Could this ever happen in England?

poet123

Person_one wrote: »

No.

Poor care happens, it happens more than any of us want it to, some hospitals and trusts are worse than others, but the vast majority of people receive good care from the NHS and then get on with their lives, or get on with their grieving and move on.

People with negative experiences are much much more likely to share them and dwell on them even years down the line than people who have positive or uneventful experiences.

I think its really important that people use the formal complaints and feedback procedures that every trust and all the professional bodies that register healthcare professionals have in place. That's how things get better, and how people are held accountable.

Even those of us who have had these experiences have to do that, how could we not? But we rarely forget.

As has been said it is hard when a loved one dies under these circumstances to take things further, you are grieving and the very last thing you want to do is fight the authorities. The undertaker took me aside and asked me if I was certain that we wanted cremation, he looked me in the eye (having seen the state of my father) and said if you want to make a complaint I will give you a statement, but it is better if he is buried. We hadn't intimated that we had that intent.

As I said I would have made the complaint but my brother dissuaded me because of the effect on my mother. She was of the old school and would probably not have agreed to it anyway.

I do think there are a lot of trusts which rely on this.

Person_one

I honestly think there is a duty to complain when things go wrong or there has been poor care.

How else do you expect things to get better?

It doesn't mean a fight, it means an investigation, there are very clear procedures in place.

thegirlintheattic

Someone (or their relatives if they are incapable) can withdraw treatment including food and water. As part of the dying process people naturally loose their appetite and thirst so they do not suffer.

Palliative care guidelines in most institutions state that even if a patient has asked not to receive food/water, if they ask for it they must be given it. Usually it's a case of them having a dry-mouth rather than being thirsty so sucking on a wet swab or an ice cube can help. Therefore I doubt the OPs story actually happened.

It is actually kinder in many cases for food and drink to be withdrawn and the person allowed to pass naturally rather than being kept alive by artificial nutrition/hydration for weeks/months with no chance of recovery. What is so disturbing in society is medicine and technology keeping people alive when doing so just prolongs their suffering and is done solely to comfort the family.

Some interesting links:
http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=428
http://www.palliativedrugs.com/SamplePDF/SMAC4e/Chapter13.pdf
http://www.hospicecare.com/manual/ethical-main.html#ARTIFICIALHYDRATION
http://www.preciouslegacy.com/chap8.html

HeatherintheHills

Person_one wrote: »

I honestly think there is a duty to complain when things go wrong or there has been poor care.

How else do you expect things to get better?

It doesn't mean a fight, it means an investigation, there are very clear procedures in place.

That should apply equally to hospital staff. Why place the burden solely on a grieving family?

Do you really believe that in all of the cases we are documenting here that there wasn't someone, somewhere within the hospitals concerned who realised that the level of care some patients were receiving was well below standard?

Person_one

HeatherintheHills wrote: »

That should apply equally to hospital staff. Why place the burden solely on a grieving family?

Do you really believe that in all of the cases we are documenting here that there wasn't someone, somewhere within the hospitals concerned who realised that the level of care some patients were receiving was well below standard?

Why would you assume I don't agree with that?

There are whistleblower policies at every trust too, even dedicated phone numbers at some. Luckily, I've never witnessed poor care.

pm04gn

Mojisola wrote: »

That does happen.

My point was in reference to jellyhead's post that family members could disagree when (if!) they were consulted. If there are disagreements then the NOK can make the final decision.

The decision to make a DNR order is down to the consultant in charge of the patients care. The subject is best discussed with the next of kin but they don't have the final say on the matter.
To be honest recovery from in hospital cardiac arrest is low and in elderly patients who have at least one health issue there chances are even lower. It's a horrible process and I certainly would encourage everyone to think carefully about it. I certainly wouldn't let any of my ill elderly relatives be for resuscitation. In this group the situation is dying rather than reversible cardiac arrest.

Last thing to bear in mind is that DNR is not treatment withdrawal. It's active treatment unless cardiac arrest occurs. So Iv antibiotics etc should be given. Sometimes nurses seem oblivious to this fact.
I did a 6 month elderly care job as a junior dr so have a fair amount of experience in these circumstances.

Mojisola

pm04gn wrote: »

The decision to make a DNR order is down to the consultant in charge of the patients care. The subject is best discussed with the next of kin but they don't have the final say on the matter.

My point was that if the medics were getting conflicting information from the family, the view of the NOK would be given priority, not that the NOK could over-ride the medical decisions.

poet123

Person_one wrote: »

I honestly think there is a duty to complain when things go wrong or there has been poor care.

How else do you expect things to get better?

It doesn't mean a fight, it means an investigation, there are very clear procedures in place.

When things started to go wrong with my mothers care, we complained, and believe me it was a fight, a fight which culminated in her death, with a contributory factor to that being a fall and resultant injury. That fall and the injury was covered up, and ultimately we received an apology from the trust for their failings.

How far do you go? Should we have sued, does money talk?

Person_one

pm04gn wrote: »

The decision to make a DNR order is down to the consultant in charge of the patients care. The subject is best discussed with the next of kin but they don't have the final say on the matter.
To be honest recovery from in hospital cardiac arrest is low and in elderly patients who have at least one health issue there chances are even lower. It's a horrible process and I certainly would encourage everyone to think carefully about it. I certainly wouldn't let any of my ill elderly relatives be for resuscitation. In this group the situation is dying rather than reversible cardiac arrest.

Last thing to bear in mind is that DNR is not treatment withdrawal. It's active treatment unless cardiac arrest occurs. So Iv antibiotics etc should be given. Sometimes nurses seem oblivious to this fact.
I did a 6 month elderly care job as a junior dr so have a fair amount of experience in these circumstances.

Sorry, but nurses know what a DNAR is.

They also know what an LOT order is, and the difference.

Sometimes doctors can be horribly patronising to nursing staff.

HeatherintheHills

Are any of the medical staff contributing to this thread taking on board what is actually being written by the relatives of patients?

It certainly doesn't look like it to me. :mad:

That settles it. When my time comes I'm doing what so many others have quietly done. A little mishap with my meds and its lights out. No need for me to carry on being frightened of what the future might hold for me once that future is out of my control.