Apologies for length of message but this is what you are up against in trying to organise care for elderly parents - this actually happened to us last friday and is set out in a note to Care Home:
To Care Home Manager
There was a major problem with my father on Friday as you are probably aware by now.
There needs to some lessons learned in the relationship between the doctor, the hospital, the ambulance service and the care home.
Firstly I am glad that my father’s condition triggered the Care home to call the doctor, to have him admitted to hospital and to let me know. The hospital is now investigating my father’s condition.
In any case there is clearly a problem with his fluid and solid intake which will need a new regime going forward in that Medical Assessment Unit (MAU) had him drinking and eating straight away after the rehydration process had commenced. His eating and drinking will need to be closely monitored/supervised when he gets back to the Care Home.
At this stage we must try and work out a system that does not see a recurrence of what happened on Friday night.
As we understand it the doctor made the referral to the hospital in the early afternoon of Friday 15th March and identified a bed in MAU to avoid my father having to go into A & E. We appreciate this attempt to save my father any undue discomfort.
However, having identified the bed in MAU at the time of his visit to see my father, the doctor did not confirm the bed until he returned to the practice after his rounds. I am led to understand that the identified bed in MAU had by then been allocated to someone else.
This is where the process then breaks down.
1. At 3.20 pm the Care home believes it is just waiting for an ambulance to take my father to hospital.
2. I spoke to the doctor I think around 3.45pm and he said my father was poorly and he had concerns – I think he also was under the impression it was a matter of waiting for an ambulance.
3. I continue to ring Care home to see if my father has left for hospital as my biggest concern is that he gets stuck in A&E at night which happened just a few weeks (31st Jan) ago but for different reasons (999 call).
4. At 7.30pm he is still at Care home waiting to go when we were told waiting was 1 to 4 hours from 3.20pm.
5. The care home is ringing the ambulance service and being told they are very busy – ambulance service is told that the patient is 92
6. At this time I make the decision to ask 2 friend/carers to go and sit with him to support Care home night staff – I think they get there about 8pm and stay to about 10pm during that time my father is waiting in a wheel chair ready to go.
7. By this time I am seeing A & E as inevitable and set off from my home in Berkshire at 9.30pm and arrive at hospital at 12.15 am or so.
8. During the journey I am in touch with poor night care worker who has it all to deal with – understandably he and the home cannot countermand the doctor’s advice but after 5pm of course the system has gone to a GoToDoc basis and there is then no continuity to pick up what has gone wrong with MAU bed allocation issue and to advise the home of the situation.
9. The reality of the situation seems to be (and we found this out on the morning of 16th March) that MAU were waiting for a bed for my father and it was not until bed became available that the ambulance service were given instructions. So it appears it was a complete waste of time in the home ringing the ambulance service because that was not the actual constraint to the transfer process.
10. In the transfer of the elderly there should be a higher set of care considerations than just putting them to one side because they did not arise on the list via a 999 call. My father was diagnosed as poorly at around 1pm and did not leave Care home until 11.50 pm.
11. By the morning of 16th March he had recovered sufficiently to eat a full bowl of porridge (assisted) and was taking on fluids.
12. When we arrived at MAU around lunchtime they said he needed feeding and they were monitoring his intake and output.
13. When we went to Care home on the afternoon of 16th March my father’s room was in a real mess with dirty water in a bowl on the bedside cabinet, dirty clothes, the clothes he had been wearing just left on the chair. I can imagine a hard pressed night service being thrown out of sync by the night’s events but the need for cleaning should have been passed on to day staff.
14. Sam left for hospital from Care home with no toilet bag or his glasses or ......etc.
15. We now await further news of my father’s condition but a lot of serious thinking is required to address the gaps in the process to prevent it happening again to ANYONE.
16. Thankfully my father was not in A & E at all – and did go straight to MAU. We were told at first he would go to A & E so when we arrived at 12.15 am on 16th A & E could not find any record and said he might be on a trolley in a corridor awaiting admission!! This was not the case – but it could have been??
Regards
Author
Topic: Caring for the elderly (Read 638 times)