Concerned about my dads hospital care

[Caroleanne34]

How do I intervene with this?? My dad was taken into hospital 6 weeks ago able to feed himself with no problems other than his speech had deteriorated. He was taken into hospital because he was becoming aggressive and didn't know who we were.

Well since my dad has been in hospital, he has completely lost the little amount of speech he had, he can longer feed himself, is sleeping on a mattress on a floor with the window open (the room was freezing today but we were told they couldn't shut it!), he has been struggling with balance and walking, the staff have been putting pads on him even though he is not incontinent and now he is struggling to swallow. I can't tell you how angry I am. He has been dressed in other people's clothes, also in hospital pyjamas with a huge hole in the backside exposing his pants, his hair looks matter with grease... My dad is a well groomed man by nature! Where is the dignity in any of this? My dad has been sleeping mainly since Friday. I haven't seen him awake, but staff have advised us he has been eating breakfast. I looked at his teeth today and it is clear they haven't been brushed in several days. He has a dental plate that needs to come out and be cleaned, however he has been so out cold that we haven't been able to wake him.

Any advice on what I can do would be helpful. I know from speaking to a continence nurse specialist last year that you should never put a pad on someone unless they are Incontinent, otherwise you will make them incontinent! we have tried speaking to staff about this and the response is "oh it must have been the night staff" ... Ok so why does he still have one on at 3pm in the afternoon? I'd appreciate any help as I am on the verge of making a huge complaint and just don't know how to approach this or who to speak to for advice

 

[jaymor]

http://www.nhs.uk/chq/pages/1082.aspx?CategoryID=68

Contact PALS, you might find they are within the hospital your Father is in. They are there to offer advice and help you deal with staff on the ward if you feel you are not getting answers. If they are not there you can phone or email them.. The link is above.

Hospitals are not the best places for someone with dementia, not enough staff who understand the needs of patients with dementia. you certainly have causes to be concerned.

 

[Beetroot]

PALS seconded, but I would also start keeping notes of date and times of when you've seen him, what you found, who you spoke to and what was said on the ward. I found notes invaluable when I had to make a formal complaint.

 

[Jessbow]

What sort of hospital is this?

On the basis of what you say, its does sound a bit dire, but presumably there are reasons for some of this happening, however innapropraite it sounds - I guess he isn't on a mattress on the floor in the corner of a general hospital ward, is he?


I don't think putting someone in a pad makes them incontinent, Lazy maybe. Again, there must be a reason for it. Perhaps he is non compliant in using the loo?

It sounds very much that he isn't agreeable to personal care-( you say yourself he was taken in because he was aggressive) Removing his denture to clean it might be quite challenging!


Does he have plentiful supply of his own clothes and Jim Jams, if so, there is no excuse for dressing him in others

Have you asked the staff nurse about any of these things? Before you complain, ask why, and if you feel the answers are unacceptable, then complain.

His mattress on the floor concerns me most- have you asked why? is the answer acceptable to you?

 

[Rodelinda]

Agree with previous comments. If he has a dementia diagnosis, or it is suspected, is it worth checking whether there is a dementia team in the hospital and talking to them. (This helped us a great deal last year when my undiagnosed mother was admitted to hospital but to be fair we didn't have to ask as the medic recognised the problem and got them involved.) PALS should be able to help point you towards any such, hopefully multi-disciplinary, team. Good luck. Sue

 

[Caroleanne34]

Thanks for the advice. I will definately contact PALS and see what they say.

To give you a brief overview, he has been diagnosed wih altzimers, vascular dementia and suspected frontolobe dementia. He was taken in initially because he didn't recognise my mum or me and was trying to escape the house. They took him into a delirium ward initially which made no difference and then discharged him home. Two days later he had to be taken back in because he was becoming aggressive, but was taken to a dementia ward. He always has plenty of clean clothes so I don't know why he was wearing other people's.

As for pads, I am a first year student nurse who had a training session with a specialist continence nurse and the one thing she said is that you never put a pad on someone who isn't incontinent because you will make them Incontinent and always to question why someone has one on. My dad knows when he needs to go to the toilet and doesn't have issues here, however as he was so aggressive at one point he had had a couple of accidents. This doesn't mean he is incontinent or that he is becoming incontinent. So I feel really this is staff laziness and totally unacceptable. I have spoken to staff and it stopped for a couple of days but then we find him wearing one again. It's just not on. I will speak to PALS and see what they advise me to do re this.

Re his room, he had been sectioned because of the aggression and part of the order was to remove furniture if there was any chance of him causing himself harm. However I feel wih the empty rooms they have, they could easily have raised the bed by putting a few mattresses On top of each other. I just feel a 72 year old man with a damaged knee and arm should not have to be straining to get off the floor. The last four days he has had short periods of agitation, but he has been allowing nurses to take him to the toilet and according to them has been quite settled. This is why I don't understand why no one has encouraged him to brush his teeth. We are taught that you have to look at the person as a whole, eating and drinking needs, mobility, oral hygiene, etc.

Yesterday he was left in a freezing room without any blankets fast asleep. I just feel he is going to die in there. I don't know if I am overreacting, but I wouldn't allow this to happen to anyone I was caring for. They have told us that he is sleeping constantly because they are phasing out the diazepam and this could take a week.

Thank you all for the advice. I'll see what I can do. I may speak to my university and see what they say, I just feel I can't be bothering them with personal issues.

 

[Louby65]

Hi caroleanne34, what a time you and your poor dad are going through . As a healthcare professional with over 33 years experience with varying conditions , including delirium of many causes , I can say that putting a pad on someone will not make them incontinent . So the advice from the incontinence is wrong . I have a feeling your dad may have episodes of nocturia which is very common in people with neurodegenerative conditions such as Alzheimer's . As we get older there can be a decreased nocturnal secretion of the anti diuretic hormone which can cause incontinence in some . Perhaps he's fine during the day going to the toilet but may experience some incontinence at night . That is why he may be using a pad but ask for clarification . The mattress on the floor is a very common practice for people at a high falls risk from a bed and although may appear very cruel, is actually a very safe intervention . However , has the hospital considered falls mats , which go under the mattress and alert the staff if he tries to get out of bed . I can't explain why he would be in a cold room , with no blanket but that does need to be investigated . As suggested in previous posts , it would be good to take notes and approach the senior charge nurse / ward manager who should answer your questions and allay some of your worries . Best wishes to you and your dad , let me know how he gets on . Lou

 

[angelface]

You probably know a lot more about this than me, but have you asked to see/made an appointment to see,the consultant?

 

[LynneMcV]

How do I intervene with this?? My dad was taken into hospital 6 weeks ago able to feed himself with no problems other than his speech had deteriorated. He was taken into hospital because he was becoming aggressive and didn't know who we were.

Well since my dad has been in hospital, he has completely lost the little amount of speech he had, he can longer feed himself, is sleeping on a mattress on a floor with the window open (the room was freezing today but we were told they couldn't shut it!), he has been struggling with balance and walking, the staff have been putting pads on him even though he is not incontinent and now he is struggling to swallow. I can't tell you how angry I am. He has been dressed in other people's clothes, also in hospital pyjamas with a huge hole in the backside exposing his pants, his hair looks matter with grease... My dad is a well groomed man by nature! Where is the dignity in any of this? My dad has been sleeping mainly since Friday. I haven't seen him awake, but staff have advised us he has been eating breakfast. I looked at his teeth today and it is clear they haven't been brushed in several days. He has a dental plate that needs to come out and be cleaned, however he has been so out cold that we haven't been able to wake him.

Any advice on what I can do would be helpful. I know from speaking to a continence nurse specialist last year that you should never put a pad on someone unless they are Incontinent, otherwise you will make them incontinent! we have tried speaking to staff about this and the response is "oh it must have been the night staff" ... Ok so why does he still have one on at 3pm in the afternoon? I'd appreciate any help as I am on the verge of making a huge complaint and just don't know how to approach this or who to speak to for advice

Hi Carolanne, I completely understand where you are coming from. This rings so many bells with my husband's experience earlier this year.

He too was admitted to hospital following an aggressive patch. He also has speech problems.

The secure unit he was on was an absolute nightmare. He was not being helped to wash, dress, shave or clean teeth and twice they stuck him in pull ups rather than show him where the dementia friendly toilet was. He was mortified, self-conscious and confused as he is not incontinent. Sadly he couldn't speak up for himself and the staff were happy to let him sit in the corner looking miserable - so I made sure I spoke up for him - loud and clear but always polite.

I was in the fortunate position of being able to visit every single day. If I found him in pull ups I threw them away and put his normal pants on, much to his relief, then I went straight to the office to say what I had done and why. I also made sure I carried out all his personal care -albeit he had to wait until I could get there in the afternoon

Like your Dad, my husband is very particular about his personal hygiene and I gave short shrift to one of the staff who looked me straight in the eye and said they had washed, shaved. combed his hair and cleaned his teeth that day -as well as taking him to the loo every two hours, as outlined in his care plan. This was shortly after I had arrived to find him unshaven, with smelly breath and matted hair, busting to go to the loo and in pull-ups.

His care plan clearly stated that his continence was to be maintained, there were to be no pads or pull ups used. The first time I tackled them I was told a new agency nurse had put pull ups on him, the second time it was the nurse in charge who said she didn't know (very few of them bothered reading the care plan)

I stuck my ground and it didn't happen again.

I respect the comments made to say that putting in pull-ups does not lead to incontinence. However, I firmly believe that without my intervention my husband would have become institutionalised and would have returned home with fewer abilities than when he was admitted.

He even thought he had been banned from using the toilet and that he had to go in the pull-ups. Fortunately, he had good bladder control and refused to do so. But for how long would he have maintained that if I had not gone in every day and taken him to the toilet myself?

My husband, a good walker, also became unsure on his feet - a mixture of the flooring being non dementia friendly to the point that he thought it was moving - and not having exercise as it was easier for staff to make him sit in the corner, watching tv. It took several weeks before I persuaded them to let me take him for a walk outside. Until that day came I made a point of walking him up and down the corridors every day, just to maintain his ability to walk.

We also had problems with him being put in other patients' clothes, or hospital pyjamas, despite having a constant supply of fresh, clean, pressed clothes in his wardrobe. Patients were also given his clothes. One day I went in and he had no slippers or shoes on, walking around on a slippery surface in socks. It turned out that a member of staff had knowingly let a patient take his shoes from his room, then, when the patient accidentally soiled himself (and hubby's shoes) he was allowed to walk off with hubby's slippers, which he then accidentally did a wee on.

Like I say, an absolute nightmare but my regular appearances certainly changed things. I really pitied the patients whose loved ones couldn't visit as often.

I would definitely go to PALS and keep notes of what you are told by staff. My note taking was invaluable for getting to the truth of several situations.

Good luck with PALS and getting things improved for you Dad x

 

[Caroleanne34]

Lou I'm afraid you are wrong. It was an incontinence specialist nurse for Scotland that I had training with. Since reading your comment I have also checked wih registered nurses and they have all said the same. You never ever put a pad on a patient who isn't incontinent as I can lead to Incontinence. Just as you wouldn't shave someone who could do it for themselves. You just de-skill that person and strip them of what little is left of their independance. please speak to a contenince team if you deal with a patient like this. I can't bare to see his happening to people

 

[Caroleanne34]

Hi Carolanne, I completely understand where you are coming from. This rings so many bells with my husband's experience earlier this year.

He too was admitted to hospital following an aggressive patch. He also has speech problems.

The secure unit he was on was an absolute nightmare. He was not being helped to wash, dress, shave or clean teeth and twice they stuck him in pull ups rather than show him where the dementia friendly toilet was. He was mortified, self-conscious and confused as he is not incontinent. Sadly he couldn't speak up for himself and the staff were happy to let him sit in the corner looking miserable - so I made sure I spoke up for him - loud and clear but always polite.

I was in the fortunate position of being able to visit every single day. If I found him in pull ups I threw them away and put his normal pants on, much to his relief, then I went straight to the office to say what I had done and why. I also made sure I carried out all his personal care -albeit he had to wait until I could get there in the afternoon

Like your Dad, my husband is very particular about his personal hygiene and I gave short shrift to one of the staff who looked me straight in the eye and said they had washed, shaved. combed his hair and cleaned his teeth that day -as well as taking him to the loo every two hours, as outlined in his care plan. This was shortly after I had arrived to find him unshaven, with smelly breath and matted hair, busting to go to the loo and in pull-ups.

His care plan clearly stated that his continence was to be maintained, there were to be no pads or pull ups used. The first time I tackled them I was told a new agency nurse had put pull ups on him, the second time it was the nurse in charge who said she didn't know (very few of them bothered reading the care plan)

I stuck my ground and it didn't happen again.

I respect the comments made to say that putting in pull-ups does not lead to incontinence. However, I firmly believe that without my intervention my husband would have become institutionalised and would have returned home with fewer abilities than when he was admitted.

He even thought he had been banned from using the toilet and that he had to go in the pull-ups. Fortunately, he had good bladder control and refused to do so. But for how long would he have maintained that if I had not gone in every day and taken him to the toilet myself?

My husband, a good walker, also became unsure on his feet - a mixture of the flooring being non dementia friendly to the point that he thought it was moving - and not having exercise as it was easier for staff to make him sit in the corner, watching tv. It took several weeks before I persuaded them to let me take him for a walk outside. Until that day came I made a point of walking him up and down the corridors every day, just to maintain his ability to walk.

We also had problems with him being put in other patients' clothes, or hospital pyjamas, despite having a constant supply of fresh, clean, pressed clothes in his wardrobe. Patients were also given his clothes. One day I went in and he had no slippers or shoes on, walking around on a slippery surface in socks. It turned out that a member of staff had knowingly let a patient take his shoes from his room, then, when the patient accidentally soiled himself (and hubby's shoes) he was allowed to walk off with hubby's slippers, which he then accidentally did a wee on.

Like I say, an absolute nightmare but my regular appearances certainly changed things. I really pitied the patients whose loved ones couldn't visit as often.

I would definitely go to PALS and keep notes of what you are told by staff. My note taking was invaluable for getting to the truth of several situations.

Good luck with PALS and getting things improved for you Dad x

Lynne I'm so sorry about how your husband was treated! It really does sound very similar. My mum asked to see his care notes yesterday and was told "absolutely not! You have to request them in writing" now she doesn't want to cause problems for my dad by asking anything else. I have to say I find the charge nurses response very unprofessional. It also makes me feel they are hiding something. I'm planning on speaking to them away from my mum as I don't want to upset her but I can't just not say anything.

As for the pads, they can make someone incontinent, regardless of what others say. I have done quite a bit of research on this due to hospital practices that I've noticed, have spoken to nurses and the specialist continence nurse. These are out on people out of laziness, no other reason. It would be understandable if there was a temporary reason such as uncontrollable bowel movements leading to embarrassment, but my dad doesn't have any problems. They have also put his furniture in his toilet and locked it, so he has no access to the toilet in his room, again taking away his independance. I'm just a student and I can't believe this is happening! To me it's quite obvious. He doesn't have his name above the door either, every other patient does, so how is he supposed to recognise his room. They assume because he can't read or write anymore that he won't know his name ... Really! He was getting confused with other rooms because they had DR.whatever under the patients names. My dads initials are D.R! So he does recognise this. I am going up today and plan to try and help wih my mum to get as much as we can done for him. My mum goes up every day but I am currently on my last years nursing placement in another hospital so my visiting is limited.

Thank you so much for sharing your experience. I will try my best to do what I can. I'm loosing sleep over this all the time. I just hope I can speak to them calmly.

 

[Caroleanne34]

how do I unsubscribe permenantly from this site?

 

[onlyme1]

thankyou !

carolanne, I've found your posts helpful and honest. I hope you will remain. bless you. x

 

[Havemercy]

how do I unsubscribe permenantly from this site?

Hi Caroleanne- do think twice about leaving this site - especially as I see you are a student nurse. My experience is that I joined a few years ago when I suspected mum had some form of vascular dementia. She died about 18 months ago now but Talking Point has massively informed my knowledge and practice as a qualified nurse - I am much more aware of the problems experienced by relatives and loved ones in the community although I am a hospital nurse. You may not always agree with everything said but it gives you aneed excellent insight into other points of view.

In fact I would say being a regular reader of the forum is part of my continuing professional development. Best wishes if you do decide to close your account and also with your future career.