You must not call an elderly patient ‘dear’
Doctors and nurses are urged to treat patients with more respect
Doctors ‘acting like vets with dementia patients’
From yesterday’s Mail
DOCTORS and nurses should be banned f rom calling elderly patients ‘dear’, a panel of officials declares today.
Expressions such as ‘bed-blockers’ – that imply patients are a nuisance – should also be outlawed, they say.
In a series of new measures, the experts want medical staff to face compulsory personality tests before being given jobs to ensure they will treat those in their care with respect.
Over the last eight months a team of officials from the NHS Confederation, the Local Government Association and charity Age UK have been compiling guidelines to improve the care of the elderly in hospitals and nursing homes.
They were prompted by a distressing report by the Health Service Ombudsman this time last year which included accounts of frail patients being left without water or in soiled clothing held up with paper clips.
The panel – the Commission on Improving Dignity in Care for Older People – says hospital staff should refrain from asking patients ‘how are we today dear?’.
In addition, they say doctors and nurses should stop reducing patients to illnesses labels or conditions – such as ‘that stroke over there’ or ‘the fractured femur in that bay’. In a joint statement, the authors of the report call for a ‘major cultural shift’ to ensure care is ‘patient-centred’ rather than ‘task-focused’.
Other recommendations include putting patients’ life stories at the ends of their hospital beds alongside their medical notes to encourage staff to think of them as people, not bodies on a ward.
They also want to encourage families to come in at meal times to help feed patients and assist with other tasks such as washing and taking them to the toilet.
The panel say: ‘Like many others, we’ve been deeply saddened by the reports highlighting the undignified care of older people in our hospitals and care homes. In too many cases, people have been let down when they were vulnerable and most needed help .
‘Solving the problems will require the consistent application of good practice and the rooting out of poor care.
‘This will require empowered leadership on the ward and in the care home, as well as in the boardroom. It will mean changing the way we recruit and develop staff so they have the right values as well as skills.’
The panel calls for ward sisters to be freed up from their administrative duties so they can take charge of ensuring patients are treated with dignity.
Their recommendations will now be discussed with relevant parties before a final set of guidelines is produced and sent out to all hospitals and care homes. The demands that those i n old age are treated with respect is in line with the Mail’s Dignity for the Elderly Campaign. Only yesterday it emerged that doctors were ‘acting like vets’ with dementia patients to avoid talking to them.
They often ‘ make it up as they go along’ because they have no idea how to treat them, a study revealed.
One consultant admitted to using a ‘veterinary approach’ towards the sick. He added: ‘And then you perhaps may not be treating them in the same way as someone else that you can talk to.’
Roswyn Hakesley-brown, of the Patients Association said: ‘Patients and relatives continue to tell us that their clini- cians do not communicate with them properly, that they are not being helped to eat and drink, they can’t get adequate pain relief and often they are not given any assistance with their toileting.
‘These fundamental issues need to be addressed and properly attended to whatever policy and regulatory framework care homes and hospitals are operating in.’
Care Service Minister Paul Burstow said: ‘Kindness and compassion, dignity and respect must be central to care, whoever provides it and wherever it is provided.
‘The big challenge is how to translate these recommendations into action.’
LET’S imagine for a moment that it’s routine practice in this country to sedate babies who won’t settle: that the more they cry, the more drugs are poured down their tiny throats.
The same treatment, let’s imagine, is also routine for the mentally disabled: whenever they create too much disturbance, we simply cosh them with chemicals.
There would be a national outcry. Heads would roll. Money would be found immediately to train medical staff and carers so that such a scandal could never, ever happen again.
Now let’s stop imagining and face the appalling truth. The nightmare scenario that I’ve just painted is precisely what’s happening to some of the most vulnerable people in the land — the elderly.
A shocking t hree - year study by Nottingham University has concluded that more than half of all those over 70 who are admitted to hospital have dementia. Yet very few doctors, nurses or healthcare assistants have had any proper training in how to deal with them.
The comments from some of the medical staff questioned for the study make terrifying reading. ‘I just don’t think I’ve ever had any teaching about how to look after people with dementia,’ said one consultant. ‘It’s distressing . . . you feel that you’re not really doing anything other than trying to calm them down,’ added a staff nurse.
People with dementia can’t plan for anything. Understandably, they are often frightened and confused. They feel stigmatised and embarrassed.
THEway to help them be calm and happy is to stick to rigid routines that make them feel safe, and by doing activities that they can enjoy in the moment, such as reading aloud. It sounds simple and it is. But it takes time, which is in short supply in acute hospital wards.
If the old and confused aren’t lucky enough to have families who are prepared to make the necessary sacrifices to look after them, they end up lonely, fearful and disturbed. They’re also often malnourished, as they’re frequently unable to feed themselves — and, as we know, most nurses don’t have time (or won’t make time) to help them with their meals.
Is it any wonder that these neglected patients can become aggressive and troublesome? At which point, the medical staff may well resort to anti-psychotic drugs to calm them down.
You’ve only to read the former breakfast TV presenter Fiona Phillips’s account of her father’s terrible last days to realise that no one is immune.
She gave up her highly-paid job so that she could spend more time with him after he was diagnosed with Alzheimer’s. Despite this, and the fact that she was once so well connected politically that Gordon Brown invited her to become one of his health advisers, she was helpless to prevent her father being given the powerful tranquillisers that, as she puts it, robbed him of his life.
Unlike her mother, who tragically also died after suffering the disease, he was often in good spirits. He loved old Fifties hits which, even as his mind went, they’d sing together. Once, when they were dancing to Patsy Cline’s Crazy and it came to the line ‘I’m crazy’, her father laughed as he told her: ‘I am bloody crazy.’ Despite the disease, he was still funny and loveable.
Then, towards the end of last year, his condition deteriorated. The care home Fiona had found kept him only a night before referring him to a psychiatric hospital. There, he was put onto a mixture of drugs so strong that when she next visited, he was like a different person: stooped, shuffling and unresponsive.
When she asked to see a list of his medication, it stretched to two sides of A4 paper. After six days he developed pneumonia and was moved to a general hospital, where, just a few days later, he died.
Like tens of thousands of other elderly people, Fiona Phillips’s father was an honest, decent man who’d worked hard all his life. Unlike the obese — on whom the NHS spends millions a year — he was not ill as a result of his own self-indulgence.
Can it really be so hard to tend to dementia patients with compassion? Do doctors and nurses need constantly to be reminded that the elderly are human beings?
One consultant in the Nottingham study said that the fact he couldn’t communicate with dementia patients meant he was ‘more veterinary’ in his approach to them.
That remark should chill us all. Tragically, Britain seems to have reached the point where our elderly can expect to be treated no better than animals.