Monday, February 09, 2015

"...we must make sure that we care for our elderly people rather better than we care for our dogs and cats"

Sue Hood, the secretary of the Nairn and Ardersier Patients Group, spoke at the organisation's meeting last Wednesday night at the Community and Arts Centre. She started by asking those present a question: “If you are over 60 or have care of someone over 60 will you please raise your hand?” 

Quite a proportion of those present raised their hands. Sue continued:

“What I was asked to do and it arose at one of our meetings that there seemed to be concerns about the care of people who are at home with chronic illness who may not have a great deal of contact with their GP. Who tick over with a bit of help from family and neighbours and others but for whom a lot of people think it’s a little bit too vague and maybe the services provided don’t actually hit the spot. From that point of view we then asked a few people to tell us their story which I’m going to do now. Obviously a little bit has been changed so you won’t know it was your neighbour or something like that because that wouldn’t be right but the stories are true. They don’t necessarily have a conclusion, they don’t necessarily have an answer but maybe between us we’ll come up with some answers. 

The first one is about a lady who was suffering from Parkinson’s disease. Her daughter told her story. Her mother ended up finally in a nursing home in December 2009. It is probably our oldest story. 

Because of her Parkinson’s she was entitled to spend a couple of days a week at the day hospital in Nairn for a period of about 12 week, where she had routine tests, blood tests and so forth done, she was seen by physios, she was seen by occupational therapists and she had some speech therapy organised at her home. The relative who had full power of attorney was able to speak to the day hospital sister for updates on her condition and how things were doing and she found this extremely useful. Particularly when her mother then needed some home help because this had been arranged by the day hospital where they had knowledge of the patient, where they could provide useful input. 

In due course her mother unfortunately deteriorated to the extent of needing to go into a nursing home but even then the day hospital was able to support and provide input and the quotation is “the help given by the day hospital enabled my mother to remain in her own home for longer.” ”

Sue then gave another example of a slightly more recent story:

“An elderly relative in his late eighties with no immediate problems had breathing problems. Within the catchment area of the practice, we won’t say where, phoned the GP and was told he must go to Nairn hospital. He was taken by a member of the extended family by car. They waited for an hour and were then told that the patient had to go to Raigmore and was taken by ambulance. If the family had been told initially that they should take the patient to Raigmore for assessment and possible treatment, he would have got there quicker; people with breathing difficulties can go downhill very rapidly. It would have saved an ambulance journey because the family were prepared to take him. 

The patient was treated in hospital for about ten days, discharged after his stay, no care package. He wasn’t very mobile. The relatives did their best but, intervention and he was readmitted to Raigmore where he had another period of a fortnight. He was then sent back to Nairn for a five day stay for rehabilitation. When he was discharged, there again there was no care package in place and an elderly family member had to do what they could. This elderly family member was in their seventies, so not exactly the most able person to do what they could. The patient did, finally, after about two months begin to recover but it wasn’t a nice experience really. 

Sue continued: “The third story was really a collection of stories. People who were chronically sick or just discharged from hospital usually had some help at home, both nursing and social. There used to be a day hospital facility in Nairn and patients throughout the practice could be referred by the GP, by Social Services, by a District Nurse and for about eight weeks would be able to attend sessions on Monday, Wednesday, Friday. They may have had one session, they may have had two but they were collected by transport and returned home at three or four in the afternoon and while they were at the day hospital services such as speech therapy, nursing care and various other things could be provided. They also had lunch there which would give them a bit of social contact. 

Later on apparently the day care remained but the transport didn’t. The journey by taxi which had to be undertaken from Ardersier was about £22 return – quite a lot of money for a pensioner. Apparently there was one person who felt this was too much, a relative paid in secret for them for transport just so they could take advantage of the service at the day hospital. It is not currently seen to be a comparable service. 

In the past, we were told, GPs used to pop in and see the chronically sick once a month or so. Monitor them, see that they were...This now happens we are told that the doctors are much too busy but it is a way of monitoring people whose condition can deteriorate quite rapidly. The family won’t necessarily notice that people are getting more likely to fall, possibly getting more vague, forgetful. They might just be not eating properly. All the sorts of things that a professional can notice and perhaps act on before an emergency admission to hospital is considered necessary. 

OK, this may well have been a golden age of care years ago but we are a society that is getting older. We are a society that is told we can’t afford acute hospitals, that can’t afford all the luxuries that we had in the past. What are we going to do with our older people? There are those who try and help out, there are neighbours, there are friends, there are family but we are more widespread than we used to be. A lot of us move away from our families and there isn’t anyone. Family breakdowns are greater, there are more people divorcing now in their sixties than ever there were, so what’s going to happen to them? We’ve got to get to the point where we must make sure that we care for our elderly people rather better than we care for our dogs and cats. After all care for our elderly and our sick is a mark of how civilised we are as a society. 

As I say there are no answers to this, there are just stories, there are just questions but somewhere, someone has got to start thinking about these under the carpet, we don’t think about, frankly, not terribly glamorous things because otherwise, the ageing population is going to grow and there is not going to be a way of coping with them to give them health and dignity and a measure of happiness.”

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