Palliative care, hospital Vs community

[Rosemary_1706]

Mum is staying in hospital w infection and deteriorating so thought Id equest fast track CHC.

Spoke to mum's community palliative care nurse who told me to contact hospital palliative care team. (and said how well they worked together)

They've just told me even though Mum has community palliative care arranged through her GP, the hospital doctor still needs to assess and refer her to the hospital palliative care department.

How common is that?! More burocracy? Now I have to wait to see the doctor - more hurdles! Situation normal......

[bowlingbun]

Make it clear that mum isn't going ANYWHERE until this is sorted out. Has she been granted CHC now? A fast track referral is supposed to be sorted within 48 hours if I remember rightly.

[Rosemary_1706]

BB, I have been sidetracked by recent hospital events.

First I needed to fight for an air mattress and pressure cushion. Next the side chair was removed leaving no chair. Nurse said a visitor staying overnight had it. Then told the physical therapists said mum required a recliner. Recliner came for two days but then disappeared. New nurses each day say theres only a couple of recliners between two large wards. Mum has not been moved at all in 3-4 days and is getting weaker by the hour.

I've complained either get recliner or transfer to ward that has one.

Regarding CHC, palliative care nurse at home once said if mum were to get CHC she would only receive three care visits at home, one less than she has at home now BECAUSE THE PALLIATIVE CARE STAFF ARE FROM HOSPICE, A CHARITY and that's all they can afford to supply. Sounded wrong to me at the time - as if to make mum decide to stay with local council care- at mum's cost. Sounds like manipulation to me.

So, what do you actually get on CHC, practically speaking? District nurses already come for catheter care and bedsore treatment.

MUM is lethargic, immobile but not in pain,. has agressive uterine cancer that doctors decline to operate or irradiate. Is she actually sick enough for either CHC or hospice? (She has many other chronic but manageable conditions too)

The nurses not repositioning her at all, not leaving water within reach, not using any hoist when they did manhandle her to the chair is just appalling to me. Even with my complaining and polite requests, I feel totally helpless. (This is the same hospital that mum has already received poor care in before, leading to the bedsores, decline in mobility, DVT , all of which have led to doctors ruling out normal treatment of her cancer.)

One point to take away is that prolonged bed rest causes serious physical and physcological decline in a.relatively short time.

[bowlingbun]

Take your mobile phone in and take pictures each time you visit. Complain to the hospital CEO and make a formal complaint. Complain to CQC (online), and get email addresses for both people you end up dealing with. Keep a diary.
I've also met the chair problem myself. I find the usual upright plastic covered chair that patients are supposed to use to "sit out of bed" so uncomfortable that I refuse to use them, either in the NHS or private hospitals, seems to be same chair, different fabric. Even as a visitor, I've found them horrible and good to get out of!
If mum has been assessed as needing an air mattress, vital if she's immobile, then again, complain to the CEO and whoever has assessed her as needing one.
No water in reach is in breach of the most basic rules. So if there's no glass when you get there, take a photo. Email it to the CEO or his/her PA. Talk to PALS. "Chris from the Gulag", a forum member, has brought together a lot about CHC. Read up about the "fast track" system.
Download from the NHS internet pages the instructions about "avoiding pressures sores". Print off a copy and give it to staff. Email it to the CEO.
Staff tend to respond very quickly to a CEO as they don't want to put their career prospects at risk. Sounds like none of them deserve the title "nurse" at all. If you think one nurse is the main problem, get her name and report her to the Nursing Council.

[Chris From The Gulag]

Thanks for the nudge , BB.

Main CHC thread ?

https://www.carersuk.org/forum/support- ... inks-32532

If whatever cannot be found , let me know ... I will have a trawl through the Internet , and then add.

[Rosemary_1706]

This morning mum's in New ward and as I had finished requesting recliner for the nth time, one was being wheeled in!

The staff there will tell you anything. This morning nurses assistant told me mum needed PT evaluation by PT from that ward even though she'd had one by same PT Department when she was on previous ward. Ward manager wanted to know who'd told me that.

I have previously complained to CQC, and hospital chief last year. Shall be doing same again but now mum has recliner.

It was seeing Chris'CHCposting and other posts that made me consider it for mum. Thank you Chris!

[Chris From The Gulag]

Your welcome !

[Rosemary_1706]

Requested fast track CHC from doctor today. She didn't seem to know mum had a palliative care nurse in community.

The recliner had vanished again. 'pals' said there was a general shortage! I told them I hoped mum was still alive when one became available. And to think the place is named after royalty!

I took pictures this morning BB. Has anyone ever witnessed health care assistant drain a patient's urinary catheter into a hospital disposable tray that was already filled with another patients urine AND ALLOW the valve end of the night bag being emptied to dip into someone else's urine??????!. She just shookt off and walked away.

And yes the hospital is rated needs improvement and unacceptable for end of life care by cqc, whatever good that does since it's been needs improvement since at least 2014!