How can hospitals improve care for the elderly?

How can hospitals improve care for the elderly 2262

The recent government-sanctioned report which uncovered many failings regarding the provision of care for the elderly in hospitals had provoked understandable dismay and outrage.

Care Quality Commission (CQC) inspectors visited 100 English hospitals and uncovered problems such as 

•Call bells being placed out of patients’ reach or not answered promptly enough

•Patients not being given the assistance they need to eat

•Patients being interrupted during meals and having to leave their food unfinished

Such medical negligence can have serious adverse health consequences. 

Patients who suffer as a result of poor health care can contact a no win, no fee solicitor to enquire about making a personal injury claim.

Thankfully, the standard of healthcare in Britain is generally very high and it is important to stress that of the 100 hospitals the CQC inspectors visited 80 met dignity and nutrition standards.

However, dignity, it seems, cannot be guaranteed at every hospital. It is worrying to think that the CQC uncovered problems relating to “staff speaking to patients in a dismissive or disrespectful way”.

Susie Bailey, a caller to BBC Radio Four’s Today programme, spent a night in hospital recently and highlighted another problem: some staff ignoring elderly patient’s pleas for help. 

She said: “It was almost as if they [the nurses] were a social club and the patients were interrupting their chat and paperwork”.

Dame Joan Bakewell, a former government champion for the elderly, told Today that she believes a “lack of empathy” can be the reason why some nurses act in an off-hand manner with patients. 

Ms Bakewell acknowledged that old people can be “difficult to help” and that there is a lot of pressure on nurses to achieve defined outcomes and “tick boxes”.

But she added: “Nursing has become more academic and less caring. The heart has gone out of it.”

Sending in task forces to identify bad practices and encourage good practices is, she believes, one answer and she would also like to see staff engage in role play; acting out the parts of elderly patients so that they can see what it feels like to “feel old and need help”.

Janet Davies, of the Royal College of Nursing, accepted there could be "no excuse for hospitals showing a lack of care but added that spending cuts and budget restrictions have made it hard to maintain high standards on wards.

She said: "Evidence shows that patient safety and quality of care is improved when you have the right numbers and the right skills in place on wards.”

Health Secretary Andrew Lansley, who commissioned the CQC report, invited medical professionals to draw attention to any concerns they might have for the standard of hospital care for the elderly.

He said: "We expect that staff across the NHS, if they see examples of poor care blow the whistle on that, which is precisely why we have introduced changes to the staff contract."

Dr Raymond Tallis, philosopher and former professor of geriatric medicine, would prefer that staff talked to each other to learn how best to improve care for the elderly.

He told the Today programme: “On wards where things are going right let’s see what their secret is.”

By James Christie

[Photo accompanying this article by Department of Health]