Elderly care in the NHS has become a national shame
Every now and then, a story comes along that is so stunning in it’s simplicity, yet so revealing of the machinations of our health service, that it takes a while before the full implications of the story becomes clear.
Consider, if you will, the tale of 82-year-old Shelia Smith admitted to Bradford Royal Infirmary hospital with suspected heart problems after collapsing unconscious at her nearby home.
In hospital, Mrs. Smith suffered four falls - very common for elderly patients - and became incontinent. On one occasion she was found ‘flat on her face’ on the floor, having been there for some time, and she was badly bruised.
There were further issues to contend with.
During a conversation with family members and a hospital doctor, it became apparent that the great-grandmother was suffering liver and kidney problems due to lack of food and fluid.
The doctor also, they claimed, warned that Mrs. Smith would be dead within days ‘if something wasn’t done’.
For her daughter, Annette Townend - who has the double-blow of suffering from terminal bowel cancer - this left no alternative but to take matters into her own hands.
So, at a personal cost of £1,000 she employed undercover carers - who pretended to be family and friends - to sit with her mother and ensure that she was eating, drinking and going to toilet on a regular basis.
That Mrs. Smith went on to not only survive her hospital experience but made a recovery to decent health, is surely no coincidence, is it? Of course it’s not!
Earlier this month a damning report by the Care Quality Commission found that one in five hospitals was breaking the law because the nursing care of the elderly was so appalling.
Elderly patients, the report claimed, are frequently neglected by NHS staff. They are left in pain, dehydrated and malnourished.
Is this a misguided and savage attack at our most treasured of institutions? A political assassination of a great public body?
Sadly, I can testify that there is a great deal of truth to the report and, by extension, the woeful tale of Sheila Smith.
Last year I had been pre-booked, at a Gloucestershire hospital, for extensive foot corrective surgery. Following the operation I awoke to find myself on the stroke and trauma ward.
My temperature had rocketed and my blood pressure had plummeted and, as I came around from the anaesthetic, I took stock of my surroundings through my pain and blurred vision.
It was a six-bed, single sex ward and, at 46, I was the youngest patient by decades. The closest in age was a 72-year-old who had fallen at home and suffered a stroke.
On my first night a jovial nurse in her 50s explained how to summon help as she pointed out the call bell at the side of my bed.
'I promise only to press in emergencies,' I reassured her. 'Don’t you worry,' she replied. 'You’ll have our attention anyway. Your youth means we’ll be like bees round a honey pot.'
She winked and I assumed she was kidding to distract me from the raging pain that had taken hold as the painkillers wore off.
Over the next three days I came to realise the truth of her statement. And, it has to be said, I was shocked by what I discovered.
First, to be clear, this particular nurse - as indeed several of her wonderful colleagues - are an absolute asset to the NHS.
She was attentive and sensitive to all her patients - regardless of age - and they clearly adored her. She was firm but fair and she made sure that all of us received the same level of care.
Unfortunately, there were at least three of her nursing colleagues who left a great deal to be desired. It brings me no pleasure to recall them.
During my time on the ward, I witnessed several of the day nurses behave in disturbing ways towards their patients. They delighted in ignoring, then taunting, some of the more needy women on the ward.
Myrtle, the eighty-something in the bed next to me had late-onset dementia.
Fair to say, she was a difficult neighbour. She routinely screamed, pressed the call bell repeatedly, claimed she was being kept there against her will and had angry and violent outbursts.
None of this was her fault. However, this didn’t stop the nurses in question treating her as if she was a pariah. They shot amused winks at each other, walking past her bed as she cried for attention.
Once she was left for over half an hour when she had messed herself and as the nurse cleaned her up, I heard from behind drawn curtains, Myrtle say, 'Ouch, you‘re hurting me.'
The nurse snapped back: 'Stop making a fuss, I’m trying to help you.' There was no apology.
On two mornings, I watched as the same nurses delayed in giving her a bed bath, even though they had assisted the other women who were in less urgent need.
Neither was the treatment of Myrtle in isolation.
In the corner of the ward was 80-year-old Anna. She and her husband had been involved in separate falling accidents and he had been taken to another hospital 20 miles away. Anna, scared and bewildered, was desperate for news.
During my time there, I heard her repeatedly plead with several of the nurses to let her ring the other hospital.
One nurse, in particular, kept promising Anna that this would happen and then she swiftly reneged.
She told Anna: 'It’s not convenient' and 'just concentrate on getting yourself better'.
Never mind that being left to fret about her husband’s condition added to Anna’s anxiety and delayed her healing.
The day nurse appeared to revel in the power she held. It was disconcerting to witness but in my bleary and drug-induced state I felt helpless to intervene.
It was on my second night that I realised my 'youth' gave me priority.
Concerned at my poor recovery, the ward staff decided to move a fractious Myrtle from her bay so that I could rest.
She was wheeled into the corridor where she stayed for the night. From my bed I could hear her asking over and over again, 'Why am I here? Where is everyone?'
No one answered her. It was as if she was invisible.
How profoundly sad to be on the receiving end of that. To know that your age confers you with a type of non-existence. As if you no longer count.
For Myrtle, as for everyone else observing, it was clear that my needs were considered greater than hers.
Neither is the experience of shunting elderly patients into corridors an unusual occurrence as numerous undercover investigations, reviews and the words of caring hospital staff have testified.
The reality is, hospitals are ill-equipped to deal with the elderly who require very specialist care, including help with feeding and drinking.
These issues, for example, resulted in Sheila Smith, developing further health complications because her food and drink was delivered to her but she needed assistance with her feeding and drinking. This was not available.
So is this just a result of staff being over-worked? Not entirely.
Some NHS nurses, and it pains me to admit it, have become so acclimatised to the environment of neglect that it has become, to a worrying degree, the uncaring profession.
Elder care in the NHS is scandalous and has been systematically failed by successive governments. Might it be that so many ministers are able to afford private care that they are not truly in tune with what the rest of us have to endure?
That the coalition have failed, so far, to rectify what is patently clear to the vast majority of citizens is disheartening at least, and down-right alarming at best.
We need to be realistic about appropriate care for the elderly. For the truth is, elderly people fighting illness already have the odds stacked against them. They require specialist care to compensate for their vulnerability, but they are not receiving it.
The additional stress and neglect they experience in hospital reduces their chances of recovery. How can we keep allowing this to happen? It beggars belief.
And that is quite aside from the fact that we allow them to be treated with such indignity.
NHS hospitals were once the cause of great pride for our nation. Rightfully, so.
Today, and specifically with elderly care, they are akin to a lottery. Where the survival rates for elderly patients are a game of chance. And that, whether it directly affects us or not, is something that should shame us all.
