"Fundamental care issues"

Dad was admitted to QEUH in February due to chest pains. I feel I should have been allowed to go in to A&E with dad initially as he was tired and unwell. He mistakenly told staff he had fallen (this was two weeks earlier). I joined dad later and was bewildered when I was told dad required a hip replacement. I explained dad was admitted with chest pains and I suspected he'd aspirated. After discussions with the doctor, dad said he didn't want to risk surgery. Dad was taken into a receiving ward several hours later and admitted to hospital. The following day he was in a single room and looked a lot better as he had been on a drip with antibiotics. I assumed he would get home in a day or so. However it was decided he should go to the Langlands' unit the following day for assessment. 

On Ward 54, I was dismayed to see that his diet said normal instead of level 5 (food) and level 2 (fluids). I had informed nursing staff upon arrival at the hospital but either this information hadn’t been passed on or had been missed. I immediately informed the nurse on the station who apologised, explaining dad had just arrived. However I knew from dad’s text he had been there three hours. There was a big jug of water by his bed, thankfully untouched and dad confirmed he hadn’t consumed anything. Someone then wrote the correct levels on the board but not under the diet section which they left as normal. I had to rub this out and write the correct details to avoid any confusion.

We left a book we had been given by his community SLT and some thickened shakes recommended by his community dietician but we were later given the book back in case it got lost, and they only gave dad the shakes a couple of times, the rest remained on his locker. The ones prepared looked much too thick and unappetising with the result that dad didn't drink them. We ended up preparing them ourselves when we came in. I later found out that staff hadn't alerted the SLT until a week or so later. They rang apologising for this oversight, and said the levels were to remain the same.

When mum and I initially arrived in the ward it was extremely noisy with staff and visitors, and dad looked visibly distressed/overwhelmed by the noise. He actually said - welcome to hell. During dad’s stay my mum, who is deaf, often couldn’t hear what he was saying. Dad looked tired from lack of sleep and I believe this affected his morale. In hindsight I feel very sad that during these last weeks of his life, dad couldn’t hold a proper conversation with his wife of almost 60 years and other family members due to background noise and lack of privacy. 

I also feel there was a lack of communication between staff and family although I was called two or three times during his two and a half week stay. When I rang the ward it took a while for someone to answer. Staff shortages seemed to be the issue. Staff turnover and lack of continuity of care was another issue. I never spoke to the same doctor twice in the ward or on the phone. I didn’t ever see a physio but dad mentioned they had been round. 

Dad required oral hygiene care but it was left to us to bring in our own swabs from home to clean his mouth. Luckily my mum was a nurse and I have knowledge regarding oral hygiene from my job, but we didn’t anticipate having to do it ourselves. I also had to buy denture paste in a nearby supermarket as the ward didn’t supply this and neither of the onsite shops or the hospital pharmacy stocked it. 

On the Wednesday before dad died I was told by a doctor that dad was medically fine and that he would be in another two weeks while they worked on his mobility. Dad groaned when he heard the doctor say this and asked about going to another hospital. He was never once up in his chair when we went in despite all the notices about the importance of getting patients up and keeping them mobile.

Dad was not fully dressed once - the clothes we had taken in were in his locker untouched apart from one sweatshirt which he put on over his gown sometimes. I felt that getting him up and dressed and in his chair even for a short time would have made a difference to his morale.

A few times I saw other patients’ underwear when they went to the toilet or were lying on their bed because they were wearing gowns. This to me was an issue with dignity. On the Sunday before dad died, I noticed him shivering and believed he had aspirated. I informed a nurse who said he hadn’t choked on his food. I mentioned silent aspiration and felt they were unaware of this. I can only hope that positioning had been adhered to during his stay as he was always in bed and was never up in his chair when I saw him. (I believe he was up once). Due to staffing levels I doubt staff had time to watch him when he was eating/drinking. 

There were visitors at the next bed and although I pulled the curtain, the lack of privacy must have been distressing for dad.

Dad liked the staff who were caring and compassionate. They moved him regularly and avoided bed sores. I felt sometimes some staff members could have lowered their voice as Dad had no issues with hearing/comprehension.

Dad died after two and a half weeks on the ward. (He had been moved to a single room which was much better). Staff were very kind and caring to my family and this was very much appreciated.