I wrote this message last Wednesday but never got round to posting it
"Mum was taken to hospital this morning, I recieved a call about 9.45 at work.
She has not been eating for several weeks now but over the last few days has developed ( yet another) UTI (Urinary Tract Infection). Now she has stopped drinking as well, she is badly dehydrated and refuses to take her oral antibiotics.
The care home sent her to Hospital and I had a call from an Spr (Specialist Registrar or junior doctor as they are sometimes called) complaining that the care home had sent my mother to a busy A+E department. (Well where else would they send her) He complained that her problems had been going on for a couple of months and what did we expect him to do ( rehydrate her for one and get some IV antibiotics into her for starters). He thinks the care home should have done this. The care home do not have the staff trained to do this. He complains that the care home only sent her because her GP was on holiday but I pointed out that they did have access to a locum GP and that the GP was monitoring her weekly and had already prescribed the oral antibiotics ( what more does he think a GP can do ?). He doesn't want to admit mum, the care home don't want to have her back because they feel her physical condition currently exceeds the skills and resources they have to care for her.
The Spr breezily suggests the District Nurses can do the IV. Well yes they can but if the care home doesn't have staff qualified in this procedure who will resite the venflon if she pulls it out as she is quite likely to do in her confused state ( more confused than ever with the UTI).
I'm inclined to support the position of the care home but am angry at seeing my mother treated like a football and not a human being.
Right now I don't even know where she is ! Whether they have started the IV antibiotics which she so desparately needs or is she still lying on a trolley in A+E some 5 and a half hours later. I've told the Spr he cannot discharge my mother until he has made the referral to the District Nurses and has had some confirmation that they can respond within 24 hours.
I've had experience before of an emergency referral to the District Nurses that was not responded to for 5 days.
If the Spr starts IV antibiotics and this is not followed up she will probably end up in a worse position than she is now with an antibiotic resistant UTI.
However the nursing home still think she should be in hospital.
What shall I do.....( now tearing my hair out and using this post to try and rationalise my thoughts). I think I'll cancel my afternoon clinic and go to A+E and give them what for. ".......
At this point I recieved another phone call from a doctor on the medical team saying they were going to admit mum as she had kidney failure. We were told she was going to die that she had hours maybe days left.
So began a bedside vigil and the horrid task of communicating this news to the rest of the family. since Wednesday her condition has steadily improved. However getting information from the hospital staff has been like pulling teeth. As many distraught relatives came and sat round her bedside no one volunteered us any information. She is still refusing to eat and drink. On sunday I spent most of the day with her and she only managed a few sips of tea and a few sips of water, not enough to keep her alive if they took the IV fluids down. Imagine my suprise then the next day, yesterday lunchtime having gone into work in the morning to get a message on my mobile to say mum was eating and drinking and was being returned to the care home. No reply from the ward telephone number, the care home have been told nothing.
A few more cancellations and I'm off to the hospital mad as hell. "What exactly had she eaten ?" a teaspoon of porridge apparrently. I asked to see the senior nurse who knew nothing as she had been off for a week so I demanded to see the consultant who had spoken to one of my brothers but who I had not seen in 5 days.
What assessments had they made of my mothers current level of functioning...none... hell, up to this point she hadn't even been out of bed. My point was that there was no evidence she could eat or drink enough to keep her alive, if they sent her back to the care home she would die of starvation and dehydration. She might die anyway but surely this was the unkindest thing they could do. Maybe she needs to go to a different nursing home where they could offer the level of nursing support she needs, maybe she needs to go to a hospice. Finally the consultant admits that she was never in Kidney failure she was severely dehydrated which has responded fairly rapidly to to treatment. Treatment that at first they wanted to deny her because she was an 80 year old lady with alzheimers disease.
They decided not to discharge her. There will be a review in the multi disciplinary Team meeting on Wednesday to agree how best to meet mum's future care needs. Six days of hell to get to this point. I'm not confident it will help I am just wondering what weasel words they will dress up a decision to discharge her back to the care home with. It seems they just want to keep passing the parcel.
Irate and despairing
Lou Lou
"Mum was taken to hospital this morning, I recieved a call about 9.45 at work.
She has not been eating for several weeks now but over the last few days has developed ( yet another) UTI (Urinary Tract Infection). Now she has stopped drinking as well, she is badly dehydrated and refuses to take her oral antibiotics.
The care home sent her to Hospital and I had a call from an Spr (Specialist Registrar or junior doctor as they are sometimes called) complaining that the care home had sent my mother to a busy A+E department. (Well where else would they send her) He complained that her problems had been going on for a couple of months and what did we expect him to do ( rehydrate her for one and get some IV antibiotics into her for starters). He thinks the care home should have done this. The care home do not have the staff trained to do this. He complains that the care home only sent her because her GP was on holiday but I pointed out that they did have access to a locum GP and that the GP was monitoring her weekly and had already prescribed the oral antibiotics ( what more does he think a GP can do ?). He doesn't want to admit mum, the care home don't want to have her back because they feel her physical condition currently exceeds the skills and resources they have to care for her.
The Spr breezily suggests the District Nurses can do the IV. Well yes they can but if the care home doesn't have staff qualified in this procedure who will resite the venflon if she pulls it out as she is quite likely to do in her confused state ( more confused than ever with the UTI).
I'm inclined to support the position of the care home but am angry at seeing my mother treated like a football and not a human being.
Right now I don't even know where she is ! Whether they have started the IV antibiotics which she so desparately needs or is she still lying on a trolley in A+E some 5 and a half hours later. I've told the Spr he cannot discharge my mother until he has made the referral to the District Nurses and has had some confirmation that they can respond within 24 hours.
I've had experience before of an emergency referral to the District Nurses that was not responded to for 5 days.
If the Spr starts IV antibiotics and this is not followed up she will probably end up in a worse position than she is now with an antibiotic resistant UTI.
However the nursing home still think she should be in hospital.
What shall I do.....( now tearing my hair out and using this post to try and rationalise my thoughts). I think I'll cancel my afternoon clinic and go to A+E and give them what for. ".......
At this point I recieved another phone call from a doctor on the medical team saying they were going to admit mum as she had kidney failure. We were told she was going to die that she had hours maybe days left.
So began a bedside vigil and the horrid task of communicating this news to the rest of the family. since Wednesday her condition has steadily improved. However getting information from the hospital staff has been like pulling teeth. As many distraught relatives came and sat round her bedside no one volunteered us any information. She is still refusing to eat and drink. On sunday I spent most of the day with her and she only managed a few sips of tea and a few sips of water, not enough to keep her alive if they took the IV fluids down. Imagine my suprise then the next day, yesterday lunchtime having gone into work in the morning to get a message on my mobile to say mum was eating and drinking and was being returned to the care home. No reply from the ward telephone number, the care home have been told nothing.
A few more cancellations and I'm off to the hospital mad as hell. "What exactly had she eaten ?" a teaspoon of porridge apparrently. I asked to see the senior nurse who knew nothing as she had been off for a week so I demanded to see the consultant who had spoken to one of my brothers but who I had not seen in 5 days.
What assessments had they made of my mothers current level of functioning...none... hell, up to this point she hadn't even been out of bed. My point was that there was no evidence she could eat or drink enough to keep her alive, if they sent her back to the care home she would die of starvation and dehydration. She might die anyway but surely this was the unkindest thing they could do. Maybe she needs to go to a different nursing home where they could offer the level of nursing support she needs, maybe she needs to go to a hospice. Finally the consultant admits that she was never in Kidney failure she was severely dehydrated which has responded fairly rapidly to to treatment. Treatment that at first they wanted to deny her because she was an 80 year old lady with alzheimers disease.
They decided not to discharge her. There will be a review in the multi disciplinary Team meeting on Wednesday to agree how best to meet mum's future care needs. Six days of hell to get to this point. I'm not confident it will help I am just wondering what weasel words they will dress up a decision to discharge her back to the care home with. It seems they just want to keep passing the parcel.
Irate and despairing
Lou Lou
