By the way . . . It’s true, no one cares when you’re old

RECENTLY I observed at first-hand the dismal state of care of the elderly in our community. The picture I’ll describe may not be the case everywhere, but where I live I have witnessed care so poor that I feel ashamed to be part of the healthcare system.

Harry, an elderly friend of nearly 40 years and my mentor in gardening matters, was in a state of advanced dementia, aged 95.

His wife, Lily, 90 — who is in admirable order, but blind on account of age-related macular degeneration — was his sole carer.

Her only respite recently was in the early autumn when Harry was admitted to hospital after finding he could suddenly no longer stand up from his chair or walk.

After treatment for an infection, he was deemed well enough to go home, but that day his wife suffered a stroke and she, too, was admitted to hospital. Five days later, they were sent home together. Though carers were arranged to visit Harry four times a day, Lily continued to be the main carer of her husband, who by then was doubly incontinent.

It meant the elderly blind lady had to wash sheets and clothes every day while recovering from a stroke.

As their neighbour, I queried why Harry hadn’t been given a catheter in hospital, but it seemed he’d been taken home before the incontinence team got round to it.

Horrified to learn this, his GP arranged for someone to come and help.

A whole nine weeks later, a nurse finally arrived at their home, but was unable to insert a catheter. It’s a difficult task and when I was a hospital doctor I probably failed at it myself on occasions. That failure was more than six weeks ago and the incontinence team did not visit again.

Meanwhile, Harry developed a cough and a temperature. Who visited? A nurse, who examined his chest with a stethoscope, diagnosed bronchitis and issued antibiotics.

One thing I know for sure is that examination of the lungs and reaching the correct diagnosis requires the experience and skill of a competent doctor, so whether antibiotics were appropriate, we can’t be sure.

Harry was eventually seen at home by a GP after his ankles swelled up on the last day of January. No further action was taken, and that night he fell out of bed and was admitted to hospital. He died four days later, a victim of poor care.

It seems that once you are old and demented, care becomes careless, in both senses of the word. When National Insurance contributions were asked of them in 1948 at the inception of the NHS, Lily tells me she predicted the promises would never last. And so it has come to pass.