mind, we're British, right?) standards?

I take it you're a nurse yourself?

You can't treat pressure ulcers with cream; she needs special dressings. I hope the GP can help x

A classic Mumsnet response 🙄

I'm so sorry OP, unfortunately I'm not a bit surprised. Been there, done that with MIL. My 90 year old DF was unwell on Christmas Day, all he had was an upset tummy but his GP wanted him to go to A&E. I had to beg him not to go. Luckily an ambulance arrived and the paramedics checked him over and did an ECG and all was well so he didn't go. I firmly believe that if he had gone in he would never have come out alive.

I shudder to think how elderly people with no relatives are treated.

I m out of it now in that both parents have now passed.

However there is definitely an issue with some people working on these front line roles who dont have a clear grasp of English or have such a strong accent its impossible to follow what they are saying. Last time Mum was in hospital there were two nurses cleaning up Mum and conversing in their native language. Mum was asking them what they were doing to her (in a calm voice - she just wanted to know!) and they completely ignored her. They didnt realise I had just come in.

I have had messages left for me giving updates on parent where I cannot follow the message being left and of course you can never just call back. I was working full time but always knew if a unrecognised number came up I HAD to answer it even though it was sometimes a scam call because I knew I wouldnt be able to call them back.

And it certainly isnt racist to call this out. We need to understand what is happening to our beloved relative.

It isnt funding. I have worked with the NHS as a supplier and most of the trusts I worked with over the years couldnt manage their way out of a paperwork. The endless meetings about very little and the cottage industries all over the place to ensure that people keep their jobs.

I disagree with you. One person doesnt make a difference at all.

The problems I have seen are down to poor management, poor supervision, poor training, poor attitude.

There is good practice but there is also poor practice. As in most organisations unfortunately the poor practitioners tend to cluster together so you will end up with a good ward or a bad ward.

How individuals can help to improve things is by pointing out sub-standard care.

The NHS needs to open itself up to feedback both from service users and also from service providers. This should be a routine part of service provision. What's gone well, what went badly. Too often poor practice is not recognised or addressed until there has been a catastrophe.

I would also get some disipline back into the wards.

People bringng in stinking take aways and treating the visit to the ward as a day out for the whole family. One chap who had come in to visit his partners relative asked me (god knows why) if he could get a shower as he had just come from work and another who had brough her kids in after school then proceeded to allow them to queue up for their dinner. The kitchen lady told them they werent entitled to the patients food and women pushed the issue back to the staff by saying they were hungrey and what was she meant to give them!

Mum was bothered by a young child who had been brought in and was allowed by her large family to wander around the ward. Mum wasnt in a great state but it didnt stop this brat pulling the curtain back and wanting to know what was going on and why Mum was hiding from them. Parent did nothing..in the end I had to go over and tell them Mum was in a bad way and didnt feel like conversing with anyone. The Mum looked at me like I was mad and grudgingly called her child back.

As an observer you see all sorts.