Jayne Dowle: Time to end this shameful treatment of elderly

I HOPE and pray that my mother-in-law never has to go into hospital. She is 90 in May, and hasn’t even seen a GP in the two decades I’ve known her. We are lucky. She is generally well. But I know that if she ever has to be admitted, my husband and I will never rest.

She lives four hours’ drive away in Surrey, so we would have to trust the doctors and nurses to look after her, at least some of the time. The thought of this dignified lady, abandoned on a trolley, too embarrassed to ask for help, terrifies me.

I worried about this before the publication of the Health Service Ombudsman’s Report into the care of the elderly in hospital. I worry even more now. The findings have done nothing to reassure me.

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The report found that half the patients analysed did not even consume adequate food or water during their time in hospital.

If medical staff cannot get the fundamentals of basic human survival right, how can they possibly be qualified to look after such vulnerable individuals? And then there are the true horror stories of people left in soiled clothes and bed-sheets, forced to urinate where they lie, because no-one was willing or available to help them.

What on earth has happened to care, compassion, common sense and respect for older people? How can this be happening in a civilised country, a country which supposedly prides itself on respecting its elders and the sacrifices they made to give us the country we have today?

It is a sad indictment on a society which – in truth – all too often forgets the elderly, and regards them as a nuisance which can be literally, shoved in a corner and ignored.

And how many reports do we need to tell us that there is something going so very wrong at the heart of our hospitals? It is clear that this problem is endemic, and long-term. Surely it is time that it is tackled, root and branch, once and for all.

Ministers must accept that it is their responsibility to put into place enforceable policies which make our hospitals places of dignity and care, not factories where the only thing that matters is the financial bottom line.

Hospitals simply cannot carry on treating elderly patients as the lowest of the low. I know that there are exceptional and dedicated doctors and nurses, like the gentle auxiliary who respected my proud grandad in his final illness, and the dashing young registrar who did some of his training at our local GP surgery.

When he told me he was leaving to specialise in geriatrics, I confess I was shocked. Geriatric medicine is not often the first choice of ambitious medical students or recently-qualified nurses.

Friends who work in the NHS tell me that it doesn’t have the kudos of working in intensive care, or bring the emotional rewards of nursing sick babies back to health. So why not encourage medical schools and hospitals to prioritise geriatric medicine, and give it the attention that it deserves?

I know that NHS funding is tight – and will get tighter – but there has to be a good case for directing resources into training doctors and nurses in specific programmes which concentrate on meeting the particular needs of older people. In the most efficient hospitals, ward sisters already make regular spot checks on their nurses, ensure that geriatric patients are being looked after, with adequate food and liquids and no bed sores, and inspect the wards for cleanliness.

It is clear that a systematic method of monitoring care is vital in any well-run hospital, but this doesn’t mean that a huge injection of cash is the only thing which can improve matters; what is needed is a fundamental change in approach.

Communication is vital. Many elderly people feel so distressed by their situation that they cannot bring themselves to ask for help. Some might not even be able to speak clearly, or become so disorientated that they can’t find the words to express their needs.

Nurses, especially, should be sensitive to these situations, and anticipate that moment when a patient can’t reach their own cup of tea, or needs the bathroom. And another thing that must change – I’ve been on wards where relatives are at best patronised, at worst ignored by nursing staff. No wonder so many of us feel we are making a fuss if we complain, until, tragically, in some cases, it is too late, like that gentleman in the Ombudsman’s Report, left forgotten in the waiting room while his wife, who was suffering from Alzheimer’s, died alone. Real change can only happen if all the people involved look long and hard at their attitudes. Everyone, nurses, doctors, administration staff, indeed anyone who is involved with the care of the elderly at any level, would do well to remember one inevitable fact.

Most of us, if we are lucky enough, will live to be old one day. We don’t need expensive think-tanks or yet another report or commission to remind ourselves of a simple truth: we should all treat others as we would wish to be treated ourselves.