What can we do about the treatment of the elderly in the NHS......

[lavenderbongo]

My Nan is in hospital and she is not expected to come out. She has no immune system left, has managed to catch one of the super bugs (c-difficile I think) and has lost control of most of her bodily functions.

The hospital want to move her out of hospital and into a nursing home. They carried out an assessment on her and it went before some sort of panel and they decided she could move to a nursing home and that she would have to pay for this herself.

My parents where not happy with this - they went to view the nursing homes and didnt like the level of care they provided. So they began to investigate and asked to see the assessments on my Nan and the panels report. The hospital eventually and somewhat reluctantly gave them the report. My parents read the report and discovered some really worrying errors.

Amongst the many errors - The ward manager in her report stated that my Nan was capable of feeding herself. She is not. She hasnt got the strength in her hands to use a knife let alone get it to her mouth. (This is extremely worrying as it appears the only time Nan is getting any food is when one of the relatives is around at lunch time to feed her).

She also stated that Nan was able to lift herself out of bed and onto the chair. My Nan hasnt moved in weeks and is unable to lift herself from a lieing down position. These two facts where backed up when my parents interviewed Nans consultatnt.

I find this really shocking - they were prepared to send Nan to a nursing home without fully stating the level of care she requires. Would they have fed her? Would they expect to get out of bed unaided?

My parents appealed the panels decision and they are now reassessing my Nan next monday. The panel decide whether Nan recieves further care in hospital and NHS funding or whether she gets moved to a care home.

Now we are not bothered about the NHS funding I just want my Nan to be looked after by people that notice whether she eats of not!

The ward manager refused to help my parents to start with - she just kept repeating that "no one gets NHS funding". But my Nan fits the criterea fully. My dad pointed out all the errors in the report and eventually had to threaten getting solicitors involved before she agreed to look at it again.

How many people out their are getting substandard care - pushed out of hospital beds before they are ready - just because they are elderly?

I am sorry if this is a bit rambling but i am obviously upset about this. I couldnt sleep much last night. I just wanted to write this down and see if anyone had any similar experiences or knew of any campaign groups I could join so that I feel I am doing something to help.

Thanks

It's horrifying. Age Concern are campaigning on it. www.ageconcern.org.uk/AgeConcern/hungry2bheard.asp If you go to 'Get Involved' then 'Tell us your experiences' and send them your story it might help them.

Thanks thebectser - i will look at that.

Sorry, pressed 'post' before I'd finished! Basically they're campaigning about the fact that 6 out of 10 elderly people develop malnutrition while in hospital - like your Nan, they don't get fed unless relatives are there to feed them etc. It's clearly not an isolated problem and so many elderly people don't have a caring family to watch out for them.

Your nan does indeed fit the criteria as I understand it, very much so.

Sadly geriactrics is a horrendous area of care. Many years ago I worked in the field and thoroughly enjoyed it, but its treated as being the dead end option for people who have nowhere else to go- and poor pay and conditions reflect this.

Thanks Peachy. We have met some amazing caring staff in the hospital but also some awful care which makes me cry when I think about it.

My Nan was left overnight in a room with a window that was broken and couldnt be closed. She was at the top of a big tower block. The wind was howling in all night.
No one did anything until my Dad went in a complained the next day.

Clothes that have been soiled remaining on the shelf for several days.

I work in a 'care of elderly ward' so here's how it should be.

your nan should have a thorough physiotherapy and occupational therapy assessment to determine what she can and can't do mobility wise. this should have ben sent to decision panel

if an individual has private savings or owns a house they are classed as self-funding. in some ways this makes things easier because you and she then has a say in which nursing home she goes to.

her level of needs will be assessed by a social worker, taking into account ward/nursing reports and physio and OT assessments. this along with patient/family choice will also go to determining which nursing home is best for her.

she and her family still have a choice. if you are not happy with the home chosen no-one can force her to move therre.

saying this it is also never ideal for any patient to go straight from an acute hospital to a permanent lacement - the differences between the 2 are too great and also the patient doesn't get any further inpput towards any rehabilitation goals. was your nan indepedent before her hospital stay?
what would possibly be better would be to be discharged to either a rehab unit - if she has rehab goals, where she would get physio input. or to an interim nursing home placement - which would give you a chance to look at other homes and decide what would be best.

meals and eating. ask for a referral to a dietitian for a fortified diet. also ask for a sign to be put above her bed telling staff that nan needs asistance with eating and drinking. ask for her to have a documented food chart and keep an eye on whether it is being filled in.

if you are not satisied with the level of care she has had make an appointment at a set time to talk to the ward manager. voice your concerns and she will investigate. if you are not happy with what she says contact PALS in writing and copy in the chief executive and nursing director of the hospital.they will have to investigate - there are set rules and time frames for this.

not making excuses but hospital wards are shockingly short staffed and sometimes it is only by shouting loud and long that things get done. shouldn't happen but it does.

DisasterArea - Thanks some brilliant advice which I am going to pass on to my parents.

We were told that she would be moved out the hospital without our permission as my Grandad has been refusing to sign the papers allowing her to go into a nursing home. He is unable to look after her on his own as the level or care she requires is to great. So it is interesting that you state they cant force her to move there.

I think that most of the people that work in these wards are absolute saints working in very difficult conditions. Its just a shame that you have to fight so hard for things that you should just be able to access and should be provided for everyone.

thanks again

sadly lavender thats the case across the entire nhs (parent of two sn kids), its really hard, we have a culture of not making a fuss, but its the only way

Ah. also if Nan is deemed 'medically fit' for discharge then she really shouldn't be in hospital at all and you'd be best to find her alternative placemnent ASAP. there are a few bits to being 'fit' for discharge - the medical bit - where drs are not ding any more medical investigations orinterventions. the nure bit - where patient o longer needs 'nurse' care like IV meds. and the social bit - where pt can be discharged safely to somewhere else.

i do believe you can actually be evicted from hospital (waaaay back i knew of someone who was) but that was v extreme.

is it possible to find somewhre local she could move to - where the care is acceptable - at least in the short term? just because she goes one place doesn't mean that has to be forever.

Mty father was told (after my mother had been in hospital for 5 months) that he had one week to find her a nursing place or they would move her out of the local cottage hospital. This was done without prior warning and in an extremely aggressive way (I spoke to the woman who was "coordinating" this move so can verify that). She was suitable for nursing home care, but it would have been far better if all the options were explained at an earlier stage rather than panic an old gentleman in a threatening manner.
The criteria for getting full NHS funding are extremely narrow - I've seen references to people who were completely bed bound and attached to machinery, who were not considered "bad" enough to get this funding.

Just wanted to say thanks to everybody you has given me advice on this thread. My parents went to the appeal panel today and have been granted NHS funding for my Nan.

Thanks in particular to thebecster for posting the age concern link. They where extremely helpul and supportive and my parents will be giving their story to them to use in their campaign.

What worries me though is that there must be so many people out there who are entitled to this but are told that they dont qualify for funding and accept that without question. Or who are so intimidated by the 7 person panel that they have to face that they dont bother or are unable to present their case effectively. It all very unfair.

bump - to say thanks