Apparently not being able to walk is not a medical problem. Well, that’s what my mother’s doctor told me over the phone just yesterday. Not even if she could walk before she went into hospital? Apparently not.
My mother was admitted into hospital over five weeks ago suffering from dehydration and malnutrition! Wow, how did that happen? Why did my mother stop eating and drinking? Well it was three weeks into her stay before a lovely physiotherapist, not a doctor or nurse, looked in her file at my request and told me that she had been suffering from urinary sepsis which had affected her cognitive abilities. Well that was good to know, but very confusing as to why no-one else had told us that.
The first ward she was in had a sign on the wall saying if you wanted any information about your relative you should ask the nurse looking after her. The person looking after my mother, at that point, was an Italian male nurse who seemed to spend all his time filling in forms and avoiding eye contact with relatives. When I did manage to catch his eye and asked after my mother his only response was to tell me that she had eaten breakfast. I wanted a little more but it was obvious it was not going to be forthcoming from him. There was however another helpful sign that must have been anticipating this reticence as it said if you couldn’t get relevant information from the nurse you should phone in a on a specified number and ask the ward sister for an update. What it didn’t mention was that phone never gets answered. At least not in my experience.
Now I know many of you will now be thinking of how rushed off their feet the nursing staff are and how many relatives must call in every day wanting an update on their loved ones. I realise that, but there always seemed to be enough time for quite lot of banter around the nurses’ station.
It seemed in those early days that every time we visited my mother she had been moved. Initially to a different bay and then onto two different wards. So as the weeks went on the regular refrain I heard every time I asked someone about my mother’s progress was, “I’ve only met your mother this morning and I don’t really know anything about her.’ Well, I thought this is a great opportunity for me to fill you in on the details. You see, before my mother was admitted to hospital with what we now know was urinary sepsis, but had been missed by two GP home visits, she was independently mobile around her house. She could walk without a stick. When she ventured further afield with my father to their favourite spot at the seaside to have an ice cream or to their favourite garden centre for lunch she took a stick with her. Now she was an elderly lady in bed and it seemed that was how she was going to stay.
That was until we were told that they had moved her to another ward. This was an orthopaedic ward. By now she had been in hospital for three weeks and I had not seen her even sitting in a chair. We were thrilled that she was now going to be encouraged back on to her feet. Having been in bed for three weeks she was weak and stiff so this was not going to be an easy job. I spoke to a physiotherapist who uttered the now familiar refrain about not having met my mother before. He was surprised to hear that prior to this illness she was mobile.This information had not come with her from the previous ward. But actually she had not been sent to the orthopaedic ward to receive more intensive physiotherapy, she had been sent there as they wanted the bed in the ward she had been in for someone else and so she was shunted off to any old bed that was free. It was purely chance that it turned out to be the orthopaedic ward. In fact, the ward sister who also told us that she had not met my mother before also informed us that she had been put in her ward because she was due to go home in two days. This was news to us. How could they send her home when she couldn’t even walk.? Hmm, communication not their greatest strength. The physio assured us that he would do his best to get her up and about again but he was working against the odds. Any 84 year old who has been bedridden for three weeks with very limited activity is going to find it hard to get back on her feet. No-one ever explained why more effort wasn’t given to getting her out of bed earlier.
At this stage my mother no longer had a consultants name above her bed. Was anyone looking after her? Did anyone know anything about my mother and her recent history? Over the weeks my mother’s cognitive abilities improved. She had been hallucinating when she was admitted to hospital but as the infection receded and she was rehydrated her mind began to clear and she was lucid 70% of the time but the rest she was still confused.
Had she had a dementia assessment I asked yet another ward sister. The sister, wait for it, who had only just met my mother and knew nothing about her, told me that it wasn’t possible to do a dementia test at this stage as it can take weeks for someone to recover from the effects of urinary sepsis. We shouldn’t assume she would remain this muddled, but it was affecting what the physios could do with her as she was unable to follow instructions fully. During all this time my mother was being helped with her drinking and feeding. She had after all been admitted to hospital suffering from dehydration and malnutrition as a result of the undiagnosed urinary sepsis. Imagine our surprise to turn up to visiting hours on the ward a couple of days later to see my mother on oxygen, with a drip and a catheter and flat on her back. What on earth had happened? Well, yet another nurse, who had not met my mother before etc etc….. told us she had become dehydrated again and the infection had returned, But not to fear they were pumping her full of fluids and antibiotics and they were sure she would soon be right as rain again. There was a rather awkward moment when I asked how she had been allowed to become dehydrated given that the nursing staff were supposed to be monitoring her fluid intake. Didn’t really get an answer to that! So my father and I sat for an hour either side of her bed while she slept soundly and looked like death warmed up – but not by much!
Move number three and she was off to another ward. Obviously orthopaedics had been promised she would be off their hands within a couple of days, but their inability to ensure she had had enough to drink meant she wasn’t fit to be sent home and someone else needed that bed. Did no-one stop and think for a moment that actually my mother needed that bed? No, they didn’t. Well, at least this ward wasn’t a three-mile hike from the car park. It had that in its favour.
In the background, the occupational health team were working like beavers getting everything ready for my mother’s discharge from hospital. We had a hospital bed delivered, a full body hoist, and turntable, a hospital style chair and a wheeled commode and a care package of carers attending four times a day. What fantastic service and efficiently delivered. But what we wanted was our mother back on her feet, not needing a full body hoist to get her out of bed onto her commode. But the day came when we were told she was medically fit and would be sent home. She had been signed off by the medical team and by the physiotherapists. She couldn’t walk, but as I said apparently that isn’t a medical problem!
On the day that she was due to be sent home I received a call early in the morning asking me if my mother could walk. Obviously by someone who had never met my mother before. We could now fill half a stadium with people who had just met my mother for the first time. I endeavoured to keep my voice calm as I explained that she could walk before attending hospital but she couldn’t now! She would be home by 11am the rather embarrassed caller informed me. I set off for the two-hour journey from my house to my parents’ to help my father with the daunting task of settling her back into her home. By the time I got there my mother had been and gone! Two paramedics had brought her home on a stretcher and couldn’t get it into the house, so they took her back to hospital. My father was understandably distressed so I made my way to the hospital without him in search of an explanation.
I walked calmly up to the nurses’ station and asked to speak to someone about what had happened. I got the feeling they were expecting me! I was told that the sister was speaking to the matron at that very moment and someone would come and talk to me as soon as possible. In any event the deputy sister was given the job. I felt sorry for her but she was brilliant. I poured out all of my grievances about how my mother had been pushed from pillar to post for the last 5 weeks. How nobody seemed to taking responsibility for her. How she had been left in bed for so long that now she was unable to walk and how unacceptable that was. The deputy sister told me that it was obvious my mother was not well enough to be sent home and that she would speak to the physiotherapists and doctors. ‘We will start again,’ she told me. As I returned to my mother’s bedside she came over and took my mother’s hand and told her ‘I’ll be looking after you now.’ What a relief!
The next morning I got a call from a doctor. My mother was medically fit and would be sent home again as soon as they could get the carers back in place. How come? Well, the nurse had no authority to tell me that she would look after my mother. As far as the doctor was concerned my mother was unable to walk due to the dementia she was suffering from. They had assessed her, you see, and decided that she has dementia. Apparently the other nurse had been wrong about that too. You can assess someone for dementia who is recovering from urinary sepsis. As to why we had not been told she had been given this diagnosis? Well, the doctor informed me that we were free to ask to speak to a doctor at any time. I pointed out that it is difficult to ask to speak to a doctor about the results of tests that you didn’t know had taken place. She agreed that this might well be the case. So they are sending her home again in a couple of days once they can get the carers in place again. Not walking and now with a diagnosis of dementia.
Moral of the story keep away from hospitals or you may come home with more than you went in with.