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 sorry if I’ve missed this and expect it’s been said but please check with the GP if she might have a urinary tract infection. It can absolutely cause severe delirium and confusion in elderly patients. If she was neglected and drank little it’s very possibly the case. I’m so sorry for you and your poor gran x

It's a bit odd - uncle not telling anyone so as not to spoil a holiday, mum telling OP not to visit as too distressing. Perhaps this family finds it hard in general to deal with difficult things?

This. I think classic British atttiude is hampering good outcomes because no one wants to make a fuss in the face of absolutely shocking care.

and a lot of staff are just spending time dodging accountability for silly lapses or mistakes. So nothing gets solved.

you have to be willing make a fuss ask for care ask for a second opinion. Ask them to explain. Constantly.

once nurses lost a friends chemo meds and accused the family of losing it and refused to distribute more. Turns out they’d left It downstairs. But friend missed chemo by a day because of it and no apology.

Glad you got in a bit of racism there! 😅

I had this experience with my father 18 months ago. In the end, we insisted he be discharged and just took him out of this particular hospital. We then took him to another one where he was diagnosed with a severe UTI.
In the original hospital the nurses were standing around, his water jug was empty every time we went in plus he really was behaving like he was deranged. In the second one, it was a completely different scenario, much more care and attention.
I’m sorry this has happened to your relative @Krupkrups - she may have a UTI and it may take a bit of time to recover from but a few months on my dad was completely back to normal. I’m sure with some care, attention from her family at home, district nurse and GP advice she will improve. Xx

Very sorry to hear this. Agree care is often far less than optimal. But yes an elderly person can deteriorate quite suddenly over a period of several weeks. Often triggered by a fall or visit to hospital. It is sometimes such a shock to the whole system when someone is already entering frailty.

It’s often the way it happens although we don’t want to believe it and it’s never the way we expect. People eventually just reach the end of their time. I’ve seen it happen to several people including in my own family. I’m glad you can now be with your gran and spend this time with her.

Racism and misogyny more like.
The international nurses I work with are ace and take their work seriously. In 30 years I’ve never stood gossiping. Chip on my shoulder possibly because of the shite conditions pushing many to cut corners.

By nurses do you mean HCAs ?

I also wonder how she knows which nurses trained where - I'm a foreigner and I trained in the UK ☺️.

It is not racism, it is fact. I am not from the UK or white. But I have seen nurses without the ability to understand what I am saying, or clearly not doing what they are supposed to be doing.

www.theguardian.com/society/2024/feb/14/nhs-nurses-being-investigated-for-industrial-scale-qualifications

Tired tropes of gossiping nurses with chips on their shoulders and forrin staff who can't speak English.

I don't mind criticism of the NHS but as soon as those lines are trotted out I feel satisfied I can ignore.

You saw the nurses in that article? Or you saw nurses who seemed "foreign" and made assumptions about their abilities and where they trained? You know lots of foreigners train in the UK, right?

Ooh, and don't forget the nurse I saw sitting down eating a sandwich!!!!!

i am so sorry, @Krupkrups
falls and admission to hospital can be very negative in the elderly.

Look up reablement OP. After discharge from hospital, patients can get 6 weeks free care. For instance, MIL broke her hip, in a fall in her 90s, and needed a plate? (MIL knew she had had surgery, but didn’t really know what they did, although she did not have diagnosed dementia - more like early cognitive deterioration)

She was in hospital for 10 days, and then discharged to a LA run rehab care home for free for 6 weeks. A physiotherapist came in to help her get back on her feet. After three weeks, they told her she’d get more physio at home, so she agreed to go home. She never saw the physio again!

Anyway, the principle is - reablement can be provided, after the discharge!

An elderly relative of mine was in hospital for a few days and was sent back to her care home with bed sores - the hospital staff had left her lying on her back. So the care home staff had her lying on her side and changed her position every two hours. They gave her better care than the medically-trained staff at the hospital did.

The nurse assigned to her at the hospital didn't seem to know anything about her. She assumed my relative could get to the toilet by herself, and yet she'd had a stroke and was more or less immobile. Also, food was ordered for her that she couldn't eat.

Some of the hospital staff seemed good, but I thought there was a lack of basic care.

You should not need an advocate to get decent care in hospital mind you.

I can understand it’s the natural thing to feel so angry when something so confusing happens. I really would advise against putting energy into blaming various staff teams and just support your grandma, I’m sorry to say it sounds as though she might not have much longer left.

It’s very very common for older people to have a fall which is then the trigger for a quick decline. Similarly my grandma was completely independent but then ended up in hospital for a month and quickly died before leaving despite not actually having much wrong. I think the care in nhs hospitals could be better from certain individuals, and I also do understand that in the current climate clinicians are being made to treat but not provide the care so much because we are only funding the bare minimum, so I don’t think funnelling your upset onto the staff team is going to be helpful (although the procedure to complain is now through PALS if you do want to follow that up). It’s the responsibility of the family to be there to care and support and engage with people in hospital nowadays. Usually when older people have independence removed, which is inevitable in hospital, they very quickly lose skills and are no longer able to do the basic tasks they used to find really easy. It’s also depressing to be sat in hospital all day with visitors only there for a couple of hours a day. A lot of older people lose motivation to keep going because they start to reflect on life and endings. Nurses aren’t there to do that side of things any more and unfortunately lots of families just don’t visit enough or spend enough time there.

Discharge is very complex - social care legally have to be informed for older people who need any support going home so that’s really something to be pleased about rather than frustrated. Regardless of hospital treatment and outcome she would need a referral following a fall at home before being discharged back there. Also the timings can be tricky with transport and changes are common last minute because discharges often do get delayed and then transport is no longer available, but really they should have made that very clear to family members as it’s a well known problem.

I would be very concerned about bed sores and think she would need to be seen quite urgently to manage that- more than a pharmacy. It sounds as though she may need to be seen by a GP to also rule out UTI .

this sounds very sad OP and I hope your Grandma is able to be home and well again soon

This can and does happen often at this age. Bed sores aside, this is not the fault of nurses or the NHS. You mentioned her memory in the OP, if there is underlying cognitive decline or dementia, a stay in hospital can rapidly progress this, regardless of how good the care is. What is described by relatives as ‘her memory isn’t as good as it was’ is often something more serious which families haven’t picked up on and a stay massively exacerbates this.

The hospital not wanting to discharge straight away is a good thing as they are letting you to the fact that she needs more support. She’s 89 - you need to direct your energy into supporting her, not criticising the nurses.

I’m a community carer and this happens a lot. Report this to the doctors and get the district nurses out to check and sort out the bed sores, try and ask for rehab team or physios to come out and assess her. Please encourage fluids as she possibly have a UTI or be dehydrated.
💐

Im really sorry OP. This sort of thing happened to my dad. A&E said he was poorly but stood a very good chance of recovery, but once he was on the regular wards he was cared for so poorly he went downhill over 12 weeks and died. One of the last things he said to me was “you should never have brought me here, I’d have stood more chance in my own bed with a cup of tea”. And he was probably right. He had a UTI that turned into sepsis. Yet they constantly left his pee bottle out of reach (and the call bell) and told me he could just wet himself and they’d clean him up afterwards (he was sat on pads). But he was a proud, dignified man and hated the thought, so he tried not to drink as much - which obviously didn’t help his UTI. It always gave him bedsores, sitting on wet pads. He was put in a chair one day and was trying to get comfortable on his sore backside and fell. He was on the floor for 40 minutes before anyone checked on him (he was in a side room because he’d caught covid, c-diff and other superbugs). Every time I raised a concern the ward sister defended it. I was sent out of his room when they washed/changed so I never realised how bad his sores were until they needed help rolling him a few days before he died. It was awful, it haunts me years later.

I have seen nurses not understanding what I am saying. English is my second language too, but they did not understand me when I was trying to ask what they were doing to grandmother. Why do I care that the nurses were the same color as me? I cared that they couldn't care for my relative properly.

I say they are not qualified as two could either not understand what they were being asked to do, or they couldnt do it and had to go get another nurse (peripheral catheter). Other friends have said they encountered the same, and when I googled it that article came up last year.

The problem I have is that there is no mention of where these people took their nursing degree

I would think if the hospital got social services involved and didn't discharge when medically fit, it may be that your relative came into the hospital in a condition that they suspected inadequate care at home. Do you know for sure they didn't have bed sores before they came to the hospital as that would have been a cause for concern and may be what delayed discharge.

A serious illness could absolutely have exacerbated your family members' frailty. Given that you didn't visit, you can hardly go about blaming the NHS staff when you never witnessed the care received.

Unfortunately nurses HCAs etc all have to get permission from the patient to do anything to a patient.
We found that with DM - she refused to eat, refused to get out of bed, refused medication, refused to let them keep turning her to prevent pressure sores so deteriorated rapidly from when she was admitted and was also very confused as to where she was. Had been fine at home doing all her normal activities inside the house. Frail people need to be in familiar places with familiar routines.
The staff couldn't carry out proper care although if we were there were able to persuade her - so of course when she was discharged home she was in bed of multiple care visits