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.

I agree, total disgrace. I would report the ward as it could be a failing ward anyway and less risk of your grandmother returning to the same place.

Continence can return. Once the delirium improves, so too can most other areas. She sounds like she could have infected wounds.

Bed sores is neglect. I would photograph them and report. She needs a GP/community team to assess whether they are infected and causing delirium. Wounds will need to be dressed regularly too.

I suspect the delayed discharge is also due to the style of bed she has at home. If she has muscle wastage and is unable to reposition herself she needs to be discharged with an airflow matress and repositioned regularly to reduce these getting worse.

If the discharge team think that a live-in uncle wouldn't do it, they may have delayed discharge and considered sending her to a care home to get her back on her feet.

Lots of physiotherapy can aid her being able to walk again. She may take a few weeks and even at her age it can happen.

Please report the ward so they can conduct a thorough investigation.

That was my thought. Urine infections can cause delirium.

Ask her GP to visit to assess her health, including the bed sores.

Which hospital is this? Bed sores are treated very seriously and have to be reported.

Most have dedicated nurses to advise, called Tissue Viability nurses. You should speak to one of them really. Unfortunately the elderly are high risk. However, gather all the information and contact PALS to make a formal complaint so it doesn't happen to anyone else.

Does not surprise me. I'm sorry OP

How often did she have visitors while in hospital OP? I fear for any vulnerable person in hospital who doesn't have family visiting, who can advocate for them. I know hospital staff are under pressure but they also don't, in my experience, care about elderly patients.

My mother was in hospital for 9 weeks last year and care was very hit and miss. My sister and I visited on alternate days and there was always something to deal with. One day she wasn't in her bed and I tracked her down to the toilet, where she'd been left for c.40 minutes, and was very distressed. She also developed a bed sore and I had to push for an air mattress. Dehydration was also a big issue. If we hadn't been there daily she wouldn't have drunk much at all. I could go on, but you get the gist. Some of the staff were great, but they were in the minority. It really made me fear for myself in my senior years if I need hospital care.

I'm sorry your grandma has suffered, and deteriorated so much. I agree with those suggesting a possible UTI. It can cause confusion in the elderly. Low sodium levels can also cause issues, so a general checkover by the GP would be wise.

"the hospital 'forgot' to discharge her twice despite my parents, uncle and care team being at home twice waiting."
Who was bringing her home? What were you all doing, waiting for her and not with her? It sounds as though there wasn't an acceptance of her changing needs by you all, so the hospital was fearful of discharging her. Who ended up bringing her home? I'm not saying that care couldn't have been better, but as said, I think that you do need to read up on very advanced aging.

I can understand why you’re upset, but given the status of your GM health, this is perhaps why her discharge has been delayed. It sounds like the set up at home wasn’t / isn’t sufficient for her new needs.
How is this a total shock to the family? Were you visiting regularly & calling for updates? Did someone explain to her care team what normal life looks like for your dear GM and what home life looks like?

I live in a completely different part of the UK it's nearly 7 hours from my parents this is me going up today. Mum asked me not to come to hospital as too upsetting. So yes it has been a bloody shock to me!!! I saw at Christmas and this is a world away!

My parents were on holiday when it happened and my uncle when he realised she was actually fine, i.e no injuries didn't want to worry them and spoil holiday.

But then it just went on and he said it was like getting blood out of a stone being passed from pillar to post being told different things by different people and then he said after about 3 days she just slept for another 3 and again no one would give him a straight answer as to why, he's quite mild mannered and sadly wouldn't have argued. That's when on day 7 she seemed to detiriorate, DM and DF arrived at hospital on day 9.

The hospital did know full well he was living there and that she had a care team coming in on a lunchtime - they seemed to want to ignore this he said????

When my Mum got back Grandma had been in over a week and she said she honestly thought this was it as in she would pass.

And yes since then she as well as uncle have been going in daily and trying to feed her get information but she could barely swallow by that point Mum was saying. And again the nurses were just evasive about her care - Mum complained and they said quote 'she wasn't engaging with the care' well yeah because in a week you've damn near killed her!!!

I have been getting on at Mum to kick up more of a stink. It took my Dad to go and speak to whatever the modern equivalent of the ward sister is in the middle of wk 3 about why hell she was still there that seemed to galvanise them and get a social worker involved who yes said that she needed more enhanced care to go back to - well no shit she does now thanks to the 'care' she's received.

They increased the care team visits and yes ordered the air mattress and hospital bedframe that people have mentioned and once that was in place she was sent to the discharge ward.

She came home Monday and it was the carers that called my Mum to say she had lots of bed sores and asking her to go to the chemist for various ointments. No one had mentioned this in hospital - I went through her discharge notes yesterday as well and they are not on there.

@Ponoka7 she's was being discharged then brought home by hospital transport - my Mum was told that's what had to happen she was on the discharge ward so Mum went home to wait for her both on Thursday and Friday last week - the hospital just said it was a mix up.

I was planning on going to pharmacy when they open and (not that I don't trust the carers - who are frankly awesome and Mum says put the nurses to shame) and just getting some advice on best cream for the sores but yes sounds like involving the GP now is wise @EdithBond

i have very conflicting feelings here. The care in hospital is not always up to snuff. Bedsores are unacceptable. The staffing is not always what it needs to be for adequate personal care for this type of patient.

however, this type of decline is extremely well known. It happened to my own grandmother. Fell, broke her hip. We got her discharged to a care home, but she lasted less than a month. The decline after a fall can be dramatic.

the situation at home seems unclear. Generally the NHS wants patients out of hospital and into a non-acute setting but they cannot if the care arrangements are insufficient. Under most circumstances I wouldn't expect a hospital team to delay discharge if the care arrangements were enough, so I really can't judge that aspect of it and there may be more than you were able to see.

It sounds a lot like you’re looking for someone to blame. Which I understand, but to want to punch the nurses in the face is ridiculous. You need to get some therapy, if that’s your reaction.

You haven’t seen your GM since Christmas, because your DM advised against visiting. Ok.
You reflect that your GM was healthy and the hospital have caused her deterioration, but it isn’t that black & white with old people. She’s had a (quite serious by the sounds of it) fall since you saw her last.
Clearly, your DM kept you away for a reason, and it sounds as though despite not physically breaking any bones, damage was done with the fall. I think your DM has badly prepared you ahead of seeing your GM, but 4.5 months is a very long time where old people are concerned.
It’s no coincidence that your DM didn’t want you to see her that way, and the hospital felt your GM couldn’t be discharged to her home. From experience they tend to get SS involved and everything moves a lot slower when you depend on the system. Vs when you show up, advise on the home arrangements & collect the person yourself things move faster.
You live 7 hours away, but at 89 your GM days ahead are fewer than those behind. If you want to spend time with her, do it. Don’t make excuses about journey time & other people. We all prioritise what’s important to us.

Hmmm. In hospital myself once and there was no one to help one lady get drinks, or help her eat, so the other patients were.
We had to mention this to her son when he visited, but also had to keep look8ng after her.
My grandmother was in hospital once, was never turned and got a bed sore, which wasn’t treated, but luckily told my mum, who took sudocrem in for her, and that healed.
Hospitals are poorly run.
They aren’t doing basic care in many cases, and are neglectful.
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@JustMyView13 my DM discouraged me from visiting her in hospital not at all. They are all in dismay about how she's declined in 5 weeks also! I saw on Facetime about 10 before she fell asleep my youngest was practicing violin for her - it's like a different person and that was only 10 days before she fell!

I don't understand how a fall can be serious if there are no injuries or internal bleeding?? What constitutes a serious fall?

First time I’ve heard of a frailty ward, they sound like a common sense solution for many patients.

And sadly @JustMyView13 I have to work care for two children i was going to shoot up the road when I knew she was in hospital though but that's when Mum said it was too distressing.

In 5 weeks!!!!

Old people can deteriorate very quickly after a fall & hospital stay. Having said I wouldn't want to be in hospital as an old person.

Spend time with her now.
You are not sure of tomorrow in her age and state.

Happens quite often.

@Winter2020 see my update

I had an elderly uncle in the same situation. No relection on the care he received but he deteriorated quite quickly . Disorientated , dehydrated and depressed. Said it was the end for him . He also was very Independent before this . Upon inquiring why he was still there despite no medical intervention we were told that he was awaiting a care plan for discharge. That would take about two weeks . We as a family decided that he would probably die before that as he wasn't eating , sleeping so insisted on taking him home to die amongst family. Carers were quickly found. He had to be spoonfed for about a month , helped to toilet after being in nappies in hospital, regularly creamed on pressure points . With this intense care meant to keep him comfortable whilst on his deathbed he lived another five years.
So don't despair things can turn around .

Tbh used to know a geriatric nurse and the general attitude was if you were over 60 then you were senile and treated like a child who couldn’t do anything

She meant well but hearing how she talked to older people on her ward somehow felt seriously off

You need to get some therapy, if that’s your reaction.

The OP is feeling emotional. I don’t think she is intending to punch anyone. Seeing loved ones suffer can make us feel intense emotions. I work in MH and find it v irritating when people recommend ‘therapy’, often as an insult, for people experiencing normal human emotions. Recommending therapy, based just on this one post from the OP makes me roll my eyes so much.

That isn’t natural progression