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.

@Krupkrups It’s her age. The body isn’t as young as it once was. Elderly people are more frail. It’s the same way the common cold can be something you or I could get over, but an old person can end up in hospital, with pneumonia and never fully recover. Falls and slips are the same. It’s like they turbo charge the aging process.

I’ve been here, and so I can totally relate how hard it is.
Hospitals are places we are used to going to get better. But they’re the worst place for old people because they are out of their routine, and immobile. Which really speeds up the deterioration of their health. Once your GM gets back settled into her home & routine, there’s hope that she will ‘perk up’ a bit. But to expect her to return to the health you remember is, in my experience, unrealistic.
The best thing you can do is see what aids you can get to assist her safety and independence. My nan’s eyesight was terrible so we got her a massive digital wall clock. She didn’t have to rely on others to know what time it was, and it helped improve confusion because she’d wake from a nap & know it was +45 mins later vs waking up confused what day / time it is. Things like this can be helpful.

Also, spend time with her talking. My nan always maintained excellent long term memory, and told stories I’d never heard before. In the end, it was a lot of confusion, and piecing together bits and bobs but I know she valued that time with me.

It can be.

Any sort of fall can kill an elderly person. Deterioration of this magnitude can happen even at home.

Don't punch a nurse.

I have quite a lot of recent experience sadly. In my opinion staff in hospital don't always listen.

As for the poster who said it's rubbish that bed sores would be ignored. My DF is currently on end of life care in hospital. He's 92. He was transferred from a different hospital with 2 undisclosed & undocumented bed sores. I have read it in his notes. And photographed those notes.Before you ask I live over 200 miles away. A family friend visiting saw one on his toe & was suspicious he had one in his lower back (because of pillow positioning). She asked & they denied it.

I did not recommend therapy as an insult. But to be upset and angry is one thing, to talk about physically assaulting NHS workers (which seems to be really common these days, and is a crime) is not a proportionate response. Hence, if someone’s mental health is suffering they should seek help. If they are a violent person and cannot control themselves, they should also seek help. If it’s a turn of phrase in the heat of the moment, then I discourage the normalisation of violence towards NHS workers.
I hope that clears things up for you.

This happened to my grandma, she was admitted for a minor procedure under local which would mean staying in for 3-4 days. She was in her 80’s, would go hill walking, swimming and cycling on a regular basis,
her dog was walked 4-6 miles a day.

She was treated like a child and a complete inconvenience by staff, upon admission she was deemed a falls risk and told by staff she wasn’t allowed to leave her bed and chair unless supported by staff. We were informed that she was deemed a falls risk as she had been dishonest when assessed for care needs etc, the staff had happily called her a liar for informing them that she walked her dog, cycled to the shops, goes to Derbyshire walking etc. They never apologised to her for calling her a liar or choosing to ignore her.

She had a complication which was caused by staff failing to do anything about a bad allergic reaction to her dressing, so had to stay I think eight more days as it risked a small skin graft failing.

On one visit we heard staff shouting at her and being very verbally aggressive for walking to the toilet on her own, we reported it to pals (heard nothing back) and she discharged herself that day. She still kept cycling, going on long walks and going on walking holidays, yet apparently wasn’t safe to walk 4m to the toilet. She wasn’t offered any physio which should be happening as standard so people don’t lose muscle mass and mobility.

The most ironic thing about the abuse she suffered at the hands of staff is that her injury that required a skin graft after one failed was caused by badly cutting her arm while climbing over a fence in the Yorkshire Dales on a walking holiday.

Exactly this

I'm so sorry you are all going through this, OP. I'm getting on in age a bit now (nearly 70) and absolutely dread ending up in hospital, as I'm sure I'd really decline because of having special food needs and probably not being able to rest enough due to noise on the ward and would likely be very uncomfortable in a strange bed. I would lose a lot of weight (am already thin) and could indeed imagine being in a poor state after 5 weeks! When you are older it's far harder to adapt and you're less resilient to change.

I really hope your grandma will improve!

Unfortunately the elderly do deteriorate badly after a fall and going into hospital can also cause a decline. I don’t believe for one minute that the hospital kept her in for no reason, they are always desperate for beds! She must have needed care and they needed to be sure she would be cared for properly once discharged. Like a lot of posters said, if you had been there and seen her decline you wouldn’t be shocked and blame the hospital. Yes, the bedsores need to be investigated and treated. She is 89 years old so honestly this is all not really surprising, I have seen the same happen with my grandparents.

I have worked in the NHS for 30y. There is a huge issue with our hospitals. Limited resources, poor leadership, disastrous recruitment and retention, KPIs that seem to have a tenuous link with actual patient care, less continuity of care, and poor communication with patients, relatives and other clinicians.

Good care often results from individuals going above and beyond. Who are willing and able to fight the systemic issues that exist.

Situations like the one in the OP are the tip of the iceberg. Elderly people need informed and assertive advocates by their side 24/7. But logistically that’s often impossible. The OP is a working mum with young kids who lives far away and ofc cannot manage this.

OP, make a complaint. Things need to change on that ward. Hope your grandmother can be made comfortable now at least. With good care, and being back home, hopefully things can improve a bit. Good luck x

@PearReview I agree with you. When my mum was in hospital last year we were there daily & she is younger anyway. I fed some other older patients because their food was put in front of them but they didn't have the dexterity/strength to feed themselves. An elderly person needs family to advocate & watch them as you say.

Agreed

It was ridiculous to suggest therapy based on that one sentence. If someone really hurt my child, I could have the thought that I want to go and punch them. I have never hurt anyone and never will. I can understand intense feelings in the heat of the moment.

A fleeting out of character emotion that is so intense, suggests a significant stressor. Not a MH condition. And I work in the NHS and don’t condone violence. Obviously.

Yes. It’s heartbreaking and not good enough. The systems need to change. Even good staff can be affected by low morale and poor leadership.

However there are still some units that function well and deliver good care. When staff feel supported themselves, they are better at their job. Even in the same hospital, different wards work better than others. That needs looking at, as there is potential for change.

Old people should not be leaving hospital with new undocumented bedsores. That is a definite.

So if she had never entered the hospital after her fall you are saying she would be in the same state 5 weeks later

I think my reply to your comment was incredibly clear. Obviously you do not. We can agree to disagree.

Indeed

Some typical mumsnet responses on here. As soon as anyone posts about something bad happening to a person or animal, it’s entirely the OP’s fault for ‘letting it happen’ and not themselves providing 100% medical or otherwise care.

I worked for a long time with the elderly in hospital and know that what you describe, OP, is all too common. In fact, if an otherwise active and healthy elderly person has a stay in hospital (often after a fall), that’s often the start of the end of their life (due to any number of bad things that happen in hospital). I’ve also seen the recent massive deterioration of the NHS over a ten plus year period. Some of it beyond shocking.

I’m worried this will happen to my mum too if she falls (then not too long after that, to me)!

I’m really sorry to hear what’s happened OP and am not surprised at how angry you are. I really hope your grandma is OK xx

Firstly, I am sorry that your grandmother is so frail. A bad fall might
relate to how long she was lying on the floor unable to get up.

It sounds like she has had acute delerium which is is noone’s fault and she then needed assessments to see what kind of help/ care she needed. It’s very difficult to know when someone is confused and not able to engage with therapy input.
If she has bed sores this needs reporting asap and documenting.

I don’t think you can justify being so angry when you haven’t been in to see her in 4 months despite her declining like this.

Pressure ulcers (bed sores not used now) are a 'never event', so you should photograph these. Ask the ward for her notes to determine their care plan they created when she was admitted.
Write down, logically, and without emotion, exactly what she was able to do prior to admission, and how she is now. Include all the info you have given here. Then contact the PALS office and ask them how to make a formal complaint.
I'm in the same boat as you with my mother. She was neglected while inhospital and deteriorated so much in physical and mental terms, she is no longer able to live at home and is now in a home.
While It is awful to think the NHS has done this (esp as we were both nurses) keep a calm head and be professional and unemotional in your complaint.
So sorry this has happened. It's disgusting. Even with the state of the NHS, there is no excuse for no care.

Unnecessary and rude

OP I don't doubt that your grandmother received sub-par treatment in hospital and I fully empathise with your rage. The stark difference between who she was before admission and now is like night and day for your family.

It might help to read up on the effects of the ageing process (not just for your grandmother's immediate needs but the titles below contain useful info for us all as that's where we are all heading) just so that the bits that are a natural consequence of her many years are not mistaken for the results of neglect and the bits that clearly are the result of neglect (the bedsores being a case in point) can be more readily identified and form part of your complaint to the hospital. If you read up a bit on falls in the elderly you will see why they are, statistically, a precursor to poor outcomes.

Also try not to despair: your grandmother might, with care and time, be able to come back from this distressing experience and be a bit more the person she was when she went in.

"The Book about Getting Older" - Dr Lucy Pollock
"Being Mortal" - Atul Gawande

Don't put 'cream' on her pressure ulcers. They require specialist treatment/dressings from a communtiy Tissue Viability nurse. Ask the GP to do a referral to the service.
You cannot treat them with any cream.

I don’t think you can justify being so angry when you haven’t been in to see her in 4 months despite her declining like this.

Seriously? A patient should receive good care, even if they have no visitors at all. The OP should be able to think that her grandmother is being looked after, whether she visits or not. The poor care is down to the hospital, not because the OP hasn’t visited. She has every right to be angry.

While It is awful to think the NHS has done this (esp as we were both nurses)

I have been a hospital consultant for decades now. When you have worked in the NHS, and have delivered high quality care yourself, I think it makes you even less tolerant of shoddy treatment. Which is why I encourage people to report genuinely concerning treatment. Things will never change otherwise.

A relative did have to threaten physical violence to get his wife out of the psychiatric ward she was put in after complaining one of her legs was swollen after giving birth
Dr who had never seen or talked to her let alone examined sent her to the psychiatric ward

Husband had seen her leg and had tried to explain to the doctor that it was abnormal and doctor didn’t believe him
Husband shoved doctor against a wall and threatened him with physical violence if he didn’t get his wife out of the psychiatric unit and a doctor to examine her

If he hadn’t done that then his wife could have been dead before anyone had actually spoken to her.
She had a DVT

Relative never got over being separated from her newborn and being put in a ward where she spent her time trying to defend herself again at women trying to push her out of bed and screaming at her as well as being separated from her newborn.