"Discharge of confused, elderly lady"

About: Ayr Hospital / Geriatric Assessment

(as a relative),

My aunt, then 88 years old, was discharged from a 3 week admission to Ayr Hospital in a manner which I felt to be at best inappropriate and in the worst case potentially very dangerous.

At the time of discharge the family felt that she was in a confused state, and not safe to be sent home, where she lived alone. The nursing/medical team denied any confusion and the discharge went ahead. She was sent home with (literally) a carrier bag full of medication and a ream of paperwork containing in very small type a very complicated list of the names of those medications she had been discharged with, alongside the dose and frequency with which to take them.

Thankfully she had family there to help her decipher this and sort her tablets out until a dosette box could be arranged from the local pharmacy. Had this not been the case she would have had absolutely no idea what tablets to take at any given time, and given her confused state, would have struggled to know which she had already taken.

This was in no way patient-centred - even without the added complication of her confusion, the extremely small font used in the paperwork, and the complex dosage instructions were not tailored for use by an elderly person. I find it preposterous that she was left to 'go it alone' in this way.

Sadly she is no longer with us, this incident happened around 18 months ago, but I am only now aware of this site as a place to air my concerns. My hope is that by sharing this information maybe someone else can be spared a similar experience.

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Responses

Response from Eunice Goodwin, Patient Feedback Manager for NHS Ayrshire and Arran, Quality Improvement and Governance Team, NHS Ayrshire and Arran

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Dear Ayrshire relative,

Firstly, can I say how sorry I am that your Aunt is no longer with you and that her discharge was not, in your own words ‘patient-centred’. As you rightly stated, an elderly person and a list of medication in a small font even without any issues of confusion is not ideal.

There are a few things we can do here and I wonder what is best. I can and will pass this to our managers for Ayr Hospital, Pharmacy and the Care of the Elderly team for their consideration. I will certainly update you on any feedback I receive from the teams.

Also, it may be helpful if you feel you could provide us with your aunt’s name and date of birth as this will help as it will give us a specific example for the teams to look into. If you do want to contact me, you can email me on eunice.goodwin@aapct.scot.nhs.uk or phone me on 01563 826222.

As you may know, it is our aim to deliver a patient-centred service and there is always room for improvement, so thank you so much for bringing this to our attention and giving us a chance to address it.

Best wishes,

Eunice

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Response from NHS Ayrshire and Arran

Dear Ayrshire relative,

I am sorry; this is a very sad experience for all concerned. I know we have worked on our processes and I am sure we have improved things since then; however, I would like to meet with you. If you would like to meet, please contact Eunice Goodwin, Patient Feedback Manger at eunice.goodwin@aapct.scot.nhs.uk or phone her on 01563 826222. We are keen to make sure we have improved the aspects of care you have mentioned.

Kind regards,

John Swiatczak

General Manger

Ayr Hospital

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Update posted by Ayrshire relative (a relative)

Dear Eunice and John,

Many thanks for your helpful responses, and the offer to meet with me. I will be in touch with Eunice over the next few days.

Kind regards,

Ayrshire relative

Response from Eunice Goodwin, Patient Feedback Manager for NHS Ayrshire and Arran, Quality Improvement and Governance Team, NHS Ayrshire and Arran

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Thank you Ayrshire relative,

I will be out of the office a bit over the next two days, but I will pick up your message whether voicemail or email and if you want, I can call you back if you leave a contact number.

Thank you for getting in touch,

kind regards,

Eunice

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