My mother has recently been diagnosed with lung cancer. Of course, when someone is innocent of self-caused lung cancer, one has to say in one breath, "My mother has recently been diagnosed with lung cancer-but-she-never-smoked-or-went-to-pubs-or-clubs." The reason for this is stigma: it's a dirty illness that carries the stigma of being consequent upon the insane self-indulgence of smoking.
(This blog takes us right back to the issue of the pervasive discrimination against the elderly and doesn't cover the ins and outs of smoking.)
Okay, so what am I up in arms about this time? Well, from the time my mother was admitted to the local hospital with symptoms thought to be a worsening of her heart failure, there have been a catalogue of errors, malpractice events, disrespect and blunderings. Good old N.H.S. !!!!! Just like you see in the media! ....And we really thought that medical abuse of the elderly happened in isolated pockets where there were serious breakdowns of management. Or did we? I, for one, see the exposure of abuse of the vulnerable in recent years in our hospitals and Care Homes as the tip of the iceberg. By the nature of things most cases will be ignored, suppressed and protected by the "group". The fact that SOME are leaking out, tells us that the real number of cases inhabit the system pervasively. Why? Because it is a basic psychological fact that where there are vulnerable people to abuse, abuse will take place. A system of protection can never be robust enough because group dynamics always dictate that any group will protect itself and its members from discovery.
Why "psychological fact"? Well, the need to have dominance over others is part of our biological nature and with some people this need is not civilised,they therefore take their chance to hurt people who are in a vulnerable state. Please see earlier blogs where I explain this in full.
So how did my mother's experience correspond to what we hear in the media? Well, there was the matter of staff not noticing that my mum had trouble swallowing. They sort of knew this as evidenced by her feeling nauseous, but kind of switched off to it. The problem was only addressed when I frightened the hell out of the staff with direct reference to the matter being revealed to the local press! What was my mum eating each day?My mum was having one soup a day. The one meal that menued soup was dinner (6pm), so she had nothing for breakfast or lunch or supper because there was no soup on offer.
And what else? Hmmmmmmmmm......... Well, when she was first admitted around 3.00 a.m. she had severe breathing difficulties requiring a drain to be inserted into her right lung. She was writhing in desperation to get air, an oxygen mask made no difference whatsoever. So they drained the lung, right? Wrong. They left her in hell for more than 7 hours because they could not, ostensibly, put in a drain at night due to there not being necessary support staff. What?you may ask. A city hospital with no support staff at night? !!!!!!!!!! Are we going mad? So what would happen if there was an RTA and the casualty had a collapsed lung? They'd let him die for want of support staff? Or could this be a matter of hierarchy of need? Pardon me for being cynical, but could it be that the plight of an elderly woman, suffering complete hell, was not so urgent or important as an RTA victim, not so conspicuous, not so motivating? Well, I think so. Suffering,and compassion for that suffering, didn't actually amount to much when it came to someone elderly. It's the same old story.
And there's more? Yes, there is so much more.... What about them forgetting to give medication? They didn't do that as well did they?
You've got it! You must have experience of the good old NHS as well! Yes, my mum had to remind them to give her her medication. She's very compos mentis you see and noticed their every error. One day they forgot to give her an injection that is given to prevent patients having a stroke. She was still reminding them at midnight that day. The next day she told them again. They checked in the Notes and found no tick for the injection! What a surprise! I looked at the Notes around lunch time and was told that although there was no tick, they probably had given her the drug !!!! I told them that they had not. Forgetting to give medication was quite routine.
Not another problem? Well,this is the biggest problem so far so please stay with me..... S.H.Os., Junior doctors, are a real problem. They have neither the experience nor the authority to say what they say. Countless times I asked if my mum could have cancer treatment and I was told that she would have a say in whatever treatment she had or didn't have. "Yes", they said, she would have a say in her treatment. She could possibly have a drug to hold back the cancer, and a test for a cell marker to determine if she might be eligible for that drug had been done and they would let us know. The next week I asked for the results of the test and was told it hadn't been done yet. They would test the fluid from her lung to find the marker. Hmmmmmmmmm. So the following week I asked again. Still no test. My mum was then discharged and we were supposed to go for a appointment with the consultant in a few weeks. As it happened my mum was readmitted prior to this appointment because her breathing had worsened again (sticking the lung to the chest wall hadn't worked).
Now for the shocker: The day before the appointment in outpatients, I asked the SHO if my mum would have to go to the outpatient appointment in the morning. She answered that since my mum was now an inpatient, all outpatient appointments would be cancelled automatically. Are you sure? I said. Yes, she said , the consultant would make a visit to her on the ward instead. So the next day I arrived on the ward at lunch time to see my mother JUST IN TIME TO SEE THAT MY MUM HAD JUST RETURNED from her outpatient appointment where she had been taken ALONE without family or friend to be with her. And guess what? The consultant had persuaded her not to have treatment. Fait accompli. They never NEVER intended to do a biopsy to test for a marker and, ALONE, my mum was steered away from treatment. Now, okay, not having treatment may have been the best thing and we may have come to that conclusion ourselves, but she was never going to be allowed to make a decision herself, she was never respected enough as AN ADULT to be allowed to ponder the facts and decide for herself and in the end it was not even thought to be necessary for her to have family backup in her first oncology appointment.I wonder why? And all the misinformation given to me by the SHOs, all the falsehoods, all the false hopes, now became crystal clear as meanderings that were never intended to offer my mum treatment for her cancer. Never. They had never done a biopsy and never intended to do so. She had been opted out of treatment as if she was a non-person, way back.
My advise to you would be to NEVER TRUST AN S.H.O., they are nothing more than children way out of their depth, imparting information that they are unsure of and taking no responsibility for what they say or their actions.
What else do we learn from this experience? Well, we can see that, as in the case of my mum, having a relative observing "the goings on" at the hospital is a sure way of an elderly person being protected. Conversely,it is also transparently obvious that old folks who are away from the protective gaze of relatives are likely to be abused. Certainly, my mother would have been in a very bad state had she not had me to look after her.
So how on earth could we stop this abuse? I think that the public should have a role in this: members of the public should have random access to hospitals and care homes. It's the only way.Please let me know what you think.......
All the Best to you..