Monday, 14 March 2011

Is Granny Safe in Hospital?

The treatment of elderly people in hospitals hit the news headlines again recently. I say "again" because the topic is becoming rather a perennial one. You know how it is - a study or perhaps just a whistleblower comes up with something quite shocking about the callous way in which old people can sometimes be treated in hospital, and the usual predictable responses are trotted out by the politicians, the nursing and medical professions and hospital management. "It must never be allowed to happen again", "something must be done" etc. etc. Problem is, it does happen again. And again. And nothing seems to be done (although I am sure that people try). And there is a tendency for the various parties involved to blame one another, absolving themselves of any responsibility for whatever horror has been revealed. And always, always,always heads are shaken and we are told "it wouldn't happen if we still had matrons."

I can see this situation from more than one point of view. Three points of view in fact: as a hospital patient myself, as a concerned relative of a hospital patient, and as a doctor. Now, admittedly, I was actually quite young when I was last actually in hospital as a patient. I got toxic impetigo in my early 20s, after getting a dose of sunburn when on honeymoon in the Med some 42 years ago. I felt rotten - well, I was quite ill - and the thought of food, well, sort of made me want to throw up. Yet the sheer quantity of food they seemed to think that sick people need  beggared belief. I mean  a cooked breakfast. Coffee and biscuits at 11, a two course cooked lunch, afternoon tea and then a cooked supper. Just where did they think that people spending most of their days on their backs were going to put all those calories. Anyway, even if I'd been hungry I don't think that I would have found what they were serving up particularly appetising. I could jus about manage some ice cream and some steamed fish.

Now from the perspective of a relative in hospital. In this instance my wife who has had a rocky ride of it in the past. On the surgical ward where she was admitted she had to contend with noise day and night, mostly from obstreperous youths who had been cutting each other up in street fights and required emergency admissions for plastic surgery. These guys and their families and friends gave the nurses a hard time, but the nurses seemed to cope with remarkably good humour. Again, the food was awful - but that presented no problem as I would call in to my wife on the way to work with provisions - mostly home made soup in a flask and some fresh bread. Back again in the evening I would sneak in half a bottle of light white wine.

Neither of these instances was a particularly big deal - we were young and able to fend for ourselves. And we were going to get better anyway. No - what really shocked me was the accounts I heard from my own patients and their families, and here I am talking about elderly patients.

An elderly lady, recently discharged from hospital, was brought to see me by her daughter. It was a long time ago, and so I don't recollect what it was about - probably review of medication or something like that. Anyway, she was perfectly lucid and able to give a good account of herself. Towards the end of the consultation she said: 'Now I'm going to tell you something, doctor, that I don't think you'll believe.'

'Try me', I said. I knew the lady well and had never thought her inclined to distort facts or even exaggerate.

'Well, every day the nurses came round with a trolley with water, cloths and towels and did a sort of strip wash on all the patients in the ward'. This was a ward where only elderly people were cared for. Unlike my patient, most suffered from Alzheimer's.

'As I said, I don't think you'll believe me. But the nurses used the same cloth, the same bowl of water for every patient. And they were washing our private parts with them!'

I was, as I remember, quite speechless.

And these stories of elderly people starving in hospitals. Now I certainly believe that to be true. I have seen them after discharge completely emaciated. Worried families felt helpless, afraid to speak up on the patients' behalf. This scandal has been exposed more than once, promised made, changes guaranteed. But it is still going on, it seems. Food is left on a tray for people who can barely lift a knife and fort. And as for the food itself - I well remember "curried goat" being on offer. Fine for your man getting in after a days work digging up the road, no doubt. But enough to make anyone feeling a tad ill (as people often are in hospitals) want to throw up. This particular offering on the menu, it has to be said, was made to demonstrate that the hospital authorities were 'ethnically aware'.

Makes you sick.


  1. 'Lessons will be learnt' - but when?

  2. I'm afraid none of this surprises me. I've heard it too often. Back on my hobby horse (and I posted about this recently myself), this is, first and foremost, about nursing. Not enough of the right kind or people go into it, and those that do, are taught largely in classrooms in order to gain degrees. Bring back the old nurse training, a good ward sister (and okay, a matron too), train nurses on the job, make them responsible for the patients' welfare, and things can only improve.

    Trust me. I was a real nurse.

  3. I do trust you, Frances. My wife was also a 'real'nurse - she trained in Dublin in the 1960s. After qualifying she went on to the Rotunda to do her midwifery training. We met at Christmas 1967 when she was a staff midwife at the teaching hospital in London where I was a medical student. She taught me how to deliver mums and it all went on from there.

    I well remember, wanting to find a quiet spot to do some revision, asking one of the night sisters if I could sit on in the ward. She graciously consented but told me I would be out on my ear if I so much as squeaked.

    I have to say I am not optimistic about any changes for the better. But rather than go into that now I might write a follow up blog.

    The reason for the rot is patently obvious to the likes of you and me, but not, it seems, to those high up in the RCN or the DOH.