NHS failing elderly people, ombudsman report warns

Health service ombudsman Ann Abraham said ten complaints showed NHS neglect of even the “most basic” human needs, in a damning report published into the care of elderly patients.

The report detailed how one patient transferred by ambulance to a care home arrived bruised, soaked in urine, dishevelled and wearing someone else’s clothes.

In another case, a man’s life support system was switched off despite a request from his family to delay doing so for a short time.

Underlying such acts of carelessness and neglect is a casual indifference to the dignity and welfare of older patients. Health service ombudsman Ann Abraham

Ms Abraham warned these were not isolated incidents and the NHS needed to undergo an “urgent” widespread change in attitude towards older people.

Of nearly 9,000 properly made complaints to the ombudsman about the NHS last year, 18 per cent were about the care of older people.

“Underlying such acts of carelessness and neglect is a casual indifference to the dignity and welfare of older patients,” Ms Abraham said.

“That this should happen anywhere must cause concern – that it should take place in a setting intended to deliver care is indefensible.”

The report detailed failures to provide clean and comfortable surroundings, help with eating, drinking water provision and the ability to call someone who will respond.

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There were also failures in pain control, discharge arrangements and communication with patients and their relatives.

Half the people in the report did not consume adequate food or water during their time in hospital and the cases showed instances of older people unwashed and left in soiled or dirty clothes.

Indignity

One woman described how her aunt, named only as Mrs H, had been taken on a long journey to a care home in Tyneside by ambulance after a stay at the elderly care assessment unit at Birmingham Heartlands Hospital.

Mrs H was described in the report as a “feisty” independent and dignified woman, who had lived at home until aged 88. She arrived at the care home “strapped to a stretcher”, soaked with urine, dressed in clothing that did not belong to her held up by paper clips, and accompanied by bags of dirty laundry, much of which was not her own.

This report shows that ageism and discrimination are still a fact of life in our NHS. Simon Bottery, Independent Age

A Trust spokesman said it had apologised to the complainant and carried out a full investigation.

In another case, staff at Oxford Radcliffe Hospitals NHS Trust switched off the life support for a patient named as Mr C despite his family’s request that they delay doing so for a short time.

His daughter described him as a “mentally active and creative” patient who was in the process of writing a book. He underwent quadruple coronary artery bypass but suffered a heart attack afterwards.

Elaine Strachan-Hall, the Trust’s chief nurse, said in this case the policy to discuss “do not resuscitate” decisions with the family was not followed, adding: “Since this case, the Trust has apologised to the family for the distress that was caused by the lack of communication.”

Ms Abraham said money alone would not help the NHS to fulfil its own standards of care.

“Like all of us, they wanted to be cared for properly and, at the end of their lives, to die peacefully and with dignity,” she said.

“What they have in common is their experience of suffering unnecessary pain, indignity, and distress while in the care of the NHS.”

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Society problem

Simon Bottery, Policy Director at charity Independent Age, said: “This report shows that ageism and discrimination are still a fact of life in our NHS. Some older people are treated as though they have a shelf life and don’t deserve the same quality of care as people younger than them.

“In our experience, this discrimination extends even further than poor treatment during hospital stays, and can be seen right across the healthcare system…Ultimately, this institutionalised neglect damages not just the patients but the healthcare system itself. Poorer treatment and after care means older people take longer to recover and are more likely to be readmitted.”

He told Channel 4 News the neglect of older people in the healthcare system extended right across society.

“This is definitely a wider issue about how we treat older people,” he said.

“We tend to see older people as having past their point of use – this is most clearly shown when we had the requirement to retire at 65. One day you are a valuable member of the workforce, one day, you are not.

Older people are regarded as a bit of a bother, and it takes more time to deal with them. Mervyn Kohler, Age UK

“Society is obsessed with being young and appearing young. We spend huge amounts of money trying to stave off old age – that has to say something about how see see old age. We also fear old age – what will happen to us. People are often really surprised to discover that old people are happier. The statistics show that we are most miserable at age 46 – then we get progressively happier.”

He said that this may change as society gets older.

“As people talk about it more, as society gets older and older people work for longer, this will have to change,” he said.

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“The other thing that will change is older people will be seen as an economic force – the ‘grey pound’. That will change – but not overnight. I think in the States they are ahead of us – I was reading about a 100-year old who is still chair of his hospital college board and sees patients. It will be difficult to have attitudes to older people in the NHS like this if you work alongside older people.”

Mervyn Kohler, of Age UK, told Channel 4 News: “There’s a negative attiude to old people in society. There are overt things, like older drivers for example, their insurance premiums rack up. And then there are more covert – older people are regarded as a bit of a bother, and it takes more time to deal with them.

“I think this issue underlines what the report said. Hospitals have to run lots of high-tech equipment in the most efficient way, so when people need time and tender loving care, that tends to get marginalised, and the NHS does begin to look as bleak as it looks in the report.

“There’s certainly a role for management here – they have to run the hospital efficiently but if they ignore the basics of care they have lost the plot.”