"Poor standard of care provided at end of life"

My father was admitted in late October. During his stay he was transferred to station 12. from CAU. After two days my father was in a great deal of pain due to him having end stage metastatic lung cancer. My father used the nurse call system to request analgesia however the nursing staff began to quiz my father on what he was currently prescribed at home. My father told them that he was getting 2.5mg of oral morphine.

It took approx half an hour to return with his medication. They then informed us that if it did not take effect within "a wee while" to let the staff know, i was unsure what a"a wee while" meant so I gauged that half an hour would be sufficient. When I informed that my father was in more pain and the analgesia had not taken effect, the staff nurse informed me that she would have to clear it with the anaesthetist. I was told that we should wait 1 hour for pain relief to work however breakthrough analgesia is normally prescribed hourly for patients. The staff nurse informed me that he couldn't get too much morphine as its bad for your liver and could result in liver failure, however morphine is broken down in the kidneys and not the liver so I feel like I was lied to.

When I informed that I was unhappy with this as he required more analgesia at this time i felt it was inhumane. The staff then brought ibuprofen gel for his back, i proceeded to tell them that this was insufficient as my father had pain due to his extensive cancer and not a muscular pain. However they proceed to rub this on my fathers back without asking his consent. We were then left with the opinion that this would help, after 15 mins my father was writhing about the bad in severe pain and i went to inform the staff nurse. It took another hour with multiple visits to the nurses station to request more analgesia. The nurse made me feel like I was a pest, and kept stating that they were on it and they would get back to me.

They eventually came and gave my father some lorazepam and we were unsure if he got any further opioids. Withing another half an hour the pain left, and he managed to sleep. We feel like his last days should not have been spent in this amount of pain especially being in hospital and we felt that if we had not been present then my father would have suffered longer as the staff did not seem to care.

The next day my father used the nurse call system to request to urinate and he required help to get to the bathroom. The staff nurse stated that someone would be with him, after 15 mins no one came. His grandson came in and my father said to him re above. His grandson found the staff to be huddled around the nursing station chatting and laughing, this did not appear to be a conversation regarding any patient care. When his grandson said to the staff they stated that they forgot.

My father was getting discharged home  the day after to die at home. There was supposed to be information supplied to contact the district nurses to inform them that my father was home because he was supposed to receive end of life care at home, we waited to 3pm awaiting this information however it never arrived. We decided that we would take him home as he was becoming agitated and he knew himself that he didn't have long left.

When passing the nurses station the staff appeared to be chatting amongst themselves and one jumped up and stated that they were still trying to get the information and that they couldn't get a hold of the specific person.

They informed me that they would phone me with the details, when they called 20 mins after leaving the hospital that they didn't require to give me the detail and that they would refer my father to the district nurses. By Monday no one had been in contact therefore I called the district nurses and informed them of the situation, they informed me that my father had not been referred.

One the district nurses came we were very grateful of their care and it was of that standard that was expected. Unfortunately my father died the next day without the care he needed and deserved all through the lack of communication by Ayr hospital, this has made a difficult time for the family even more distressing.