Wednesday, 16 February 2011

Can we sink any lower?

Just when you think the world can’t get any more insane you read another story about the NHS and realise that the lunatics really are running the asylum. Take today’s announcement that hospitals are to start using trespass laws to evict elderly patients whom, in the hospitals’ view, are bed blocking.

Anyone who has ever had to take care of an elderly patient or relative will know that the provision for home care is patchy at best. Sick elderly people who live alone and don't have any close family are not able to take care of themselves. What home care there is available is about to become even rarer than hens' teeth with local councils determined to slash frontline services before reforming their gold-plated pensions and stratospheric salaries. Dave Cameron’s Big Society will have to take up an awful lot of slack to fill the void.

My own experience of care of the elderly in their homes includes a 79-year-old lady being left to nurse her sick husband , including having to change his catheter bag, administer drugs and deal with washing the bed linen once a day and changing bed sheets with her husband still in the bed. There was an offer of some care workers to pop in on a daily basis, but these individuals were pathetic excuses for help. They often arrived late, spent most of their time texting friends on their mobile phones and refused to do anything that involved lifting the patient or cleaning him up. Frankly, I don’t know what the point of sending them round was.

The same lady needed help herself last year. Her husband had died and now she needed nursing. The same useless bunch of poorly educated young girls turned up with one aim in mind: to get their time sheet signed – complete with falsified arrival times – and then to push off to the next ‘client’. All they did was microwave the old lady’s dinner and make her a cup of tea. In the meantime, she was left to sit in a chair that was soaked in urine.

And now our hospitals want to use the law to throw out people who need nursing and send them back to their homes in the care of useless carers, which, incidentally, the elderly must pay for. The number of spaces in council run homes or funding for places in private care homes has reduced dramatically so what's to become of these vulnerable people?

Is the NHS really proposing that we throw out elderly patients and let them fend for themselves? Because that’s what these proposals will mean in practice. Once again, words fail me that we can be such a barbaric and uncaring society that we can't even manage to feed, bathe and care for the elderly and give them a little bit of dignity.


  1. These people have not considered that they too may need hospital care as they get older. Would they themselves like to be treated in this way or would they be happy if it was their own relative being treated like this. Changes will only happen when it directly affects them.

  2. It will never affect them, they are for the most part rich enough to pay for care. Its us poor sods, those that work all their lives, pay taxes, save for pensions, who have to sell their homes to pay for (inadequate)care.
    Hope the leg is improving TM, can't wait for the Channel 4 programme.

  3. And let us not forget that these people have worked all their lives, paid taxes, brought up children, yet we treat them as a second class species who have nothing to offer society.
    We as a society are always ready to stand up for the rights of children (as is only proper) but we need to stand up for all our vulnerable , the old, the weak, the disabled and the young.

  4. It's such a hard question. This problem will not be fixed unless we have adequate care in the community for elderly patients. That means good quality nursing home care and good quality, available community in-home care.

    In my (short) working experience on a hospital geriatrics service, elderly patients (and their families) who do not want to be discharged from hospital are NOT being difficult.

    It is true that once they are medically stable there is no reason for them to be in hospital. But most of these patients and their families are at their wits' end struggling to look after an elderly beloved family member with little support and resources. All too often hospital staff see the family or patient as being "difficult" when really they are crying out for much needed help.

  5. What disgusting treatment. But I do have to say, where are their children or ven granchildren? The number of people who dump their parents in hospitals and homes is the real scandal. My own mother is 86. She is still pretty independent but needs quite a bit of help in many ways e.g. she can't get onto a stepladder to change a lightbulb. So I help her. She has too much money to get one penny from the state in spite of having such a low income that she pays no tax. So I help her. She can't even walk round the library to choose a book any more. So I help her. If I didn't she would have to go into a home of some kind and She would be utterly miserable and it would be the end of her. I've always sworn to myself and to her that I would make sure she could stay in her own home as long as possible and I'm lucky enough to be able to do so. But I'm not exactly young myself and I still work full time. So when I think of all the people who stuff their parents into these hellholes I get very angry.

    Keep up the good work. I'm looking forward to the programme next Monday.

    Hope the leg is improving.

  6. I have seen how difficult it can be for a son or daughter to look after an elderly parent who needs nursing at home. My wife struggled to look after her mum and hold down her job. Her mum needed to be visited daily and she would ring us 20 times a day as her Alzheimer's got worse. We tried so hard to cope but in the end she had to go into a council-run home because she couldn't walk any more. She's now getting adequate care and my wife visits three times a week. Some children clearly don't care for their parents but others do have jobs or live at the opposite end of the country. It's tough especially in our increasingly mobile society. I think things are a bit better in Europe as there's not such a strong tradition of kids leaving home to go away to university and then settle down in other parts of the country.

  7. It was reported in one of the tabloids many months ago , that the government want more relatives to look after the elderly relatives at home , they even give you 50 grand to build a granny flat extention, cheap in the long run for them as it saves nursing fees in a home, and they plan to shut down a majority of nursing homes across the UK.


  8. We're having the same issues here in Canada...a shortage of extended care beds. These are people who are too medically needy to be in their own home or need 24 access to nursing care but aren't ill or medically needy to need the acute care hospital. Then there is the need for personal care attendants, licenced practical nurses (those two pretty much are the staff of nursing homes) and Registered Nurses and doctors that will attend to nursing homes.

    It all costs money doesn't it? And front line workers are the first to go.

  9. One of the problems is that Social Services are increasingly dragging their heels over providing care packages for elderly patients.
    Social services will argue that, while the patient is taking up a hospital bed, they are in a 'place of safety' so not a high priority.
    The problem with this is that hospital beds are being taken up by people who have no clinical need for them, depriving others of treatment.
    If the hospitals can, effectively, evict these patients then they suddenly become a higher priority for Social Services to deal with and should get their care packages sorted out quicker.

    At least that is the theory.

    At the end of the day, the NHS cannot provide even a remotely acceptable level of care to sick people if beds are filling up with elderly patients with no pressing clinical needs.
    Just for once, I don't think we can completely blame the NHS for this.

    Mind you, it's all about to get much worse.

  10. It comes to something when one branch of the state has to evict a frail and elderly person in order to get another part of the state to carry out its statutory duties. If local councils can't provide sufficient care then they really need to scale back some of their 'aspirational' and non-essential services. We pay a lot of tax and National Insurance in this country and yet our public services say they are always strapped for cash. Where is the money going?

  11. I do feel there is a bit of misinformation here. Social Services are under a great deal of pressure and there are real sanctions for not getting people out of hospital, they can be finedf £100 per day, and a minority of families play the system to keep granny in a free NHs bed as long as possible. It is not unknown for families to announce they are going onm holiday and they will play no part in helping with discharge arrangements. the fact is there is little remedy for hospitals when people take advantage in this way so using tyhe trespass laws may be the only way to get people out of hospital who are denying a bed to others who need it.
    It is not the case that there are plans to close nursing homes, these are all privately run anyway so the government has no power to close them, they function in a market. There is always a battle between councils and the providers over pricing. There is however strong case to say many councils do not pay the full cost of a bed and state funded clients are through no fault of their own subsidised by self funders who not only have paid their taxes, fund the full cost of their own care andpay extra to subsidise state placements. The low prices paid by councils lead to cost cutting by profit making corporations who now own most nursing homes. Staff are badly paid and worked into the ground. Managers are usually on call 24.7 and many become ill with stress.

    I trace the current position, which is worse than it was ten years ago, to the decision under the last government that the system of community hospitals where old people wnet after acute treatment in order to recover, under care of a geriatrcian, with a multidisciplinary team to ehlp them rehabilitate. This was considered 'too expensive' and the push is now on to get people out of acute wards and home often in a huge rush before their needs can be properly assessed.

    The poor quality home care referred to here is unacceptable and would not happen in our area. the council in the area concerned is responsible for monitoring quality under the contracts and cracking the whip.

  12. I'm sorry to hear about the care of the woman and her husband. We have been very lucky to get good day care for my grandmother- however, it has not always been the case. We've had some utterly uncaring 'carers' come in. Little things which have amounted to no consideration.

    To list a few; not feeding my grandmother properly (sandwiches without fillings, she began to lose weight), not emptying her comode, not communicating properly (yet again the mobiles come in here), not loading the dishwasher (my grandmother can barely walk let alone do that) and not washing her (talcum powder was used for a subsitute for months and the whole bathroom was covered in a thick layer) or dressing her properly. As someone who cleans the house, I found many of these so called 'carers' hadn't cleaned up after themselves or made an effort to leave the place in the state they found it. Dirty spoons and messes on the kitchen counter top is one thing but it's another when you are spilling soup, leaving out dirty cans, empty egg shells, dirty pans etc.. My grandmother is lucky to have me to clean the place weekly but what if she were alone? I'd hate to think.

    Luckily the service has improved dramatically and although she is now in hospital (sadly suffering from malnutrition due to that bloody food and the other inconsiderations of a general ward) she had been enjoying home life with their aid. Some of them did a super job. I remember one carer even would cook her food instead of heating her frozen meals. Some would even visit her when they were off duty to have a come of tea and a chat. They brightened her life up and I'm grateful.

    A family can only do so much, we can't be around all the time and that's why it's the aid from carers that make all the difference. If it weren't for them then our Grandmother would have spent the last 2 years unhappy in a nursing home.

    Honestly, I think if people were better paid for their service and trained properly we would see a better standard of work. Some of those carers are stars on minimum wage... some on the other hand could do with some proper training and an evaluation to see whether or not they should even be working with the dependant elderly!

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