I thought it would be best for me to make a “clean break” from TP when my mother passed away, but I have an ongoing complaint process relating to various aspects of a hospital encounter which keeps on dragging me back! It’s sad to see so many people still going through all the familiar problems. This is academic for me now but I wanted to share the info on this aspect in case it’s useful for anyone else.
Where I went wrong: I knew that my mother was in terrible pain when she was in an orthopaedic ward in hospital after an emergency op. I raised it with nurses on the ward. They said she’d had all the pain relief she was allowed. I made the mistake of accepting this answer at the time.
What I should have done: Lots of you will know there are different pain assessment techniques for assessing pain in people with cognitive impairment – and the hospital does have guidelines in place that they should be used. However, if doctors don’t use them (and if our case is anything to go by it seems to be standard practice of doctors to ignore the guidelines) then the result is of course that they make their prescription decisions on an incorrect basis. So Mum was repeatedly assessed based on simple oral enquiry, which she wouldn't have understood, and prescribed just a standard dosage of a household analgesic for almost all of the relevant time. But of course the nurses will simply comply with the doctor’s orders. So what I SHOULD have done was insist on speaking to the doctors and ask them how they’d assessed her pain – and then I would have realised that they had underestimated her pain levels and she would almost certainly have been prescribed some stronger pain relief. So the moral of the story is don't just question the level of pain relief in place but also question how they assessed the pain to arrive at the prescribed pain relief.
It’s taken me the best part of a year to extract the relevant information, and even so I’ve only gained it by reading between the lines, so I’m just posting this here in the hope that it may help some other person as naïve as me to avoid their relative being in agony in hospital. It beggars belief that one has to check up on everything the experts are doing but it seems typical in the area of dementia care!
Where I went wrong: I knew that my mother was in terrible pain when she was in an orthopaedic ward in hospital after an emergency op. I raised it with nurses on the ward. They said she’d had all the pain relief she was allowed. I made the mistake of accepting this answer at the time.
What I should have done: Lots of you will know there are different pain assessment techniques for assessing pain in people with cognitive impairment – and the hospital does have guidelines in place that they should be used. However, if doctors don’t use them (and if our case is anything to go by it seems to be standard practice of doctors to ignore the guidelines) then the result is of course that they make their prescription decisions on an incorrect basis. So Mum was repeatedly assessed based on simple oral enquiry, which she wouldn't have understood, and prescribed just a standard dosage of a household analgesic for almost all of the relevant time. But of course the nurses will simply comply with the doctor’s orders. So what I SHOULD have done was insist on speaking to the doctors and ask them how they’d assessed her pain – and then I would have realised that they had underestimated her pain levels and she would almost certainly have been prescribed some stronger pain relief. So the moral of the story is don't just question the level of pain relief in place but also question how they assessed the pain to arrive at the prescribed pain relief.
It’s taken me the best part of a year to extract the relevant information, and even so I’ve only gained it by reading between the lines, so I’m just posting this here in the hope that it may help some other person as naïve as me to avoid their relative being in agony in hospital. It beggars belief that one has to check up on everything the experts are doing but it seems typical in the area of dementia care!
