We are failing our vulnerable elderly (26 May 2011)

The big news today was, of course, the detainment of wanted war criminal Ratko Mladic in Serbia but lurking behind that in home news there have been various news items highlighting the poor care our vulnerable elderly have been receiving in this country.

In England the Care Quality Commission (CQC) reported that three hospitals in particular had failed to meet legal requirements regarding the nutritional requirements and the dignity of elderly patients in their care.  

The CQC found in their inspections that patients were reporting that they’d been treated as if they were stupid, literally had food shovelled into their mouths and part of the report notes that some elderly having no say in their treatment and, just as worrying, they were not asked for consent before treatment was administered.  This is a total and utter lack of respect for our elderly population.

In Scotland, an Edinburgh care home, Elsie Inglis, found itself under police investigation following the death of 59-year old resident from the home who had been admitted to hospital with breathing difficulties died.

Elsie Inglis was inspected by Scottish Care and Social Work Improvement Scotland (SCSWIS) on April 20 2011 and the results were pretty horrific.  Over all the home failed badly and now many of the residents have moved out to other care homes.  Again nutrition was a failing with people requiring highly calorific diets not receiving them.  I’ve read highlights from the report in the media and today I also read the report.  

The following, which you made have read parts of in the media, is directly from the inspection report:

“There were examples of one person being given a pureed diet when this was not needed. There were several instances of people eating stew, casserole and mashed potatoes with their fingers. There was no finger foods offered to them. One person was seen using a deep bowl for the main course. This was cracked and chipped and not fit for use despite some plate guards being available for use.  Inspectors did not see any adapted cutlery or crockery in the home despite the likelihood that some people may have benefited from these.”

It’s only one part of the pretty damning report but highlights that people were having both their dignity and their nutritional needs completely ignored.

Is this really how we treat elderly people in this country?

It’s not over yet.  I read today the entire report called ‘Starved of care‘ which is a detailed report of the investigation made by the Mental Welfare Commission for Scotland into the treatment of an elderly patient at a Scottish hospital.  The elderly woman, known only as Mrs V, suffered from dementia and was shunted from pillar to post and was subjected to distress by watching other patients eating meals while she herself was nil by mouth.  Mrs V could not understand why she wasn’t allowed to eat.

Reading ‘Starved of care’ it’s obvious that Mrs V could have been cared for so much better by the hospital and many staff acknowledge that.  However, the fact that she was treated the way she was at the time, when more could have been done, is something that needs to be addressed.  

In dealing with her distress staff at the hospital administered 95 doses of sedatives in 16 days.  The were broken down into the following:

  • 13 intramuscular injections of chlorpromazine;
  • 16 intramuscular injections of lorazepam;
  • 57 administrations of rectal diazepam
  • Latterly, 9 administrations of oral chlorpromazine.

I am particularly saddened by the case of Mrs V because if only a small amount of communication and thought had been used then the outcome for this lady would have been entirely different.
The biggest part of my job is working with the elderly and I am very aware of the great work that goes on in the care of the elderly but, as usual, it’s the horrific care that’s highlighted most and in these cases it should be.  Elderly people, particularly those with dementia, are some of the most vulnerable people in our society and we MUST push forward and bring the care up to a much higher level than it currently is.  Why should elderly people suffer indignity? Why should their nutritional needs suffer because staff are not trained enough to know about their needs, or care enough?

There is no need for it – it must change.

Update: Elsie Inglis care home has now closed following its failure to meet SCSWIS requirements.  The owners revoked their own licence and closed the care home down.