Caring for the elderly

ROYAL Oldham Hospital's director of nursing, Marian Carroll

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Are we really looking after elderly patients?
OLDHAM’S nursing chief has spoken exclusively to the Chronicle following a series of complaints from readers distressed over the care given to elderly relatives.

Severe criticisms came from people left feeling helpless and angry as their relatives failed to get help to eat and drink, were left lying in faeces, and were discharged in the same or worse condition than when they were admitted.

Relatives said they could find no-one to answer their questions, and although care provided by some nurses was excellent, they were prompted to speak out to prevent other elderly patients facing similar ordeals.

Marian Carroll, director of nursing for Pennine Acute Trust, which runs the Royal Oldham Hospital, promised all complaints would be thoroughly investigated and relatives informed.

She was also eager to assure the thousands of people who need hospital care in Oldham each year that such cases were not the norm: “The NHS overall delivers excellent care, but we do fail some patients,” she said.

“Their relatives speak to other people about their experience, which leads to an impression that care is not good.” Every service at the Royal Oldham Hospital has a dedicated matron available to talk to families with concerns.

The five cover accident and emergency, the medical assessment unit, surgery, medical, and rehabilitation and stroke services, the latter also responsible for patients with dementia.

In Oldham, one in four hospital beds is occupied by a patient with some form of dementia. Many are admitted for an unrelated problem - a broken limb, say, and many have several medical issues.

A common theme among complaints is lack of communication: work continues to improve the information given to patients and their relatives.

Mrs Carroll explained: “Communication is key. We keep saying to staff they should put themselves in the shoes of relatives.

“The longer someone stays in hospital, the outcome can be a lot worse, particularly for elderly people.

“It is very hard for someone used to caring for a husband, wife or parent, to hand over that care to someone else who does it differently.”

She added: “Pennine Acute Hospitals NHS Trust is committed to providing a service which delivers excellent care.

“Sometimes things can go wrong and on these occasions we welcome suggestions on how we can improve services.

“Many problems can be resolved by talking things over.”

A number of the complaints received by the Chronicle involve allegations that little notice was taken of information given about how the patient was before falling ill - one of Mrs Carroll’s points is that staff should get an idea of a patent’s normal home routine, mobility, eaing habits and so on.

Though senior staff constantly confirm their committment to listening to patients and relatives, there are times when the system gets it wrong. Our case study below details just one of four tragic cases revealed in tonight’s print and eChron editions.




How to raise your concerns
Relatives with concerns about the care given to a patient should follow this chain of command when complaining:

1. Ask to speak to the nurse in charge.

2. If not satisfied, ask when the ward sister is next on duty and ask to speak to them.

3. If still not satisfied, ask to see the matron.

4. If the problem remains unresolved,, ask to speak to the divisional nurse manager.

5. If all this fails to win satisfaction, there is the official complaints procedure - though most complaints are resolved satisfactorily before this point.

There is also an option to use PALS (patient advice and liaison service) which helps relatives to makes complaints - phone 0161-604 5897 9.30am-4.30pm weekdays or email pals@pat.nhs.uk - or ask for a ward visit by a PALS manager.




CASE STUDY: STANLEY LYON
‘Just another old man taking up a more worthy person’s bed’

AMONG four case studies listed in today’s print and eChron editions is that of 77-year-old grandfather Stanley, admitted to the medical assessment unit at Royal Oldham Hospital on March 7, from Acorn Lodge residential home, Failsworth, on the advice of a GP.

The father of two and grandfather of four, was dehydrated and unable to swallow. His daughter, Yvonne Ferguson, said she was shocked when she got a call from the hospital saying they were trying to rehydrate him, but were not prepared to resuscitate her father if he had a heart attack, nor to give him intensive care.

“I was told they would play it by ear, and if he improved they would do a swallow test. When I visited he was perky, telling jokes, and I was told they would keep him over the weekend.”

The following day, Yvonne rang the ward and was told her father had eaten two puddings and was being discharged.

“I couldn’t believe it, I knew he couldn’t eat.”

Mr Lyon’s 76-year-old wife, Anne, had not been informed and she was already on the bus to visit him. She arrived to find her husband had gone.

When his 87-year-old brother arrived to visit, he was asked to take medication they had forgotten to send with Mr Lyon.

“Dad arrived at Acorn Lodge with no medication in exactly the same condition as when he went into hospital. I sat with him for hours trying to feed him, but nothing went down. Up until Christmas he had eaten like a horse, and it was awful seeing him like that.

“The hospital told me if he was readmitted they would do exactly the same, that is fill him full of fluid and send him home again.

“I was absolutely livid, but there was nothing I could do. We just had to sit there and watch dad starve to death, it was horrendous.”

Mr Lyon died on March 19.

“The NHS did not do their duty to my father —no doubt just another old man taking up another more worthy person’s bed,’ said Yvonne.

“I won’t accept this appalling treatment.”

The family made an official complaint to the hospital and tell their story here in the hope of forcing changes to the way older people are treated at the Royal Oldham Hospital.

“I know it won’t bring dad back, but this situation has opened my eyes to the plight of those elderly people who have no-one who cares for them.


How the Trust responded
“We are sorry Mr Lyon’s family feel his care was inadequate and regret that the family have felt the need to make a complaint.

“We have thoroughly looked into the care provided to Mr Lyon by doctors and a senior nurse as a priority.

“We understand from a consultant physician that no further active medical treatment was available to Mr Lyon requiring hospital care.

“Based on clinical information, Mr Lyon was discharged from the ward and returned to his nursing care home following appropriate treatment.

“A letter has been sent to his family from the trust giving an explanation of the appropriate care given and a response to the issues the family have raised.”



JOIN THE DEBATE
The complaints we have received have prompted our special report on the NHS and the elderly,but there will be hundreds of others delighted with their care. What’s your view? Comment on the story on this page


TOMORROW: Medical Correspondent MARINA BERRY has been given special access to the Royal Oldham Hospital to witness care given to elderly patients.


The full version of this story, and extra cases, can be read in tonight’s print and eChron editions