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’m an older person, mid 70s, and have to say I couldn’t fault the care I received when in hospital for 3 weeks 2 years ago. I was grateful enough to make a donation to the hospital charity.
Must say I’m surprised to read of patients being kept in hospital for what would seem too long. I mostly hear of the other way around - wanting to send them home when there won’t be adequate care available,

My mum 83, had a fall about a year ago - was admitted, similar story, nothing broken, but they wouldn't let her come home, I live with her - after 2 weeks she had been left far less mobile than before and incontinent.

The NHS (who I contract to, so see it) have twofold problems with the elderly, first they are not properly set up for it, second, to some extent they don't give a shit about anyone over 70, I've heard different Drs say it - and that's partly down to resources and time, both are pressed, and the Drs think it is better to focus on younger patients who have more life ahead - and you kind of can't argue with that given their limited resources.

But of course it becomes endemic and a self fulfilling disaster - the lack of care leads to delayed discharge, bed blocking etc etc... shit show.

Sadly that is how the NHS is run, in many years working in hospitals as a technical contractor I have met many wonderful people, and the aim of it all is fine, but nothing works, nothing is joined up, there is a bewildering tree of administration and management. Won't ever get fixed, there isn't the will to do it.

Exactly the same situation with my 92 year old Grandmother

Admitted to hospital for a few weeks over Xmas after a fall, delirium and then she got RSV in hospital.

Moved into a care home funded by her in February and she's deteriorated rapidly since the fall.

Went back into hospital a few weeks ago then discharged back to care home on an end of life pathway and the NHS will now be funding the care home.

She's had excellent care throughout, she's just really old and the elderly can deteriorate rapidly. Especially after a fall or infections.

We're just waiting for her to die now and hope it's soon. When she's lucid she just tells everyone she doesn't know why she can't just die, asks why has she lived this long? and tells everyone in the room, staff included that she loves them.

She's ready to go and we want that for her.

Edit to correct a word

Silly post. Elderly people absolutely can deteriorate quite rapidly. What was OP supposed to do when she was in hospital?

Sorry OP it’s really awful the care they get is often shocking and if they don’t make a fuss the way just looked over.

hopefully now she’s home you can help her recover.

it’s horrible to witness, the NHS left my family member who was unable to communicate due to an injury in a room with no lights on or food for 24 hours. Horrible horrible stuff.

IME geriatric care can be appalling in hospital unless the family are visiting regularly to check and chase things up. And even then, unless the nurses tell you about the bedsores you don't think to rummage under the patients bedcovers to check their sacrum! Hospital delerium is a thing and she could have a UTI (or be dehydrated, especially if it looks like she's not been eating).
Did any family member contact the hospital when they were told she'd be being discharged and say it would be an unsafe?
Report her bed sores to the GP as they'll need to arrange dressing correctly to heal. Th GP may need to arrange a hospital bed with air mattress so her sores can heal. Or someone will need to move her in bed every couple of hours.
Report to PALS at the hospital she was in too!

If you have worked in the NHS, it's likely that you have at least one colleague who has been physically assaulted. Worst off the top of my head a doctor lifted off the ground by the throat and strangled, he was very shaken and distressed by what had happened, don't know the long term because we only worked together a short time. A paediatric nurse punched in the eye who had a significant injury requiring hospitalisation - she did not return to work that was literally the end of her career. Physical assault at work ends careers and ruins lives. The OP's choice of words has triggered a few people I think, even though that wasn't her intention and she is just expressing her understandable distress.

It doesn't help the OP to blame the NHS for her grandmother's delirium without a full understanding of the facts. It's also easy to blame acute hospital wards for problems which are far bigger and outside of their control - eg staffing ratios and other resource, the general way that we approach elderly healthcare, social care and so forth.

The elderly are not taken care of in NHS hospitals. It seems almost illegal to criticise the NHS or nurses here, but it is the truth.

Hospitals in England have become like the middle ages, if you want to survive as an old or vulnerable person you have to try your best not to go to one.

Anyone who cannot loudly advocate for themselves is left to rot. If you aren't well enough to consume your own drinks and food, you will end up dehydrated and missing meals. If you can't toilet yourself, you will be left sitting in your own mess for hours.

But don't worry, you'll be woken every hour through the night for something pointless that could really have waited, but needs to be noted on some paper, so the enjoy the sleep deprivation.

Add to that tired nurses with chips on their shoulders who get annoyed if you interrupt their gossip, some foreign nurses who are clearly not qualified to UK standard and no matrons and you have hospitals from hell for the vulnerable.

I understand why people who haven't experienced this (yet) don't believe this sort of scenario can pan out quite how OP is telling it. But we've also had an almost identical experience. Elderly person admitted to hospital, and then just rotting there for no reason, despite family pushing relentlessly for them to come home, and having perfectly adequate support already in place.

The whole experience has made me realise you can't be polite and British and trust the professionals to do their job when you have an elderly relative in hospital. It's so different from hospital treatment that younger family members have received (eg cancer) which has generally been excellent (although I have also had one terrible maternity experience)

Our GP and district nurses were excellent in this situation - definitely give them a call this morning.

I'm a contractor to the NHS, and a huge supporter of it, but it is crazy that anyone who critiques it is shot down. It's in a dreadful state, needs top down reform, to be reborn. But that can only happen if criticism is taken seriously, reviewed and acted on.

It needs love, but tough love - there is this cult like "can't criticise the NHS" obsession, its owned by the public, run for the public, paid for by the public and imperfect - it should be a duty to flag up concerns, and a duty to address them.

The hospital and social care may have well-founded concerns about your uncle's care of his mum - his actions sound quite strange (not letting your parents know, not actively advocating for his mum in hospital, not informing himself properly about what was happening). Maybe it was more a case of her caring for him? Which isn't uncommon with adult/elderly sons and their much older mums.

Sadly the rapid deterioration after a critical event (trauma from fall, hospital stay) is something frequently seen even with good care.

And I find the idea that families shouldn't help care for their loved ones in hospital utterly bizarre - you wouldn't just abandon a child in hospital, so why an elderly person?

I feel for you. My dad went into hospital some years ago. He'd had a stroke some years previously, caused by medication. His swallow was deemed 'not safe' by the speech therapists, so he was not allowed food or water. This was on a Friday, and he had to starve all weekend, as they only worked Monday to Friday. He passed away a few weeks later as he had wasted away. I am still livid to this day.

Yes - if their body is failing, depending on what is having issues, then the other organs have to work harder.

My MIL has chronic heart failure, but all her other organs are struggling to keep up.

Given the obvious reasons why this happens I don’t understand why there isn’t more voluntary support - why can’t relatives or volunteers go into hospital and help feed and turn bed ridden patients ? After all if they will have to do it when the patient comes out?
also why don’t more elderly self discharge ? If they can’t that suggests they are in a very bad way

My (not elderly) DH was admitted to hospital, the bed next to him was occupied by an elderly man who had fallen and was confused. The way he was treated by the young nurses was shocking. He was left to find his own way to the toilet, where of course he missed. He was spoken to as though he was an idiot, when what was needed was someone to sit with him and explain calmly why he was there and what would happen. He desperately wanted to go home but didn’t know how. The lack of compassion really shook me, tbh.

I don’t understand why this means you couldn’t visit your grandmother even once in 5 weeks.

Distressing for who?

Sadly this is true, patients are left lying in bed and denied any exercise even if they were mobile on entering. No one checks if they’ve eaten anything, drunk anything. A stay in hospital can set a patient back months, they’re almost dumped in a bed and forgotten. I know as this happened to a member of my family, they even treated him for the wrong illness and did not discover that he had a life limiting cancer growing.

When someone ‘has a fall’ as opposed to, for example, tripping over an obstacle, there are myriad reasons for the occurrence. A sudden drop in BP, a TIA, balance issues, weak muscles etc. Any of these could be considered to herald a rapid decline in independence in the elderly. A prolonged hospital stay often increases the risk.

If relatives are able to regularly provide assistance in the hospital environment, bringing food, drinks, conversation etc., then outcomes are usually considerably better.

Bedsores, however, are definitely not to be expected, and this issue needs to be urgently addressed.

Also make a fuss. Make a complaints to PALS about the bedsores.

the nhs is not above reproach.

there is this cult like "can't criticise the NHS" obsession...

Comments like this baffle me. There is constant criticism of the NHS on here and in the news as well. What people defend is the principle of a health service that is free at the point of delivery. I don't know anyone (within the NHS or outside of it) who defends the state it is in right now. That doesn't mean we should just accept stories like this and join in with OP's outrage though. There are aspects of this story that just don't add up and I think OP needs some more detail about what actually happened before she resorts to punching nurses in the face! (Yes I realise she wasn't actually going to do that...)

The poor OP and her grandma. She’s obviously desperately worried and distressed. Think about the impact of thoughtless, callous words, for god’s sake.

I know it absolutely beggars belief, but I've also had experience of this. A relative stuck in hospital for weeks simply because of paperwork. In our case the discharge notes were lost three times.

It was like being stuck in a fever dream. The nurses just got on with their day to day medical duties, but didn't seem to have any understanding of the admin side of things - they were not able to chase it for us, and they couldn't even explain how we should chase it up ourselves. The Drs were almost completely unavailable - we'd tell the nurses that we absolutely had to speak to a Dr and they'd tell us to make sure we arrived by 9am (but we might have to wait around until the afternoon) but then it would turn out that the Drs had done their ward rounds at 8am and then disappeared into the ether.

And your end up just stood there under the bright lights, with people bustling about around you, but nothing ever actually getting done, and no way of speaking to anyone who might have any idea what was actually going on

Sorry to hear this OP.

My grandpa was healthy (no known conditions, didn’t take any medication), relatively fit, and showed absolutely no signs of deterioration at 90 years old. He was alert, could wash himself, walk everywhere unaided, cook, clean, do the gardening, talk the hind legs off a donkey…

He got out of bed one morning and fainted, luckily he landed on his bed and his only injury was a bruise from whacking his wrist on the bedside table.
However, within 12 weeks of this it like he was a totally different person. He would barely talk, he’d been diagnosed with dementia, kidney failure, had more and more falls (6 in one week was his record), stopped eating and drinking properly, and required 24/7 carers.

Sadly, elderly people can deteriorate very quickly and delirium following a hospital stay is not uncommon either. It only takes one tiny event to trigger the ‘end of life’ process. His wife (my lovely step-grandma) was the opposite. A slow but very obvious decline over about 20 years.

It is awful to watch our loved ones decline, no matter how quickly or slowly it might be. I felt so much anger watching my grandparents become a shell of themselves, I don’t know who my anger was directed towards, but I felt it hard. I feel like it made grieving so much harder too because I was focussing too much on trying to blame someone or something, rather than trying to process everything and remembering the better times.

This.

I would insist on documenting the bed sores before she is discharged from hospital. Otherwise the hospital will claim they developed en route home. Absolutely no excuse for this.

A relative of mine (not old or infirm) was in hospital for an extended period recently. She had a terrible bedsore that her husband knew about, as did one shift/team of staff, but once her husband asked another shift how the treatment for the bedsore was going, and the response was blank faces and 'What bedsore?'
I'm afraid communication between staff in hospitals is often sadly lacking, to say the least.