Dad fell in hospital

[Annonmum1974]

Has anyone had experience of elderly relatives in hospital - Dad was admitted with shingles lives with Alzheimer’s but it’s manageable with care at home and in the moderate stages (time confusion handling of finances etc gone) - since being in hospital he’s been administered with OxyContin and pregablin spends most of his time disorientated and far more confused asking why dead relatives haven’t been in and thinks he’s anywhere but hospital and also had issues with AKi since being in there (acute kidney injury) aka dehydration. I cannot fault the efforts of the drs and nurses but there are of course simply not enough - they seem to think my dad has the brain capacity to push a buzzer for help but the poor man is so delirious he hasn’t a clue where he is at the moment - his mental capacity has changed so much in a week. When I was told he managed to somehow get up from his bed and fall whilst heading to the bathroom and was possibly lying there for an hour my heart broke but I’m also whacking my head on a wall - I keep explaining that he is so confused he doesn’t know where he is but nothing is happening and it’s going to happen again - I don’t know why I’m posting really - just frustrated and feel like it’s the worse place he could be at the moment and it’s heart breaking - food just left in front of him which he sees but can’t manage alone now and fluid intake isn’t happening unless im there - it seriously feels like you have to be there constantly just to keep an eye on them and make sure they aren’t neglected - I’ve repeated repeated and repeated myself but my goodness it’s frustrating and upsetting up there

I can only express sympathy and empathy I’m afraid. The same happened to both my parents. It makes me upset and furious to think of it. Older people just not getting the care they need and deserve in hospital - the most basic care at that: eating and drinking fgs.
Youre doing your best. Keep doing it, and showing your dad how much you love him x

Can you get him into a residential home, the care will be better.

Is there a dementia team at the hospital that can support him?
sounds shocking doesn’t it? That food just sits in front of him? That he’s not drinking?
I would escalate your concerns to the ward manager firstly or PALS.

So sorry you are going through this OP, it's a proper shitshow isn't it.

Falls in the elderly can be catastrophic. My dad was never the same again after his. There can be a bit of a "chicken and egg" thing going on, in that it is possible a ministroke caused the fall and thus diminished his mental capacity, but it is also possible that he was deeply disorientated by finding himself in an unfamilar environment. In the case of your dad, the powerful drugs they're giving him will also be complicating things.Even a UTI at that age can cause delirium, so a kidney injury is also likely to be making things worse.

I wish I could have wrapped my dad in cotton wool and ensured he was cared for beautifully to the end of his life, but in reality things didn't really work out that way as care decisions had to be made quickly based on what was available at the time. My only consolation is that he was confused enough not to really understand the position he was in, although I'll never really know.

The thing about food and liquid intake with dementia of any kind is that the area of the brain that controls appetite no longer operates as it normally does. There also comes a point where fluid intake is not properly absorbed by the body and just causes complications.

Things might get a bit messy from here on, I'm afraid. All I managed to do was visit him as often as I could (although that was exhausting for a million reasons) and tell him I loved him, and know that he understood. I wish it was different, I really do, and that I could give you more positive advice. Maybe someone else will. Good luck 💗

I am so sorry for your experience too - I guess we just dont realise how broken elderly care is until we are in it - it’s just upsetting to see how after long lives they are being left in such a state - I’ve found my dad sat in his own mess, pills left out in front of him not taken - it’s neglectful and there’s nothing you can do but speak out but then there’s nobody able to change it from what I can see.

I think you have hit the nail on the head. Someone needs to be there most of, if not all, the time. Can you set up a rota? If you can't be there, then PALs and read the riot act about care, supervision and feeding. And rinse and repeat.

It's an horrendous time and I am very sorry. Don't make excuses for the staff though, kick up a stink.

Thank you all who have replied so far - I’ve tried the firm approach but politely as I suppose part of me feels if I stay this way then I might get a better reaction for dad but after last night I agree I need to escalate it - this is a dementia friendly ward apparently - I’m probably also tired I live an hour each way and been everyday for the last 12 days and not a big family just me really who is able to attend - on top of working with occupational therapy to get care moving forward at home (financially my dad is ok so that makes life much much easier wnd I am lucky to have that) and stuff that needs doing I am exhausted but my dad needs a voice and I’ll be there just to do what I can but I feel for those not able to do that who trust the system to care for their relatives - the dementia service is a good idea as is Pals and I will try that tomorrow

Sounds a terribly difficult situation for you . I echo spending as much time as possible at the hospital to oversee things . The ward sounds dangerously disorganised and you need to kick up a fuss to whoever is in charge. Start thinking and planning now on where your dad will live once discharged. Things move very slowly within hospital/care sector so the more you can feasibly plan ahead, the better.
wishing you - and your dad - all the best.

It's so hard. My mum went in with a knee injury and a member of staff left her propped up against the bed while he changed the sheets. Needless to say she fell and broke both wrists. With hindsight we should have sued although to be honest it was by no means the worst thing to happen to her in hospital. I hope you manage to get your dad home soon.

The thing is with shingles he doesn't need to be in the hospital just given proper meds, fluids, food. There's a great residential home nearby that offers a great halfway house service between hospital and home.

It's getting all the services to agree that takes so damned long.

I’m so sorry you and your Dad are going through this. I really sympathise. It’s so stressful, and you feel completely helpless. Hospitals are not suited to maintain the well-being of frail elderly people. As a patient, you need to have all your wits about you, or, as you say, someone has to be there constantly to keep an eye on things. Whenever my Mum was in hospital, I had to try and make sure that either I or one of the private carers she employed were there at mealtimes at least. My experience of hospitals with both my Mum and my MIL was that they were not cared for properly. My Mum was given beta-blockers for ‘low mood’ (after she had broken her hip!) and they rendered her almost comatose. I had to wait 5 hours to speak to a doctor who agreed that she shouldn’t have been prescribed them. MIL had a fall in the bathroom of her side room, from which she never recovered. She was supposed to have the bed rails up, and they tried to argue that they had been, and that someone who didn’t have the strength to lift a cup to her lips had clambered over the rail (successfully) and fallen once in the bathroom. We didn’t believe this unlikely version of events.
I admit to being biased, but I think hospitals are, ironically, the very worst places for vulnerable people. Does your Dad need to be in hospital? Is it possible that he could be cared for at home? I don’t know if it’s the same now, but there used to be a 6 week care package available for elderly people being discharged from hospital. I would try and speak to a doctor to query why he has been prescribed drugs which appear to be making him worse - what are they for and are they absolutely necessary? At the end of the day you know your Dad much better than they do and you have every right to advocate for him. Good luck, op.

So sorry to hear this. My advice would be to contact the local authority and raise a safeguarding. These things need to be done so there is evidence that preventable falls are happening due to lack of staffing. I manage care packages in the community, and so many ICBs refuse to pay their carers to be with them during hospital stays, due to 'double funding' my opinion is, that if someone is assessed to need care in the community, this should extend to hospital visits as they do not have adequate staffing to provide the necessary support. If he has a paid carer at home, and ever requires a hospital stay again, fight tooth and nail for the funder to approve their home carer to provide support in the hospital - this is needed more so, if they are being administered medication that worsens their symptoms (mobility, confusion etc)

This happens day after day. I see people suffer falls related injury and severe preaaure damage in hospital and it makes me furious that this has somehow become an acceptable part of a hospital stay, for already vulnerable people!

My father who had dementia fell in hospital last year and broke his hip. Seconding PALS. I would put in a formal complaint in writing about what sounds like the lack of understanding of dementia, your concerns about possible further injury and lack of supervision. I'd include as much as you can - the lack of support for adequate nutrition and hydration certainly, his inability to use a buzzer, are they supporting him to clean his teeth, can they evidence that they are checking on him regularly, do the staff introduce themselves each time they speak to him and explain what they are doing, are they supporting him to remain dignified and covered (my father was inadvertently flashing the ward), what is the discharge plan and everything else you are concerned about. I'm sorry, I know how hard it is for you.

Great advice on here. Wish I’d done some of these things

My DFs dementia got considerably worse when he was in hospital for an infection. Dementia delirium I think they called it. He never fully went back to the baseline from when he went in.

I went in daily until they would release him back home to us.

Christ the NHS is shite.

If you left your relative like this you’d be up for neglect, rightly so.

A friends’ mum slipped on piss in the hospital ward loo, lay all night. The corpse was found by another patient.

On a helpful note OP, get 1-1 dementia supervision from the so-called hospital and you can also get agency carers to come in and feed and clean your relation (you pay for this).

We had to get carers visiting in hospital for my parents. They were starving and unmedicated. Some nurses were cruel.

appalling but not unusual.

what treatment or tests is he receiving at hospital that he can’t have at home? Given they are doing him more harm than good there why can’t he be discharged?

can he afford a private care home for recuperation/rehab?

Quite honestly the NHS isn’t fit for purpose. Look at the Doctors strike, the lack of care in many wards, the appalling waste of money and the fact because it’s free people don’t value it, eat what you want, smoke, drink - you will be fixed by the NHS.

I would like to see a referendum on whether we start charging for some services with the usual caveats for people who cannot afford it. It cannot go on like this with more and more money being thrown at it and no improvements.

Also if you are being trained by the NHS you need to commit to stay for 5-10 years. Other countries do this

You mention your dad was put on pregablin in hospital. If you mean the nerve pain drug then one of the side effects of that is dizziness and falls. When I tried it the drug it gave me such severe vertigo that I could not even walk 3 metres to the bathroom.

You may want to double check the name of the drug and if it is the one for nerve pain see if there is an alternative.

Also, when my father went into hospital after a fall at home he was continent. After three weeks in hospital he was doubly incontinent as the nurses found it easier to leave him in bed rather than accompany him to the bathroom. An appalling percentage of elderly people end up incontinent after a hospital admission in situations where they had no bathroom issues before receiving hospital care.

Have you spoke to the staff about a mental capacity assessment and deprivation of liberty? It sounds like he needs enhanced levels of care (to be 1-1 at all times). Ask the staff to see a copy of the capacity assessment and see if you agree with what they have documented. If you dont then contact PALs as that will require a safeguarding report against the hospital. They have a duty of care to your dad as their patient and staffing levels should not come into it. Patients requiring enhanced levels of care come first.

Does he need to be there? If you are self funding, can you put him into a nursing home with 24 hour care? Go to the CQC website and see what is available in your/his area. Look for good or outstanding ratings. The ring round and talk to them. They usually like to do an assessment before admittance. Round my way it's about £1800 a week.

Elderly patients never come first! @CharlieUniformNovemberTango2023 I guess you don’t have experience of seeing how the elderly are treated on these wards. The NHS simply doesn’t nurse old people. It tolerates them. They don’t talk to relatives and it’s impossible to get any sense out of staff. My advice - go to Switzerland. Pets are treated better but it’s ok, we’ve got yet another doctors strike coming up. Patients come nowhere in the NHS, especially if you are old.

Sadly this will only get worse if op doesn't do something.

Thank you all some very good advice and I will escalate my concern today and fight for more monitoring on him - I am so sorry to all of you who have had to go through similar the stories above have been upsetting to read and my heart goes out to you all. Unfortunately my dad does need to be in hospital with his shingles at the moment as he also has a form of blood leukemia called CLL which makes fighting infection harder so he’s developed a condition in his nerve endings causing extreme pain so is on stronger meds plus they are supposedly keeping an eye now on his kidneys due to the severe dehydration (that happened in hospital) there is nothing I want more than to get him home and am working with occupational therapy to get equipment etc - they’ve been good and as I mentioned above my dad has funding to have private 24 hour care at home so all of that is lined up and we are lucky not to have to rely on social services and wait times so that is a relief. An excellent suggestion above to ask if a carer can be brought in to stay overnight with him in the interim and I will most definitely check that - it would be amazing to think that can happen to provide reassurance and stop him trying to move at night with such dreadful confusion. Thank you all again x