Wednesday, 14 October 2009

Liverpool care pathway

More information on the subject of euthanasia and doctors playing God can be found here. It's an interesting read and essential if the subject concerns you as much as it does me.

65 comments:

  1. Ijust don't know what to say. We use this in our hospital and I've always had my suspicions about the motives behind it. Nobody ever fills it in properly anyway. Is it because they haven't carried it out to the letter or just because they forgot to write in the LCP? There is a saying "if it's not written down it didn't happen" and I'm rather inclined to believe that is the case, that the care doesn't happen. I am disgusted at the way this country treats the elderly, especially those in need of care. I have heard too many horror stories from friends who have lost elderly parents. People rarely complain because it's too much red tape at a time in their lives when they cannot cope with officialdom because of their sad loss. My stepfather is in hospital at the moment and I am disgusted at the lack of care he is receiving. At least I can pop along and keep an eye on him because I only work along the corridor.

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    1. State-sanctioned murder .
      Thatcher's Legacy .
      Pure Evil .

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  2. It is scary, isn't it. On the one hannd, if applied properly them maybe the LCP has a role to play in palliative care. But I worry that it could be open to abuse.

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    1. we have a group on face book called the liverpool care or death pathway .. any input for or against is welcome so we can all come together but most of all stop this barbaric torture ,,,, and may i also add this is not just used on the elderly babies inc too ... also look up side effects when a patient is dehydrated ..... its not the cancer or any other illnesss that causes this it caused by lack of fluid xx

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  3. I have enjoysed reading your blog and supporting you in your quest to improve the hospital food. Unfortunately I nursed my father last year with pancreatic cancer and in total agreement with doctors nurses and us the LCP was used. I feel unable to read your blog from now on as I feel this will incite much emotional reaction from people imagining that this path is chosen lightly. I wish you well in your recovery and hope that this area of your blog will not backfire.

    Very best wishes to you and your family for an at home Christmas.

    Ruth

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    1. if someone is in a hospice setting then yes maybe it is a good thing as we all know if we go into hospice its our last few weeks left ... there is no place in acute hospitals who are already under staffed etc etc no care no dignity and when people realise what is happening there will be a price to pay oh and the insentives for patients on the lcp should stop now ... how much is your loved one worth ????????????????? approx £20.000 each person

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  4. Yes TM, I agree with you. The key word is properly.

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  5. Hi Ruth

    I'm really sad you feel that way. I've loved reading your comments and enjoyed your support. I don't have any agenda over the LCP and I'm more than willing to have my mind changed by reports of good outcomes. I really don't think it's reason not to carry on reading the blog and it makes me very upset to think that my views could have offended or hurt you in any way. I often read views that differ from my own because I find I often learn from them and it stops my beliefs becoming blinkered or entrenched. I really do hope you will reconsider your decision.

    TM x

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  6. My father as of last weekend has become a victim of the LCP
    He was put on it (without our knowledge), due to suffering from bacterial meninigitis but pulled through
    Unfortunatley it was too late for him in the end because due to the dehydration (lack of drip) had become confused and although not written on record, tried to get out of bed only to have a fatal fall (unfortunately he was in a room on his own, beause he was in a ladies ward due to lack of space which believe didnt help the monitoring of him or the drip that was trying to get him back to normal.)

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  7. This question is naive but I do not know much about the LCP. Is the withdrawal of nutrition, water and antibiotics mandatory for NHS patients if the hospital deems it appropriate? Could a family refuse the plan on religious grounds? I am the wife of an (Eastern) Catholic priest and have no problem with using morphine to control pain despite its side effects, but consider water and nutrition to be normal and not ‘treatment’ until dying has actively commenced. ( I have done CPR in Chicago so have attended a number of deaths in hospital.)

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  8. Interesting to note some of the response from the Marie Curie Palliative Care Institute Liverpool [MCPIL], the home of the LCP, to the recent press coverage.

    In a statement put out on 18th September they say:

    'When a patient is dying they generally eat and drink less - this is part of the normal physiological process of dying. Food and fluid is provided to the patient as tolerated and at their request, and is not withdrawn within the LCP Framework. Fluids via a drip (artificial hydration) are given when the doctor/clinical team makes a decision that this will be beneficial and not cause undue distress to the patient.'

    Later they go on to say that any 'intervention' may be withdrawn if the multi-disciplinary team believe that it is in the patient's 'best interest' for this to happen.

    They also quote a letter to the Times [17th September] from Dr Bill Noble, President of the Association for Palliative Medicine GB and Ireland:

    'Treatment with subcutaneous or intravenous fluids is occasionally indicated when dehydration causes distressing symptoms, but is futile in patients where poor oral intake is part of a general deterioration that is inevitable in a terminal illness. It is potentially harmful if administered to patients with heart failure leading to congestion of the lungs.'

    So where does that leave us?

    Still appalled, of course, about the case of Jack Jones who was mis-diagnosed with terminal cancer and put on the LCP, which led to his death, when he could have been treated for the pneumonia he had and survived.

    Wondering also how often withdrawal of AH is in fact the norm, with its use the exception.

    Struggling with the power of doctors to take 'best interest' decisions when the person may have the mental capacity to take that decision for themselves.

    This is where the Mental Capacity Act clashes with established medical law and practice. The MCA establishes in statute a 'presumption of capacity', which means that unless an adult [over 16 for the purposes of the Act] is formally assessed as lacking the mental capacity to make a decision, no one has the right or the legal authority to make a best interest decision on their behalf; but also, if the person does not have the mental capacity to take that decision, then the person proposing to take the intended action must make a best interest determination on their behalf.

    So, in terms of the MCA, if I am dying but conscious and lucid I should be able to insist on AH up to the point of death. However, I do not actually have that right, because under other medical law no doctor can be forced to continue with a treatment or an intervention that they do not believe is clinically justified.

    I have the legally binding power under the MCA to refuse a treatment or an intervention - both when I have capacity and when later I lose that capacity. That is the Advance Directive to Refuse Treatment. But I have no complementary right - nor do my relatives - to insist on the continuation of treatments or interventions whether I have mental capacity or not.

    This, not least, is where the often used phrase "living will" falls down. In a true will I can dispose of my goods in any way I choose, but under current law I cannot make positive choices about my medical treatment, only negative ones. Not a living will then, more a "living won't."

    So it is as ever "My life - or death - in their hands" and I have a strong desire to know just what these hands are up to. As MCPIL say - the LCP tool is only as good as the people who use it.

    There should be an audit and on-going monitoring of the incidence and prevalence of the LCP in each hospital and hospice, any withdrawal of AF and AH including when and how those decisions are taken. (I want that profiled by age and by socio-economic group. Can you guess why?)

    I want to be able to trust that the LCP is only being used to ease the process of dying and not to hasten death itself. There is always talk of 'evidence based medicine.' I insist on the right to 'evidence based trust.'

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  9. There are always going to be times when the medics get it wrong. that is inevitable, unfortunately.

    However, my concern over this is that as long as voluntary euthanasia is ilegal in this country, how is this legal? It is, after all, hurrying the end of someone's life.

    Palliative care in the UK in hospitals can be very poor and it is good to see this being adressed in the form of a care pathway but I think it is vitally important that medics do not hide behind this piece of paper instead of actually interacting with the families of those concerned.

    I have been involved in nursing for more years than I care to think about and so have seen many people die in many different circumstances and allowing people who have reached the end of their life to go with DIGNITY is a good thing. Fighting to keep someone alive is not always in the patient's best interest.

    I do think the UK need to look at the whole issue of euthanasia properly and openly and accept that insisting people 'live' is not always in their best interest!

    This is purely my personal opinion and not intended to cause distress or upset to anyone who faces these issues.

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  10. Some more cases/information gleaned from the web.

    2 articles in The Telegraph
    http://www.telegraph.co.uk/health/healthadvice/maxpemberton/6139668/Liverpool-Care-Pathway-The-decision-to-withdraw-treatment-from-a-patient-is-an-incredibly-complex-one.html

    http://blogs.telegraph.co.uk/news/geraldwarner/100008455/the-liverpool-care-pathway-may-be-the-slippery-slope-to-backdoor-euthanasia/

    Care not Killing
    http://www.carenotkilling.org.uk/?show=842

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  11. There are audits Peter, both locally and nationally.

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  12. Thank you for posting this and other articles referencing the "you're not fooling anyone, you know." care guidelines.

    And do stop posting those dreadful post mortem photos.

    Paula

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  13. Hi there Nurse,

    The reason that it is legal for medics to remove drips supplying hydration and nutrition is because the Mental Capacity Act re-defined food and fluid provided by 'artificial means' as medical treatment. Previously it was under the banner of basic care. But if it's medical treatment, then it can be given or removed as such. It also means that a patient can demand that drips and the like can be removed, but cannot demand their provision. There was a huge controversy over this in Parliament at the time, and Ian Duncan Smith predicted that the MCA would return to Parliament to be amended. I think he was right..
    I'm doing a series of blog posts on this just now and the next one is going to be on food and fluids if you're interested.

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  14. My 80 year old mother is again in hospital, she suffers constant chronic pain due to severe arthritis and gout, her kidneys are barely functioning, her heart is very weak and all her major arteries are blocked. She is virtually unable to do anything for herself; drinking; feeding; going to the toilet; washing herself are all but impossible. Her pain relief medication is causing her to suffer terrifying hallucinations so she has been taken off them and allowed to suffer unbearable pain. Her quality of life is non-existent and getting worse each day because she is so scared, not of dying, but of living. She has been saved by medical science on numerous occasions when she has suffered heart attacks, prolonging life at all costs is not a worthy ethic, it is not length of life but quality of life that really matters, and this kind of suffering cannot be justified.

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  15. Further to my previous post I arranged a meeting for the family with my mother's specialist and discussed then agreed the Liverpool Care Pathway. From being seriously distressed due to the hallucinations and severe arthritic pain, the morphine pump made her last few days peaceful and calm, the family stayed with her 24/7 and she died with us present. The feeling of loss we all share is tempered by the knowledge that she no longer suffers the umberable pain she fought aginst for far too long. Her time had come and the LCP approach spared her further torment; the prolonging a life she no longer beleived worth living; and allowed her to die with some dignity.

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  16. i as a palliative care nurse i am quite distressed to read some of these comments about LCP, we use this pathway and it is only meant to be used in the last few days of life, with full discussion with family and patient if applicable before it is commenced, before the pathway i watched as unneccesay proceedures and medications were given to patients who were quite clearly dying, so as a health care professional i can honestly say give me the LCP every time

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    1. quite clearly dying is a load of bullshit how many have been taken off it and still alive today who are you kidding yourself whitewash.

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    2. the liverpool satans care pathway more like it i did not realise that so many relatives object to this satanic pathway how can it be allowed from all these horrors being written even qualified professors and doctors in this line of work in hospitals write to the newspapers god help us who are these idiots to allow this immoral execution to take place which is proven fact to be wrong with the doctors whistleblowing.

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    3. to palliative care nurse you stand by this barbaric l c p because you get paid doing this starvation and poisoned to death, you say give it to you every time , you only get it once mate then your stone dead, I would be the first to give it to you and I would watch you suffer, and be happy too.

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  17. this message is for these people who think its barbaric not to feed a dying patient if you give a dying patient food you run the risk of them aspirating and it going into their lung, causing apiratrion pneumonia and dying of infection, as for 'ARTIFICIAL hydration if you give a dying patient a drip because they are not moving around all this fluid pools and ends up in their lungs in effect the patient is drowning in their own fluid not a nice way to die, some of the comments posted on this blog you need to do some reserch before you print this stuff, furthermore as a patient nears death the vast majority lose the urge to eat and drink its just the natural process of the body shutting down, so when some of these blogs talk about how terrible it is not to feed or hydrate these patients who are we doing it for...is it to make them feel better cos it certainly isn't for the poor patient in the bed, something to think about people!!!!

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    1. if you stop starving and dehydrating patients you wont get your coquins blood money and the patient will live longer stop saying there lungs will fill up with fluid i would sooner be fed and not poisoned to death like doctor harold shitman did, dont make excuses like you want to be starved to death yourself when your time comes, thats a load of bollocks you are paid for on bupa they dont get paid to put you on the death pathway you die naturall with painkillers if needed not 24hr syringe driven into a coma.

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  18. My Dad was placed on the lcp on 6th November 2009 and died on 18th November.It was the most horrific time of my life. He was put on it without any dicussion with the family, we were informed by the Doctor that he was not filling us with medical jargon and that Dad was dying.Dad had stomach cancer 2 years ago,had surgery but all his scans and biopsies since had been clear. He was admitted to hospital with pneeumonia and we were told it was clearing. Dad was alert, eating and bright. We were confused and asked to speak to the Doctor to why Dad was dying his answer was he never recovered from his surgery and possibly his cancer was back he confirmed that his pneumonia was clearing. Dad was put on a syringe driver 5 days before he died he never had had food or drink after that. On numerous occassions we asked for Dad to be reviewed but our request was refused and no Doctor came to see him in the 12 Days. The day after Dad died Mum and my Brother went to make the funeral arrangements and were informed by the undertaker that the hospital wouldn't release the body what a shock, Dad had to go for a post mortem and we got the final results and death cert in Febuary. Dad's cancer was not back and he died from pneumonia which were told was clearing.
    I am angry and can't greive properly for my Dad
    The following is from th lcp website
    "All the careful details of the pathway are a salute to the enduring worth of an individual life such an ending can help those left behind to pick up the threads of memory and begin to move forward."
    Dame Cicely Saunders
    This is not what i'm feeling right now
    Love and miss you always Dad

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    1. My sincere condolences .

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  19. my mother became hospitalised with a DVT on her left leg was then said to have developed a chest infection(since referred to as bronchopneumonia) and was placed on the death pathway by her doctor who did not seek a second opinion from outside the team first(he later told me he took the decision alone!)Kidney failure occurred following hospitalisation(first written up records of saline being given was over seven hours after her arrival at A&E).The doctor,not on duty in A&E when my mother had initially been there)later said he felt dehydration had been a factor in the kidney failure. The 'bronchopneumonia' improved significantly and about 45 hours after being on the pathway of death her doctor restarted treatment .From that day on I heard no abnormal chest noises.After two days of being conversant with her family during visits to see her deterioration occurred and 6 days following the restarting of treatment she died.Death certificate gave three causes of death.1 Bronchopneumonia 2.Chronic Renal Failure 3.Hyoercalcaemia. The hospital maintains that bronchopneumonia was rightly given as the first cause of death, and say abnormal chest noises continued to be present throughout the last week of her life.Perhaps the morphine during the last few days hid it from my ears! I'd certainly heard it when she'd been put on the death pathway.For two days the chest noises were horrendous - yet she'd not died.The point is that it seems far more likely to me that at time of death it was the renal situation that was the most probable number one cause - and that without that it's questionable whether bronchopneumonia would have been problematic enough to bring about death.Did the 2 day period on the death pathway cause recoverable kidney failure to become irrecoverable due to the deliberate witholding of any fluids? I can't prove it did but that doesn't mean it didn't!If she'd not been placed on the death pathway the question wouldn't arise.Doctors aren't perfect.Errors of judgement will occur.Even if his decision didn't cost my mother her life he'll not know for certain that it didn't.He's got to live with that.No rule should allow one doctor alone to rely on their own judgement when making such a decision(and agreement just within the team isn't sufficient ~ people are disinclined to outwardly disagree with their captain!) Though a rule says one doctor can rely on their own judgement in such cases that doesn't mean they have to! A human beings first duty is to do what the heart says is right.Consult from outside the team.In wards predominantly made up of terminally ill dying elderly people palliative doctors may not feel that frequently involving doctors from outside the ward in assessing the patients conditions would be looked on favourably.That's why the rules need to insist that it's done.For as long as that rule isn't implemented I will know that the real agenda is geriatric genocide.WAKE UP!!!
    I'm posting as anonymous because i'm still going through the complaints process with the hospital. I'd particularly appreciate any responses to this from qualified doctors because i'm obviously not impartial in my comments here and do want to see both sides of the arguement.

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    1. Old people die! it's afact of life. Why so scared? Why so keen to prolong their suffering. All the anti LCP anecdotes are about people in their 80's and 90's with terminal conditions! What do people expect! Bizzare!

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    2. We expect our elderly to be cared for .

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  20. i have a simular horror story to the one above and at the moment an investigation is on going at my local hospital. as i became more and more dissatisfied with my mums hospital care i started to keep a diary logging every thing that happened sadley mum lost her life on the 7/4 2010 i believe she was put on the care pathway without my knowledge i believe some one ticked her box. the diary is three pages long and as soon as i get the answers to the questions that i have asked the hospital to answer june 4th is the date i have been given i shall send the whole thing diary,questions and answers to the daily papers and anyone else who is interested. ina

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  21. Please keep me informed. I may be able to help.

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  22. will do. i have listed all the questions i want ansaered from them. as i said i am told that app june the 4th i will have my answer there are about 30 quesions i need answering. i did actuall challenge them about the care pathway and the staff nurse admitted that our hospital practice it but hassened to tell me my mum wasnt on it becaus she wasnt terminally illn so part of my questions were if she wasnt on it why where vital medical services like pre hospital medication, drips, food ect withdrawn. after i get my answers i will need to write my responese to their answers and then my own conclusions then i will get back to this site ina

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  23. UPDATE ON MY lO MAY 01.34 COMMENT:- Attended hospital meeting on 13 May (First meeting was July '09 when I spoke to original Dr.He's since left the trust so saw different Dr at latest meeting)Discovered kidney failure was responding to drugs at time when mum was placed on L.C.P.I'd asked to be told what specialist had said about renal situation following onset of k failure(she'd been in Whipps X month earlier.Back pain diag.as arthritis of spine.Read it can put pressure on kidneys and affect function so wanted to know what specialist had said).NO RENAL SPECIALIST CONSULTED>Would have req. contacting Broadlands Hosp.miles away in Chelmsford so not warranted.(P.Alexandra Hospital Harlow is a large genhospital in its own right for goodness sake.Don't they have renal specialists?)What did lab test results show as source of chest infection called bronchopneumoniaDr didn't have that information.- She said high protein & calcium levels meant it was virtually certain there was underlying cancer anyway-no other explanation.Oh really! Letter from Whipps X assures me there was no hypercalcaemia month before death-calcium levels were normal.Also that they'd suspected cancer so checked for it with scan.No metastases.There was a chronic k condition but function was stable when transferred to physiotherapy hospital in Epping.(DVT developed there few days later so they sent mum to Harlow for treatment).
    Few days at Harlow when severe chest symptoms occurred.Horrid chest noises.2 days of continuous rapid gasps for short breaths.Head high.Mouth permanently open.Hands hot as fire then cold as ice.Is this DVT lung blood clot symptoms??Somebody tell me please.On LCP for 45 hours approx.Symptoms abated(vanished actually).Hosp. say abnormal chest noises throughout last week of life.I heard none for last 6 days.Mum was conversant and laughing with us day when treatment restarted.(still aided by oxygen mask).Asked how later noises were measured and how they compared to earlier.No actual measurements taken.Someone just wrote in a box that there were chest noises!Ticxking boxes.Y did wave mattress appear on bed day after treatment restarted?So many questions.Bronchopneumonia issued on d certificate as number 1 cause of death.I don't believe it.No.1 cause of death surely renal failure.(or negligence!)
    Dr said would have done same as original Dr.She'd previously written decision 'should not have happened'.Work that one out!I said its wrong that one doctor should make such a decision alone.She said the real problem is ensuring dying patients aren't overtreated.I should have reminded her original doctor had restarted treatment 45hrs later. The Dr I saw recently I suppose wouldn't have bothered! Voices raised at meeting.I asked that meeting be brought to an end.Disgusted.Walked out.The sheer arrogance.Arrogance is not wisdom but those with it confuse the two and think them synonymous.I don't know for sure that my mums life could have been saved but this arrogance is dangerous and will cost other patients lives if it's not reined in by compulsory rules.Guidelines advising full consulatation isn't sufficient.The arrogant see a guideline to mean it doesn't have to be followed if they know better-arrogance always believes it does.Ye God's wept!!!

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  24. hi again recieved my answers from the hospital not good everything denied questions egnored or not answered properly. i have got to write now my answers to their answers the a conclsion and sum the whole thin up should have it finished by wednesday then if you are interested with send you the whole thing diary,hospitals answers and my summary by email and then i would be interested to know your thoughts on it please let me know ina

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  25. I have read articles and comments on numerous websites on the subject of LCP. Overall I feel there is lack of objectivity on the subject – those for and those against – rather than its control. I can see that LCP was probably designed initially for all the right reasons and I can see how those in extreme pain and in their final hours can benefit. There are many kind and attentive nurses defending this form of ‘care’ and I’m sure that many are doing an excellent job.

    Unfortunately it is not LCP in itself that is the problem it is the NHS use of it and the many, many cases that have come to light (and the many others that almost definitely exist) where patients, not in fact in their final hours and not in extreme pain, have been allowed to die in a terrible manner.

    My own mother (83) earlier this year was deemed by the ward doctor to be imminently dying . She was admitted with a urine infection and subsequently deteriorated. I was called by the doctor as I was away at the time and told that she would not live for more than a day or two and they were putting her on LCP. I jumped on a plane and did indeed find her gravely ill. I believed the doctor in charge and felt LCP would make her comfortable.

    The next day she perked up and although could not speak, was aware and could make odd jestures. We were told this was normal but she would deteriorate again quickly. Nearly a week later she was still alive and by this time I was beginning to feel that yes she was going to die but now as a result of dehydration. What normal healthy person could go on without fluids for any length of time? My mother must have been a lot stronger than we were allowed to believe.

    I decided to tackle the medical staff. I found it astonishing that the Sister agreed with me and told me that she had already brought up the issue of reintroducing fluids but was told NO. Being a weekend, there was no ward doctor, so I asked for the on call doctor. He listened to me and prescribed fluids. The next day, once the ward doctor found out she went crazy as her instructions had not been adhered to. She immediately stopped the fluids. I asked her to look at it from my perspective and the fact that my mother was in fact dying through dehydration and I had condoned this until that point but wasn’t prepared to let this go on.

    She told me she had every right and had the power to overrule me and what she was doing was the right thing. No medical explanation. She also said I was making her worse by asking for a needle to be put in. I felt she was playing God and did not want her power questioned in any way. Less than two days later my mother died.

    I later find that 16 people (around 75%) in the same ward were on LCP. The relatives of other patients I spoke to had said their parents had been admitted with relatively minor complaints and had been admitted directly to this ward and put on LCP without their consent. I don’t know about the others. It does seem however that admission to this ward, with a doctor there full time daily for five days (no consultants), was a likely death sentence. No reassessment of a patient’s condition seemed to be made but this is just based on my own experience.

    I regret that I did not ask more questions to start with nor took action sooner. By the time I realised it was too late and there was no going back and had to let the process continue. I just believed what I was told and in an already distressing situation it is hard to think clearly.

    I saw no evidence of any controls within the NHS. Concerned nursing staff are not permitted to speak out as it is the doctor’s decision and they are frightened for their jobs.

    In a lot of cases I am sure LCP can work but without controls it is open to abuse. There are far too many cases now proving this to be so.

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  26. In a hospitl in the south East , my husband was actually dying but allowed to go without fluids for about 20 hours, during his last about 5 days of life I think he had about 2l.of saline and a few sips of liquid. I knew that he wasn't getting enough fluids but the hospital lied to me saying he could not swallow.I found a baby type drinking cup by the bed (visiting hours were only 3 hours a day) I was distraught about that as well .and tried to find out if he could swallow or not. An agency nurse told me no one could check until the speech therapist came in in a couple of days, I was distraught. Then I found out she was lying and nurses could check. I found a nurse who admitted that he could swallow.
    Then I carefully spooned him some carrot juice, he seemed very thirst but could not speak, due to a stroke he had had.The consultant walked past and said loudly, I forbid him to have any more.It was very distressing for me that he was thirsty and possibly hungry, but nothing compared to the 3 hours a day visiting hours. My husband would become distressed having no short term memory, ( this was several times during his 11 day stay, on about 3 occasions he was injected with midazolam or other sedative, (on 2 occasions the nurses were caring and helped him through just by listening to him). When he had the sedative it would put him out of action for about 16 hours.What he really needed was me, his wife. I regret not asking him if he was hungry/thirsty he could answer by squeezing my hand.There are no records in the notes of nurses asking if he was hungry etc. In the latest LCP version (12)it says fluids do not have to be withdrawn, however this hospital is still on version 5 or 6.I think he was put on it without discussing it w me (I would have had kittens and not agreed).Are there other people who have had this"patient can't swallow"lie?

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  27. I am so sorry to hear your experiences, miss. My heartfelt condolences on what must have been a very upsetting time. Rest assured, I'm looking into this issue. I'm deeply troubled by what I've heard. This needs further investigation. Thank you for telling me about your experience.

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  28. I was informed by a staff nurse the day my father died that he had been on the Liverpool Care Pathway. This was later denied by the hospital. It haunts me to this day that I will never know exactly what happened in his final days. I feel the system is open to abuse the way it stands at present.

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  29. i, just cannot beleive the horror stories i am reading it did happen 20yrs ago with my mother in law, and the same thing has just happened to my wife, my wife was upset then and then the same treatment was given to her starved to death.why it should be allowed to continue i just dont understand.

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  30. its, the top doctors who tell the nurses, and syringe drivers on call they are too scared to treat a patient how they should be nursed, if they dont do has told, its in front of the top doctor, and told they are unsuitable for the job. its not the nurses fault is it.

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  31. My Father was on the liverpool care pathway - he has terminal lung cancer and went into hospital with double pneumonia. He was very anxious as his breathing was laboured and they sedated him with his permission. They told us he had been put on the Liverpool Care Pathway and we accepted it.
    One day we were at the hospital and the syringe driver had run out, we mentioned it and visitors later in the day say it was the same when they visited, therefore most of the day he was not getting his drugs (including sedation) that evening my Mother visited and he was very alert and watching TV answering quiz questions correctly! The next day he was back to his confused sleepy state. We were concerned that he was being sedated unecessarily at this point (he was not eating and drinking very little) the Doctors decided to reduce the sedation on our suggestion and low and behold my Dad returned to us!!! He had conquered the pneumonia and started to eat and drink and within days was taking steps out of bed. My Dad has been back at home with us for over a month now.............if the sedation had not been reduced would he have starved to death? I am sceptical of this way of treating people but I am also very pleased with the staff at the hospital and for a very underfunded NHS I think my father got the best care he could have done.

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  32. That's a terrible story. I'd be interested to hear more. I very much want to make a documentary about the Liverpool Care Pathway. At its best it can alleviate suffering but at its worst it's euthanasia by the back door. Please contact me if you have any personal stories you'd be willing to share about LCP. We need to investigate and explain this treatment to the public at large. It can and will affect many of us.

    Traction Man

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    1. Hi, I have a terrible story regarding the lcp we were cheated and so was our poor grandma (nanna)who lost her life, due to this barbaric procedure. We were not informed she had been placed on the lcp until it was well under way, and they did not discuss what it was either. It was done in a very sneaky way. The lcp was mensioned in a passing comment, that is how I now know what it is. It is now too late, to save her. The hospital withdrew all life saving medication fluids, and food. Nanna could eat, drink and swallow previous to the commencement of the lcp. a couple of days earlier nana said 'I have out stayed my welcome in here'. Nan was linked up to a syringe driver of morphine, which placed her in a comatozed state. and could not speak, or see us. Hospital staff did not inform us at all. I arrived at the hospital for visiting, and was shocked at what i saw. they then told us she could be dead in a couple of ours, after i went to find someone to find out what was going on. They did not even telephone us, to let us know. She could have died alone. Nana was diagnosed with many nasties and none of them were conclusive, as full tests were never carried out.
      They told us they were
      'keeping her comfortable' Nanna was murdered by the nhs. I would be happy to share my experience with you, as i believe in the wrong hands this a very dangerous scheme. I agree, if the pathway was used for terminally ill patients in pain this is a good thing. However, our story is completely different. We all need the lcp monitored closely, and only used in the correct situations. These are our loved ones. This is our future, we will all be old one day, which is a scray thought? that we may find ourselves in the same situation.

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    2. Hi there,

      Thank you for raising awareness of the LCP. I am also horrified at the use of this pathway.

      My nana went into hospital with a suspected gall stone. Although she was 92, she was in good general health and lived in her own home independently. We were surprised to get a phone call telling us she has 24 hours to live as her kidneys were failing. The next day we were told my nana agreed she didn't want any invasive treatment and we got a leaflet explaining what to expect when someone dies.

      She perked up after two days and was eating, talking and drinking saying she was glad to be alive. We asked the doctors to reassess but they said she wasn't producing much fluid so this was just an expected rallying.

      My nana lasted 18 days on this pathway and her final week was horrific for my family to watch. She looked emaciated with black blisters on her tongue that looked so painful. I realise she was an old lady but I don't think she knew what she was agreeing to and she certainly did not deserve to die in this way.

      If she was so poorly, why did she last 18 days without any treatment? Or did she die from dehydrating to death?

      Best of luck with your investigations.

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  33. My 81-year-old mother went to A&E following a fall last year - it was relatively minor. On the way there she was in good spirits entertaining the ambulance men and accompanied by her carer who lived opposite. They thought she would be home in a couple of hours. The carer went home on the bus. My mother then fell from a raised bed onto her head. She was admitted to MAU where she fell again. No-one in the family was told of the falls. My brother visited but was led to believe her injuries were from the fall at home. Three days later her carer visited my mother now on a ward and could not believe what she saw. My mother looked as if she had been in a fight with Mike Tyson. The carer asked staff what had happened and they said the injuries were from her accident at home. Her carer was disturbed by this as she knew it was not true. She alerted me and I spent the next six weeks trying to get the hospital to acknowledge what had happened. Critically my mother's mental status had changed - she was bed-ridden, slurring her words but had moments of normal alertness and lucidity. Her notes mention confusional state which is delirium - a condition often confused with dementia. It is a treatable condition and should be acted upon as an emergency. Her condition was not addressed and she was discharged five weeks later with a diagnosis of dehydration. She was no longer able to care for herself and a care home was thought to be the best temporary option. I informed the nurse at the home about the falls and asked for a second brain scan - I had been told the first taken in the hospital showed only age related changes but I understand damage and bleeds can show up later. She fell again and ended up back in the hospital this time she was placed on an MRSA isolation ward. Still no diagnosis and no care plan - one night she had an "event". IV's were put in place but stopped the following morning because of a "suspected overload". The following day I phoned every few hours to find out when she would be given food and fluids and I was told she was too drowsy to accept any. I asked when an IV drip would be put in place but was told they might do that in a few days. It only takes a few days for an elderly person to die of dehydration. There was no discussion with family and no diagnosis of her condition other than they suspected Cerebal Vascular disease. The following day I phoned again and the same excuses were made - none of the family were there with her and I was hundreds of miles a way. I caught a flight and found my mother curled up in a foetal position - eventually I realised she was just being ignored and not actually dying and started to give her water on a teaspoon. It was clear she was thirsty and wanted to drink. She was able to drink if it was given to her and eat as well. Her insulin had also been stopped. I couldn't believe this was happening - especially as once she had fluids she was able to converse. I spoke to the doctor on the ward the following day. There are never any Consultants around and most of the doctors attending the elderly are FY1s. Excuses were made but what they intended was clear. IVs were re-instated and insulin. A solicitor's letter followed and the consultant claimed that "no end of life care plan was in place". My mother began to improve and become more alert but she developed an infection. We believed she was being given antibiotics and the necessary care to fight the infection. We did not know that sepsis was indicated and the consultant had written in the notes that there was no point in treating a potential sepsis and not to escalate my mother's care. She died five days later. In the last few days the consultant had claimed my mother had progressive Vascular Dementia but there had been no sign of that in February three months earlier. It's nine months since my mother's death and the questions surrounding the failure to provide food and fluids or the decision not to treat sepsis leading to her death have still not been answered

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  34. The Liverpool Care Pathway is a death sentence. Take your loved one out of hospital if they want to put them on it as it is a sure killer and not the painless pathway they claim.

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  35. the only people who say the liverpool so called care pathway is the right option are them who use it, i think thats because of guilt, very few agree with the back door murder, a hell of a lot say its a very nasty way to treat a patient by starving, dehydrating, and finally syringe morphined to death, no one can explain it different, its disgusting.

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  36. the more i read of all the complaints of the pathway it points straight to one thing saving money for the hospitals, they cannot be taking lives early for nothing else, it all sounds good, with the nice, pallative care, gold standards, not forgetting they help you with the religion, even free parking to soft soap you with, also a meal the patient can not eat, because they are sedated to the eyeballs.

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  37. hi, traction man you are without a doubt correct about this being, euthanasia from most of the relatives letters written, it is without question murder to save the nhs money and bed blocking, this liverpool death pathway is a crime against patients, to whitewash it they mention, dignity, gold standards, exellence,palative care,macmilan nurses plus free hospital parking its all whitewash when they have done the dirty work, they will get you the priest or the vicer, and help you with the funeral,big deal for the barbaric treatment.

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    1. Hi, we were offered no preist, my granma's religion was taken into consideration. They just linked her up to the syringe driver of morphine and left her there to die. No oral care or nothing. No drink no food, no meds. They did not tell us she was on the path way. we had to find this out the hard way, when it was too late.
      Its obvious they are killing off the elderly. or why be so sneaky. We need awareness. unnecessary lives are wasted this way every day. I am going to the hospital soon to meet these people that dicided the fate of my granma. Evil murderers in my book, they were very sly. In some hospitals It's similar to munchausens by proxy on a mass scale.

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  38. i can only say one thing about the liverpool care pathway is that it should be put to sleep forever.

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  39. Outraged by the LCP!13 June 2012 at 18:44

    http://theneedleblog.wordpress.com/2012/05/20/the-liverpool-care-pathway-the-dirty-secret-of-the-nhs/
    Please read the above, there are so many stories online about this abhorrent practice!
    My Father was placed on this so called *care* pathway of death and was crying out for fluids after the third day. I know of other stories of friends and relatives who have been placed on this money saving NHS device. It is purely designed to save the NHS costs and return their beds quicker. Morphine does NOT compensate for dehydration which is a hideous painful death. The NHS Consultants and nurses should be ashamed of themselves by following this disgusting directive and implementing this in their wards, there is NO care here. I actually have heard of a particular Doctor who feels so strongly about the LCP that he will not commit his patients to the LCP!
    It is nothing more than legal torture of our beloved families and friends, and I hope in the very near future is is finally killed off itself!

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  40. to outraged by the LCP, one of the reasons it wont be killed off, because those implementing this hitler regime, are on private health themselves they know it will not be used on them, ministers dont wait in casualties for hours at a time, straight to the front of the waiting list, its all paid for by expenses they need to save money for all their perks so they kill them off quickly to save money, the LCP will go down in the history books as a horror scam.

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  41. it seems as though only the poor and frail pensioners go on the quick pathway to death early, i have never heard of a rich person executed on the pathway or famous they buy themselves out of it, by the bupa doctors, david cameron come from behind closed doors, lets have a debate on this british barbarism its a disgrace to mankind and should be terminated not the patients.

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  42. My dad died 4 months ago after around 30 hours on the LCP in a hospice, and I find myself tortured by guilt. He had been heavily sedated for several days beforehand, and had not been given meals due to sleepiness. We brought in snacks, and he was eating them whenever he woke up while we were there, and during the night. After several days of this we were informed he had been put on the LCP and he died the next day. I find it difficult to bear my dad's death now - knowing more about the LCP than I did then (at a very difficult time in my life when I didn't have the opportunity to research it) - and am driving myself mad wondering if this was the best option for my dad. I know that once he was on the LCP he was so sedated that he couldn't have drunk or eaten anything, but the night before they put him on it he was still able to swallow and enjoyed a drink while we were there. They never explained how they knew he needed to be put on the LCP the next day, and we were too upset to question it at the time. This cannot be the gold standard of care of the terminally ill - can it?

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    1. These comments are heartbreaking. I'm working to bring this whole matter to wider attention. It has been aired recently in the Mail and Telegraph but more needs to be done. Much stricter guidance and informed consent from patients' families is vital. Please keep posting your experiences as I am very interested to read and hear what you have to say.

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  43. I suspect my father was put onto LCP. He had a very rare form of skin cancer, 21 consultants were present at his hospital appointment! I will not go into full details but 8.5 hrs operation to remove tissue from his scalp and ear. I was told that his operation had damaged nerves in his throat and that he could not eat or drink. 1 month later he passed away. How can I find out if he ws put onto LCP?

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  44. Three of my elderly family members died in ways I think unacceptable. My grandfather slowly choked on meds because we had been forbidden to give him anything to drink. My two grand-aunts died of hunger. One because no-one took the time to ask what she could eat. The other because she was on a pathway. It is murder. We need a European Directive to prohibit this practice.

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  45. First I am sorry for all your loss, and special that they were your wonderful parents! ....For my understanding everything what is going on in your country is happening even here in America with several people, with variety ages, and not only 70 over!I am giving my self as a good example! I am a teacher in America's schools, and everyday I saw my students that are having constatly health problems, and their doctors are not helping them at all!Very sad but this is the reality! ....Now lets tell you about my story of the may 2012 that in fact is a result of sevearal problems unsolved from all the doctors since Jun 2011. ...On dec 2009, I let a cosmetick doctor to ground my all upper 14 teeth and kept them for 17 months under the ill fit temporary, and as a result of that bacteria developed there, and of course all my drink and food got there and as a result of that created a big health problem not only for my all upper teeth but for my all body , and since than I have been so sick and of course none of the doctors knows what is going on, even though I told them that I got a big infection asa result of unneccessary work in my mouth done from this bad cosmetic butcher doctor, and of course we gave him 27k, for just to grind my all teeth, and now noone is able to fix them but some of them have to be removed. I went to several doctors and none of them comes with a diagnose, but one of them wanted to give a preventive therapy with 2 antibiotics, but since I have been suffering for so long since dec 2009, special 2010, and , 2011, and special the strong hit was on may 25, 2012.So , naw as you see I have been suffering from a long time with two mayor bacteria coccus and bacillis , that none of the doctors wanted to write it down but thanks to my persisted nature, I got the test of sputum results on agust 2012 which was order from a very nice lung doctor, and he gave me prevenyive therapy, but I I have the knowledge and the experience of the other people, and the goverment health care web page, that tell to the doctors " DO NOT GIVE THE PREVENTIVE THERAPY TO THE PATIENT WITH THESE BACTERIA(LIKE A tb bacteria) if the person have avtive TB" ....for my understanding if the person have all the symptoms of active TB, this is the fact that the person have the TB DISEASE..."
    But because I told all these doctors that alkl the symptoms showed up after the cosmetic doctor touched all my teeth and he did sevral retreat root canal even though was not his speciality!He also keeept my teeth for 17 months under the not proper fit thre temporary bridges( it was long time to keep strong healthy teeth under these ill vise bridges and not even cemented, but strong interlock that only the dentis could removed them from my mouth. So I got TB, and none of them is telling me the strand and none of them is coming with the strong intensive therapy with 4 antibiotics for a long period at least minimum 12-16 months, because as I see now from my blood test that bacteria had penetrated into my bone marrow, and is going to be very hard to kill it deep into my bones.
    My platelet had drp dramatically, and all my blood parameters are going wild! I am sure thyat the cancer doctor will come with her answeer blameng my gene,or with something else and never blaming the cosmetic doctor that did not prevent the infections of my all 13 teeth and the gums, and my mouth that was being sore as results of this buthcher constatly huting my healthy tisues to the point top be so sick and infected that it penetrated into the pulp of each tooth, and infected my stem cell, and after that my whole blood stream got these strong BACTERIA that it is very hard to kill them even with the most strongest antiobiotis.Even though I am not70, 80, 90, b

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  46. AND AS you see you can take me as a bad example that the doctors let me to walk like a DEAD person with BAD PNEUMONIA around the people, and also the hospital told that I can go in the Work even though I really have VERY ACTIVE TB, but seems it politically wrong to admit that I got the bacteria in their health department offices as a result of the dentist neglects, and i would say careless. They also are keeping their own people in the dark related to how many people have TB in particularly in our area, and also they lie to people and also with documents, they do not write our words related to our pain going to them and our symptoms, and what we feel in our body, and the real reason of us looking for help to them!! ):
    BASICALLY , DO NOT TRUST THEM AND TRY TO FIND A PRIVATE DOCTOR WITH MONEY AND TO COME AND VISIT YOUR FAMILY MEMBER AT HOME, BECAUSE HOSPITALS ARE NOT GOOD AT ALL.
    HERE IN FLORIDA THEY EVEN CLOSE THE SANATORIUM BECAUSE THEY DO NOT HAVE MONEY TO KEEP IT, AND THEY EXCUSE THEM SELF THAT HERE IN FLORIDA IS NO TB, ALL ARE CLEAN!!!!!!!!!!!!!!!
    REALLY EVERY ONE MAY PASS PNEUMONIA BUT THE DOCTOR TELL YOU AND WRITE IN THE DOCUMENTS , ALLERGY, ACUTE BRONCHITIS, ....BLA BLA...AND PEOPLE GET PARTIL MEDICATION, AND AFTER THAT BACTERIA GET STRONGER AND STRONGER AND STRONGER,....UNTIL ONE DAY YOU WALK WITH CANE, AND LATER YOU WILL BE ON THE CHAIR, AND LATER ON THE BAD, AND LATER ON THE DIRT!!!!!!!!!!!!
    BIG IRONY FOR 21 CENTURY HEALTH CARE FOR ALL OF US! GOOD LUCK TO YOU ALL , AND IF THE DOCTORS ARE GOING TO HELP ME TO SURVIVE AT LEAST 3-5 MORE YEARS I WILL BE ABLE survive from ALL OF Their SCRUTINY, HYPOCRISY THAT HELPS ONLY THE BIG CORPORATION OF THE MEDICINE, AND ANTIBIOTICS THAT ARE MAKING TRILLIONS FROM ALL THESE INSURANCE COMPANIES! SAD BUT IT is ALL THE TRUTH, AND EVEN THE FAMOUS ACTOR SUPER MAN STEVE RIVES ON his given INTERVIEW BEFORE HE DIED THAT "I AM DYING AS A RESULTS OF THE POLITICS GAME OF ALL THESE ANTIBIOTICS CORPORATION"....." THEY ARE EXPERIMENTING ANTIBIOTICS AFTER ANTIBIOTICS IN MY BODY AND WITHOUT RESULTS WHEN OUT THERE IS ANOTHER EASY WAY TO SOLVE THE PROBLEM".....AND ALSO HIS WIFE DIED AS RESULT OF THESE CRAZYYYYYYYYYYY BACTERIA, THAT CREATE PNEUMONIA!!!!!!!!!!!!!! YEEEEEEEEEE

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  47. DO NOT EVER FORGET THAT IS ALWAYS A CAUSE AND EFECT, WHICH IN THE HEALTH CASE IT VARIETY OF BACTERIA AND VIRUSES THAT CAUSE THE PNEUMONIA, AND OTHER PROBLEMS IN OUR BODY LIKE TUBERCLE BACILLUS, A TERRIBLE BACTERIA, THAT CAUSE THE "WHITE PLAGUE" WHERE THE WHITE CELLS ARE DIMINISHING WAY FROM THESE STRONG BACTERIA,...... .....PLEASE THERE IS A VERY STRONG ANSWER FOR CURING THE PNEUMONIA, THE LIVER, THE LUNGS, OVARY, THE THYROID GLANDS( WITH IODINE ISOTOPE 131, OR OTHER IODINE, PLUS VARIETY POTASSIUM, WHITE CURRANT, AND OTHER AND OTHER NATURAL SOLUTIONS) PROSTATE GLANDS, PITUITARY GLANDS ( THE HEAD OF ALL THE GLANDS), AND OTHERS AND OTHERS AND OTHERS PROBLEMS COMING AS A RESULT WHEN THESE DEADLY MICROORGANISM INVADE OUR BODY AND THEY REALLY KILL IT SLOW OR FAST DEPEND ON SEVERAL FACTORS THAT EACH OF US KNOW. LIKE PER EXAMPLE: WHEN THEY GOT IN, WHERE THEY GOT FIRST INTO OUR BODY( LEG, MOUTH, BRAIN, ARM, SHOULDER, STOMACH, EYES, teeethhhhhhhhhhhhh( TERRIBLE PLACE TO GET BACTERIA IN BECAUSE THE WHOLE BODY IS KILLED)....AND FOR HOW LONG the bacteria was IN YOUR BODY, AND WHAT THERAPY YOU HAVE GOTTEN, AND HOW MUCH THE DOCTORS ARE WORKING FOR HEALLING YOU, ARE THEY REALLY HELPING OR DRAGINGGGGGGGGGGGGGG! LIKE ALWAYS!
    SO , TRUST YOUR SELF, COMMUNICATE WITH PEOPLE, AND DO NOT TRUST DOCTORS THAT WORK WITH INSURANCE BUT LOOK FOR DOCTORS THAT THEY DO NOT CARE FOR PROFIT! THERE ARE SOME REAL GOOD DOCTORS THAT THEY LOST EVEN JOB AS A RESULT OF THEIR PHILOSOPHY TO HEALTH THE PATIENT WITH THE NATURE WAY!
    GOOD LUCK TO ALL OF YOU , AND HOPING THAT ONE DAY SOME NICE PERSON WITH THE HELP OF the GOD WILL FIND THE REAL SOLUTION OF ALL THESE BAD SICKNESS AN DISEASES, THAT THEY NOT ONLY KILL ALL OF US BUT ALSO THEY AGE US IN VERY BAD WAY.

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  48. Its such as you learn my thoughts! You seem to grasp so much approximately this, such as you wrote the ebook in it or something. I think that you simply can do with some% to force the massage house a bit, however other than that this is magnificent blog. An excellent read. I will certainly be back
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