Wednesday, 7 September 2011

Elderly abuse in the N.H.S., Royal United Hospital, Bath.

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..


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  6. Thanks very much for publishing this article.

    I am sorry to be replying so late. The details of the scandal at Stafford has brought back memories of my mother's admission to the RUH, folowing a stroke and her eventual death and further research led me to find your blog.
    The days that my mother spent there were the worst of my life as we fought to keep her alive. At one point, we discovered that they had signed her up for Pathway, strictly against our permission. At one point the arranged a meeting with my brother and I to talk about my mother's ongoing care. We later discovered, they had being psychologically analysing us which is of course, against our human rights, as we were not patients. We were labelled 'unusually devoted children in the notes which we later demanded to see.

    I witnessed some appalling lack of care in that hospital and at the time, following my mother's death,could not get anyone in authority to act. I refused to leave her for the duration of her time there as I was convinced that she would not survive at their tender mercies. As it was, my mother was in a geriatric ward. We were told that the consultant was a neurologist but when we probed the director or medicine, she was a geriatric consultant with an interest in neurology. She was also part time and we had to wait days to see someone.

    In the meantime, we were trying to find a human right lawyer to get my mother out of there as we could not even get her out of there to another hospital without the consultant's permission and they actually told us that 'this would be her last admission' early in her stay and seemed determined to make that the case.
    I only left thehospital when my brother was there to keep a watch in brief on her and to make trips into Bath to buy books on the medicines they were pumping into her.

    I urge anyone whose loved ones are vulnerable to monitor what is being administered to them and how they are being cared for.

    One thing I learnt from a sneering intern at the RUH is that doctors are no longer required to take the hypocratic oath; something I was not aware of.

    I still feel the same anger and frustration and there will always be the nagging doubt that my mother could have been saved. I have to live with that but I applaud you and those who seek to ensure that no one loses a loved one without the assurance that everything is being done for them.
    I am very glad that your mother got through the ordeal and wish you and all those who have had the compassion to respond to this blog very best wishes.

  7. Hello,

    My experience relates to a 90-year old mother in the Bath Royal United Hospital. In a 3-month period from November last year 2012 we experienced the following.

    Being told by a dismissive & unsmiling doctor in the MAU that she had 3-days to 3 weeks to live. She lived 3 months. A doctor should not have said this.

    Being placed in a scruffy run-down ward late in the evening where alzheimer's patients were placed. Had to listen to screaming from mentally ill people. Our mother was actually scared of being there and so were we. We wanted her into a better place.

    No sanitizing hand wash available by her bedside for 2 days as container was empty. I had to ask twice for it. A ward sister did not like it when I had to ask for the second time.

    Tablets issued but seen to be taken.

    11 weeks sat in a worn out chair for 14 hours a day.

    1 nurse & 2 assistants one evening with 25 patients.

    In my view too many young doctors and nurses that do not really understand elderly people or indeed their elderly relatives concerns.

    1 elderly lady fell out of bed during the night as no side guards in position. Told by a much younger woman that nurses could be heard laughing when they had left the ward and went back to their station

    Blood clotting injections missed for 3-days as nurses apparently not understanding new drug charts - what!

    Only 1 shower in 3 months. A Bath promised after her first stay in hospital but never given.

    Personal clothes with excrement mixed with clean clothes in locker after bouts of diarrhoea.

    Disputes on a day of first discharge between hospital and social services relating to reablement package - unbelievable.

    Being told that she had lung cancer by junior doctor when not proven.

    No incontinence pads available in one ward. Told that patients could pee or poop themselves in bed or in their own clothes. Staff looked fed-up and did not like criticism from the public.

    Tablets seen on floor. Hypodermic syringe in with sweets.

    very large woman allowed to be partially naked on bed in ward in front of other patients and visitors. Nurses appeared irritated when this was mentioned but they eventually did soemthing.

    Further dirty clothing in with clean in lockers.

    Not allowed to feed a dying mother at meal times yet could feed her at visiting times. This is madness. In Spain they actively encourage feeding.

    Video taken of dying mother unable to feed herself and no concern shown by staff. Matron asked me if I had asked mothers permission. Who are these people?

    Hospital refuses copies of medical notes after application 2 months ago. The hospital is being very secretive along with another issue I cant mention here.

    Our mother died February this year presumably via the Liverpool Pathway but that we cant exactly find out.

    I really want someone to hear my full story where I have more to say.