The Shipman Effect

[rynner2]

Sad, sad, sad...

'Shipman effect' harms pain care
By Kristine Pommert

John, a widower whose alert brown eyes belie his 80 years, is choking back tears as he looks at a photograph of a pretty, slim woman in a blue suit, taken in the 1970s.

This is his wife, who died of lung cancer two years ago.

"My wife suffered in the last stages extreme pain," John recalls. "And when she asked to be relieved of it, we were told that she couldn't be given any more pain relief if it might hasten her death."

John's wife spent her final weeks at a nursing home, treated by a local GP.

"It was quite pitiful. She was so distressed. She said that she'd asked them several times to give her more medication, and they declined.

"And she said, 'they wouldn't treat an animal like this.' That will stay with me for the rest of my life."

John believes that the main reason why his wife was refused sufficient pain relief is what's become known as the Shipman effect.

Britain's worst serial killer, Greater Manchester GP Harold Shipman, murdered elderly patients with opioid drugs which are normally used legitimately to alleviate pain at the end of life.

As a result, some doctors are now reluctant to prescribe them. They fear that if a patient dies of an accidental overdose, they may be branded the new Shipman.

Central London GP Dr Laurence Gerlis has radically changed the way he works as a result of Shipman.

He no longer makes home visits. And he no longer carries or prescribes narcotics, such as diamorphine.

This means he can no longer treat patients who require such drugs, such as people with terminal cancer or acute heart attacks.

"It's about risk management," he says. "I want to be above suspicion in every possible way. Which means giving a poorer service to my patients, but taking myself out of harm's way."

Regulation fears

But not everyone agrees that the Shipman effect is an issue.

The Royal College of General Practitioners believes that only a small minority of doctors have changed their practice as a result of the Shipman case.

Other experts argue that given the right training and careful record keeping, doctors should have nothing to fear.

Yet in a snapshot survey by the Small Practices Association, a quarter of the 200 members who responded said that they are now more nervous about prescribing narcotic drugs.

One in three no longer carry them in their medical bags.

One in three also fear that increasing regulation of the use and movement or narcotics - introduced in response to the Shipman Inquiry - will hinder their ability to treat terminally ill patients adequately.

New proposals unveiled last month by England's Chief Medical Officer mean that doctors will also have to prove their fitness to practise every five years.

Some believe this will cause further insecurity among the medical profession, as might any court case against a doctor who has hastened a patient's death through incompetence rather than malicious intent.

'A travesty'

Any such case could be "a disaster for palliative medicine", warns Professor Karol Sikora, one of the country's leading cancer experts.

"It would mean that before any strong analgesic would be given in hospitals, in a hospice, in the community, people would think twice, because they could be accused of exactly the same thing."

After Shipman, patient safety has become a primary concern.

Yet it could mean that others like John may go through the agony of watching a loved one die in avoidable pain.

"It's a travesty," he says, "that so many people think everything's fine with our palliative care system."

The Shipman Effect is on BBC Radio 4 at 2000 BST on Tuesday August 8.

http://news.bbc.co.uk/1/hi/health/5252902.stm

 

[escargot]

There is a whole field of medical ethics devoted to terminal care and the death process. Indeed, the concept of death as a 'process' rather than as an event has enormous implications for everyone involved.

One problem is that as doctors no longer feel trusted to get the balance right between relieving pain and hastening death in terminally-ill patients, they under-prescribe. Patients may then die in terrible pain, watched by helpless relatives. Very sad indeed.

It comes down to the 'double effect'. Doctors have traditionally been trusted to manage this for themselves, but now they're not.
There are several reasons for this, most not involving Shipman.

 

[_Lizard23_]

I woke up to this on Radio 4 this morning.

Without going off onto one of my tedious over-regulation / anti-PC / litigation culture rants I do wonder if fear of reprisals hasn't increasingly been a factor in care of terminal patients for some time.

Euthenasia has been a hot topic for quite a while and I can see the moral arguments on both sides, as well at the potential for abuse, but my mother relates, for example, that during her childhood in grim and grimy rural Yorkshire, when doctors' visits cost money and most people died (as they were born) at home, it was far from unusual for a doctor to come out of the sick room and ask the relatives to go in and say their goodbyes before he administered what was often a final dose of morphine, or the first of a series which would at least render the patient completely insensible for what little time remained to them, if it didn't actually finish them off itself. Everyone was aware of what was happening. At the doctor's discretion and with the agreement of the family etc, euthenasia has probably in effect been an open secret for most of medical history.
This seems far more appropriate to me than leaving people with only hours, days or weeks left to live in agony as their loved ones watch and wait.

/edit/ after proclaiming that 'no one has the right to decide who lives and who dies' elsewhere on the board recently, I just had a pang of hypocracy after writing this. Nonetheless I support voluntary euthenasia for the terminally ill and those with zero quality of life. Given the choice between one more afternoon of excruciating pain before dying in agony and a nice smacked out drift from this world, I know which I would choose without question, and if I were unable to communicate or carry out that choice myself I would hope that those closest to me, or those professionals to whom my care was entrusted, would have the sense and decency to do it for me.

 

[mindalai]

I've got to say that, in hospital at least, I haven't noticed too much of this going on. Palliative care patients are generally prescribed as much pain-relief as is necessary to keep them comfortable. It's widely accepted by doctors that although this may hasten death it's still necessary for patient care. It's known as the double effect and it's something doctors take very seriously. I've never met a doctor who underprescribed for someone in this situation, and apart from that the doctors are not the only ones involved. There are specialist teams for pain control, including nurses and pharmacists and I've can't think of any terminal patient I have ever seen in hospital that has wanted more painkillers and been refused. Possibly I've just been lucky but it does seem to me that doctors take their responsibility very seriously. It may well be different in the community but even my small amount of experience there has been that terminal care by district nurses is very good and they also take the pain relief seriously.

 

[escargot]

I wonder if - putting aside the very real element of scare-storying that we see here - the 'problem' is the other way around, ie that a few doctors are not daring to exercise the double effect for fear of reprisal?

If that were the case, then a little re-training would help, for sure.

Doctors have a lot of both responsibility and power, especially where patients are at their most vulnerable. Ironically, Shipman most often attacked patients who were not particularly vulnerable. Seems unfair if all doctors fall under suspicion becasue of him!

 

[TheQuixote]

I've can't think of any terminal patient I have ever seen in hospital that has wanted more painkillers and been refused.

Ummm... I have, last year to be exact.

I ended up staying with my father 24/7 when we were told that he only had a few days to live, only coming home for a quick change of clothes or to catch a few hours kip. Towards the end, I was there constantly.

Everytime I asked for some PRN for him on a night, I encountered sighs and rolling eyes because they would have to call a doctor in from another part of the hospital. That would take another hour and once when one did turn up they asked the staff why they had been called out when they could have administered the medication themselves.

Other times we would be told to wait until they got to him as "We are busy you know.". Two hours later he would still be without the medication while the staff were sitting at their station eating a 'no solid foods', senile patient's Roses chocolates. What could I do? If I'd kept making a fuss then he would become upset, the staff had us all down as trouble-makers or over anxious relatives.

He was crying out in pain and the PRN wasn't even working and I'll be honest, this isn't swayed by the fact it was my father, but he was treated like a piece of crap by the staff on the ward as were the other men in his bay. The way he was spoken to, the way they would leave his food out of reach and then remove it saying, "Oh you're not hungry today then??" if no one was around to feed him.

He had numerous heart attacks whilst he was there and we were told quite sternly by a ward sister that it was due to him not keeping his oxygen line in place - he kept pulling it out.

He hadn't even been on an oxygen line when he first entered the ward and certainly didn't have one at the time of the first heart attack and even after!! The fact was, he couldn't physically move his hands to pull the damn thing out. When we pointed this out the staff tried to backpeddle but thankfully we were able to take action against them for it. The patients advocate service (for what little they did do) was probably sick of us calling them.

I regularly discovered medication on his side table that he should have been adminstered that they had 'forgot', his pain relief... and I once witnessed a member of staff shout at my father for not moving his legs for her. He had MND and believe me, it took me all my time to speak quietly to inform her that he physically couldn't move his legs, he was unable to move fullstop, perhaps she would like to doublecheck his records. My father even said, "If I could my love, I would..." and she replied with, "You're not even bothering!" and gave a rant to him about her back and how it was lazy patients who had caused her bad back. :shock:

She was piece of work and before anyone asks, yes we had numerous formal complaints upheld.

This isn't indicative of all the medical staff we encountered (I was lucky, on his last day one of the staff who I used to work with years previously and also a ward sister were wonderful) or indicative of every hospital but I don't know, I didn't want to ruin anyone's day by coming out with all this... I just wanted to point out that with all the so-called advances in palliative care nowadays, the ill-treatment of terminal patients, especially those over a certain age does still occur cos I've seen it myself in action.

 

[_Lizard23_]

The way he was spoken to, the way they would leave his food out of reach and then remove it saying, "Oh you're not hungry today then??" if no one was around to feed him.

I experienced exactly this first hand in hospital as a child strapped to an orthopedic frame immobilised from the chest down.

More recently my elderly mother, who, already struggling with mobility, has suffered a stroke which has left her registered blind and very weak and frequently confused etc has been admitted to hospital for various emergencies and routine investigations and, being over a certain age and having a brain injury (although still ferociously intelligent and quite coherent) has been put on a ward literally packed with senile and incontinent old women where the standard of care is so atrocious I have had difficulty making people believe me when I tell them.

Patients in that ward are routinely left lying in their own shit for half a day in spite of repeated pleas to be cleaned up and the place is virtually abandoned at night so that on one occasion my mother was awoken by another patient falling out of bed and then screaming and sobbing in a pool of her own piss and blood FOR SIX HOURS with a broken arm while my mother repeatedly pressed the alarm button to no effect whatsoever.

Even while I was visiting, requests for medication and other items (another pillow for example) were completely ignored for hours on end while the staff went back to their huddle in the coffee making area, and even if/when things were brought they were usually just plonked down with no one seeming to bother telling one another, or looking up in notes that my mother is blind and therefore needs things actually handing to her.

I heard a nurse welcoming a visiting doctor to the ward with the words 'welcome to la-la land'. They had a good laugh at that one.

In short they consistedly treated the patients in there as if they were insane whether they were or not and as completely worthless, not even human. They're old and barmy the lot of em, what does it matter? I can only imagine that that attitude doesn't get any better if they are on the brink of death too.

I am not, incidentally, claiming all medical professionals behave like this, I know it's a hard and often grim job, and one I myself could never do and I am sure there are many who really are hard working and sacrifice a great deal to help others and so on as we are so frequently told, but they are not working on ward 21 of the HRI and I'll bet it is not the only place either.

So I am sorry to hear about your experience with your father Quixote.
/edit/ as a general rule I do not tend to discuss this kind of personal information here, but your story really chimed with me and due to my experience with people not believing me about my mother I thought I would share.

 

[escargot]

It's a good job he had a 'pushy' family.

I've seen this from several sides myself.

I once went on duty and walked into a sideroom to see a terminal lung cancer patient who was in such pain, despite a Graseby pump, (which administers the correct dose automatically at set intervals) that he was crawling on his hands and knees up and down the bed. I asked his family if anyone was coming to him and they said yes, we keep ringing and the staff nurse says Dad's 'fine for now'.

I could see that he wasn't so I went off and harrassed the staff nurse myself. He basically told me that as an unqualified care assistant I had no idea what I was talking about and the situation was under control. We had 'words' and he sighed, put down his paperwork and followed me down the ward, where he found that the pump had run out and the poor man was indeed without pain relief.

He rushed off and came back with a syringe, the man had an injection and settled down and I had an apology from the nurse.

I said, I don't need an apology. Just doing my menial job. You need to listen more.

That man was in the greatest agony but his family were docile enough to take the nurse's word that his pain was under control. Took a minion like me to sort it.

This was the only time I ever saw such a scandalous thing, though. So I think it's rare.

 

[TheQuixote]

More recently my elderly mother, who, already struggling with mobility, has suffered a stroke which has left her registered blind and very weak and frequently confused etc has been admitted to hospital for various emergencies and routine investigations and, being over a certain age and having a brain injury (although still ferociously intelligent and quite coherent) has been put on a ward literally packed with senile and incontinent old women where the standard of care is so atrocious I have had difficulty making people believe me when I tell them.

That sounds exactly like the ward my father was shoved on when it became apparent he would be a 'bed blocker' in the coronary care dept..

Lizard_23, I'm really sorry to hear about your mother's experiences. I hate to think and even remember what goes on in the geriatric wards of hospitals. If my father had been younger he would have been on a general ward and I know his treatment would have been more acceptable.

He was the only one who still had all of his mental faculties on his ward. Seriously, even some of the staff would say what a change it was that someone could answer them back. The other patients who were in his bay, well none could speak and those that could were incoherent. There were 'walkers', those who would get out of bed and wander. The one chap who was admitted after my father was violent not only towards staff but patients as well. My dad woke up one night to find this patient pulling his bed clothes off. As the staff had left his emergency call out of his reach, all he could do was shout. He couldn't retaliate.

My dad could still grip and squeeze things so if they left the emergency call in his hand, he could call for help when one of the other patients tumbled out of bed.

Quite regularly we would discover that the nurses/staff had placed the buzzer out of his reach even though he would beg them to leave it in his hand. That and the other stuff I've related is one of the reasons I stayed with him in the end. It seemed they would rather change sodden bedclothes the next morning than assist him with a urine bottle - he was most proud that he hadn't become incontinent due to the MND but rather than help him retain his dignity we were constantly harrassed to get him to agree to a catheter.

Towards the end I was having to go and call the nurses when one of the other patients became distressed or needed assistance. I even helped them with their meals after I'd sorted my dad out and escargot, the most caring and most efficient staff I encountered were the 'menials'. Seriously, sometimes if we weren't there, the ward hostesses would help my father with his drinks even though they weren't supposed to and had a thousand other jobs they should have been doing instead.

It makes me so angry to think of what happened during that time and I do hate, and I mean hate those staff I encountered who couldn't give a shit about the patients they were meant to have been caring for but I can think rationally and like I say, I know it isn't indicative of every single person in the NHS. What was distressing though was my father's initial reaction about being put on this ward, he was devastated and would beg to be taken home but we couldn't, not only did we not have the facilities in place but his doctors told us that they would not discharge him unless it was to a hospice that was over 20 miles away.

My grandmother had been admitted on the very same ward 28 years previously and had been left strapped to her bed, soiled and ill-treated. My family had taken action against the hospital then and it was very apparent that nothing had changed in those years between.


EDIT:

edit/ as a general rule I do not tend to discuss this kind of personal information here, but your story really chimed with me and due to my experience with people not believing me about my mother I thought I would share.

Pretty much the same here, that's how I usually feel. TBH it's still a raw topic with me. I try not to dwell on or remember what happened in the hospital too much so this will be my last post on the subject.

 

[escargot]

When I worked in homes and hospitals I would discreetly urge rellies to 'drop in' on elderly patients as often as possible, especially at mealtimes, to make sure they were being cared for.

I have a lot to say about the criminogenic conditions existing in hospitals but I feel that it would be better to be discreet as there are personal feelings at stake here.

 

[mindalai]

I'm so sorry for all of you that have had such horrific experiences. If it's any consolation at all the vast majority of nurses and healthcare assistants genuinely care about their patients and would not tolerate the sort of situations you describe. Clearly it still happens though. All I can say is keep complaining every single time or it will never change. It doesn't matter about being thought of as being pushy families. The staff might bitch about you in the staff room but I would have thought that with the threat of a complaint over their heads they will pull their socks up a bit. I hope so anyway.

 

[Min Bannister]

Bloody hell. :sob:

Seems that there are problems from both ends of the spectrum, people who are afraid to do anything in case if litigation and those who just don't give a toss one way or the other. Either way, the patients are the ones who suffer (and their families).

 

[escargot]

Yup, so true. Minda's right though - it's better not to let them get away with it. I reckon that bad treatment is rare though.

A nurse is bound by their code of conduct to be a 'the patient's advocate': the nurse is supposed to protect the patient. This is why it's ethically not only permissible but positively necessary for them to whistle-blow when they see harm done.

 

[mindalai]

I also think (and I hope I'm not being wildly optimistic) that this is something that will improve in the near future. My personal experience has been that this kind of thoughtless and disrespectful behaviour generally comes from nurses of the old school who have not been trained recently. I'm by no means saying that all older nurses act like this. That's very obviously untrue. But I do believe that more emphasis is being put on patient advocacy in nurse training now than in the old days. I was a student nurse until less than a year ago and it's a constant theme throughout the training that the patient always comes first and is central to everything that we do. Certainly I don't think anyone I trained with could ever behave like the nurses described above (I hope).

Unfortunately though, elderly care is not a speciality that a lot of newly qualified nurses want to go into and they have relatively low budgets for training etc, so elderly wards often end up employing the people who can't get jobs elsewhere - with fairly unpleasant results for a lot of the patients. Doubly unfortunately the elderly are the most vulnerable group of patients who have most to lose from shoddy nursing. I just hope that the NHS will see sense and start putting more of the budget into elderly care. After all it's a growing area.

 

[powelly67]

I have been qualified as a nurse for just under a year and have been absolutely shocked and appalled by your stories. Thankfully I have never heard about or seen any events that have been described. I would have no hesitation in whistleblowing if I ever saw behaviour such as this. BTW I work on an elderly care ward and it is damned hard work but extremely rewarding even when looking after terminally ill patients. The trust where I work has recently come out top in the country for elderly care. I know it is no comfort for those whose relatives have suffered such cruelty and incompetence but please believe me when I say that we nurses do really care for our patiens often in difficult circumstances.
Re the drug prescribing thing, I and my colleagues get extremely frustrated at the ineffectual amounts of pain relief that sometimes the Docs prescribe. More often than not it is some 25 year old kid just out of medical school who does not realise the extent of the pain that people are in so we have to tell them to give the patients doses that, yes will shorten their life, but will make things as comfortable as possible for them.

 

[Ravenstone]

My Dad was attended by a male student nurse recently. The problem was, my Dad was due for a review by the Sister, or at least a qualified nurse. The night staff had pointed this out to my Mom - they specifically said that a student should not attend because they could not sign off the required check. Or whatever. Whatever the reason, Mom was specifically told that a student nurse could not do what was due to be done that day. So who turns up? A student nurse. Who then took offence when Mom repeated what she'd been told, and who then 'phoned the Sister in charge of him, and told her a completely different story (despite my Mother being in the background and saying "I didn't say that!"). The upshot is, he won't be attending again.

He said he's done three years training and he knew what needs to be done. He said that, although he hadn't yet taken his finals, he knew his job completely. He actually states, quite firmly, loudly and repeatedly, that he knows everything.

My Mom describes him as being 5 foot 2 with a 6 foot 2 ego.

Apparently, he's already got a name for himself with the District Nurses, after he attended a seminar, and told a Sister of several years experience that she didn't know what she was talking about. The Sister was saying that she believed student nurses should spend more time on wards and being supervised, and not sent out unsupervised for home visits. He told her that he'd nearly completed his third year, and was quite satisfied that, as he'd finished training since she had, that he knew more about nursing than she did.

I can see him going far.

I have several stories about nurses. Most of them are not good, unfortunately. But I won't bore anyone with them, and anyway, they contain too much personal information.

 

[OldTimeRadio]

Almost exactly eight years ago I was waiting in a local emergency room bay with a female friend who was awaiting hospital admittance.

The bay directly across the ward from her held a male patient who was absolutely SCREAMING with pain, but with absolutely nothing being done for him. My friend was exceedingly troubled by this. I myself was highly surprised as the hospital in question is nationally-recognized for its top- quality patient care.

I walked out to the nurses' station to express my concern.

"Oh, don't worry about HIM," I was inforned. "You see, he's a SURGEON himself."

 

[rynner2]

My Mom describes him as being 5 foot 2 with a 6 foot 2 ego.

A classic poison dwarf type. Not the sort of person who should have personal care of others. (They're bad enough in other jobs!)

 

[escargot]

Powelly, you remind me of what Dr Rob Buckman says: to paraphrase, 'green young doctors need to be guided by experienced nurses to stop them killing people.'

I have worked, as an untrained minion, in many care/nursing situations and believe that poor care results from poor management of staff. Where management is strong, standards of care are too. As an agency carer I could see this very plainly, as an outsider. You can learn a lot that way.

 

[stu neville]

Exactly what a nurse I live with said - those that trained under frighteningly rigid matrons and sisters invariably make much better nurses. However caricatured the Hattie Jacques type matron may have been, when they were around the NHS ran a whole lot smoother. Unfortunately, as the latter are becoming rarer by the day, as more and more responsibility is shoved onto lower grades, standards aren't going to improve. No detriment to the nurses, as it's not their fault - but they can't provide duty of care and fill out forms about how many biros they'll need next year at the same time. And this is a major reason that so many nurses train then shove off elsewhere - they don't want to end up being an underpaid administrator with occasional patient-duties with no hope of career progression until someone leaves. Pretty soon, the NHS will be crawling with high grade career nurses with nowhere upwards to go and no junior nurses to take their place when they retire or just jack it in out of sheer frustration.

Some, like Mrs N, deliberately took a pay cut by dropping down from Senior or Sister to ordinary E grade Staff Nurse just for job security - a smart move as it transpired, as those grades are being chiselled away bit by bit, in her Trust at least.

Bring back the matrons, and ditch the clipboard-wielding bean-counters. Let the people who know about people in hospitals run said hospitals.

Most administrators know sod all about people. They're Oscar Wilde's comment about cynics ("They know the price of everything and the value of nothing") made life, and given their own designated parking space.

And where do the doctors and nurses and patients park? In the NCP round the corner, for £12 per shift.

Sorry, rant over.

 

[escargot]

:lol: One of the most loathsome people I ever met was a bed manager at the local hospital.

One time, she came onto a ward and demanded to know where the staff had hidden a particular bed - a special one, of which there were only a few in the whole place.

It had probably gone to the next ward, with a patient in, and would be returned the when same shift came back on.

I was only there for the day and knew nothing about it. The ward manager stalked around the ward, asking all the staff individually where the bed was, as if they would crack and confess to melting it down.

She confronted me, and I said politely, sorry, I'm agency, I don't know. Her reply was a loud 'That's the trouble with YOU PEOPLE! You don't CARE!'

I was baffled. Why would anyone go to such trouble to make their own job more difficult? THAT's bad management.

 

[Ravenstone]

Yep. Bring Back Matrons. My Grandparents were nurses, my Grandfather being a senior charge nurse in a psychiatric hospital. My Nan would recount stories of incredibly strict Matrons, whom the staff nevertheless adored.

One thing Matrons used to do, of course, was ensure the ward was thoroughly bleached every week. Walls, floord, ceilings - the whole shebang. My Dad was 'barrier nursed' recently in a room with carpets, curtains and flock wallpaper, from which they'd just watched as the previous occupant was removed in a body bag. Fills you full of confidence, that kind of thing.

 

[zardozzz]

I heard a radio prog today on this subject. The stats are a huge 50% of us are gonna die in hospitals if we get mortally ill these days. Only a lowly 4% of us will be "lucky" enough to get into a hospice for proper palliative care.

I herad terrible scary stories of people ending there days in pain. A few decades ago hospitals used to give out Heroin/coke injection to people in great pain and very effective it was too. In these less enlightened times thats about as likely as us getting free money on the nhs. If one of my family were in similar pain i would feel no shame whatsover in buying opiates on the street, if it meant my relatives going out in the pain free state that these modern times deserve.

 

[mindalai]

People still do frequently get heroin injections for pain, and the only reason they don't use coke any more is because there are more effective drugs available.

 

[OldTimeRadio]

My Mom describes him as being 5 foot 2 with a 6 foot 2 ego.

A classic poison dwarf type. Not the sort of person who should have personal care of others. (They're bad enough in other jobs!)

Isn't this what is known as a "Napoleonic Complex"?

Though I shouldn't criticise - I'm only 5' 7" my own self.

 

[Ravenstone]

My Mom describes him as being 5 foot 2 with a 6 foot 2 ego.

A classic poison dwarf type. Not the sort of person who should have personal care of others. (They're bad enough in other jobs!)

Reminds me of that obnoxious, odious little psychopath in The Green Mile. Not Wild Bill. The prison guard.

I do reckon that people like that exist, in mental health hospitals and prisons. Mind you, I also reckon the other staff would probably 'arrange' for them to suddenly be left alone with one or two of the more violent patients, without any nearby staff to assist.....

Dad's had another operation today. Which is the second operation he's had at this particular hospital, which hasn't been what was explained to him or to do what he was expecting. The last time, he was told the operation was a temporary measure. When he came round, they told him it was permanent and irreversible. Not that I've anything against doctors doing what needs to be done. After all, I reckon they get him on the operating table and realise that maybe they shouldn't be doing what they said they'd be doing, and something else would be a better course of action. And, of course, you don't want them bringing him round and saying, "Actually, we need you to agree to this operation instead because we think it's a better idea". No - it makes sense to do what needs to be done at the time. But still - it's disappointing. We thought he'd be out in a week; now it seems he's going to be in for a very long time.

 

[again6]

Groan. It's depressing and scary, isn't it? And no different in Australia. The tv current affairs shows here regularly air an 'expose' of conditions in city and rural hospitals, with members of the public claiming doctors have advised them to remove family members from this or that hospital because of the apalling conditions, such as blocked drains, antiquated bathrooms and kitchens. One man (one of many to complain about a well-respected city hospital) reported that he'd had to remain by his son's bedside night and day, because huge cockroaches would have crawled all over the son's body -- and face ! -- if a family member weren't there to flick them away.

A gorgeous little old man starred in a current affairs programme not long ago, in which it was revealed that the administrator of a relatively up-market aged persons' home regularly instructed staff to serve literally rotten food to the elderly residents, many of whom were suffering some degree of dementia. The little old man wasn't suffering dementia; in fact he was very astute and had managed to buy and operate some quite sophisticated equipment in order to record what was going on around him.

He said the administrator had withheld toilet paper and detergent from his bathroom for over two years (1) as 'punishment' for complaining and for contacting local members of parliament and the media. The old man had a thick file of all the letters he'd written. Those in a position to rectify the situation and who are paid to do so, had ignored it, until the media became involved. Then there was a scurry to get in front of the camera with claims of 'full investigation'.

The tv programme contained film shot by the old man, showing crippled and feeble old folk being bossed around and bullied like cattle. Ex-kitchen staff appeared on the programme and said they'd been forced by the manager to serve food so rotten it had initially been thrown by staff into the garbage bins in the yard. The manager had forced staff to retrieve the rotten food, cook and serve it. This had resulted on several occasions in a large number of food-poisoning cases amongst the elderly, at least one of which was so severe, an already sick old woman died.

The external of the nursing home was lovely; gorgeous well-maintained gardens and driveways with plenty of seating areas for the old folk. The public areas were also immaculate, because this is where families came to spend a few hours with their elderly parents. But the out-of-sight areas were something else again.

The nursing home was run by one of the churches. It was quite expensive for residents, but families believed they were providing the 'best'. From memory, the residents had to pay a substantial sum up-front, and the weekly tarrif excluded all but those with private funds.

The place was not supposed to make a profit, according to the official spokesman on the tv programme. All profit was supposed to be spent on residents and maintenance. However, the tv programme's investigations revealed that in the past 12 months, the loathed manager had extracted a profit of over $300,00, by recyling rotten food, short changing residents and their families by withholding medications and essentials, etc. And this was one of the better 'showplace' elderly peoples' homes ! At others, there are, according to witnesses on tv shows, beatings and other physical abuse for the most trivial 'offences' committed by old folk no longer able to protect themselves.

It all sounds grim. Hope I have the courage to leap off a cliff or something when the time comes and while I still have the wit and strength to do it.

 

[Nemo]

(Proberly not the right place for this?)


http://news.bbc.co.uk/1/hi/health/5281724.stm

'Nobody would help my father'

Bert Webster's problems were far from over when he was admitted to hospital with a lung infection, following a fall at home.
Bert weighed just 44.3 kg (seven stone) when he was admitted to hospital in north London in October 2005.

But during his three month stay the 77-year-old lost another 2kg from his spare frame.

(C) BBC ' 06

 

[OldTimeRadio]

....it was revealed that the administrator of a relatively up-market aged persons' home regularly instructed staff to serve literally rotten food to the elderly residents, many of whom were suffering some degree of dementia.... the administrator had withheld toilet paper and detergent from his bathroom for over two years (1) as 'punishment' for complaining and for contacting local members of parliament and the media.

There was a newspaper report from California three or four years back concerning the director of a large nursing home who was questioned by the state health authorities about the truly abysmal care she was giving her Alzheimer's Disease patients.

"Alzheimer's Disease?" she replied. "What's that?"