Well done for 'Point of care' - proof that good quality care is achievable.
It is important to get the ethos of care for the elderly ingrained into all Acute Hospitals. Care of an ill patient is Acute Hospitals responsibility. We need to get this right, not by blaming and scapegoating, but by changing attitudes and importantly funding these nurses and carers.
Let us do a trial where one group of Hospital does only outpatient activity procedural activity i.e. cardiac catheter, endoscopy etc and the other group inpatient Acute medical and surgical. This will be trialled out in practice in the future. Wait for the results - two tier system one productive and the other struggling.
While I agree that acutely ill elderly patients need cared for within the confines of an acute hospital, alternative pathways do exist for some that do not require specific interventions only provided in hospitals and would be better served being cared for in their more familiar environment - home. Involvement of Geriatricians at the front door is one way to facilitate this. And, I am aware that there is talk and plans to fund hospital-at-home for appropriately selected elderly patients in the near future.
There can never be any excuse for poor care, but I dare say that undue pressures from poor staffing in some instances can encourage less than optimal care for the most vulnerable.
Many died in situ however they were kept comfortable and their families were grateful.
These facilities were considered vital by Geriatric Consultants but were seen as an unessessary luxury by the PCT.
Promises were made to provide Care in the Community to enable early discharge which sounds good and many patients are happy to be sent home often to die however the level of support has often been inadequate depending on the location of the indevidual.
Some are sent to Care Homes however the policy of social services has been to reduce to a minimum use of these facilities ,which means that most of the residents now suffer from dementia or similar.
In the final analysis management determin the quality of care in an institution and individuals need to be held to account for their treatment of the elderly.
I would like to draw attention to the DH policy of involving patients and families and looking to get patient feedback. pateint feedback has many benefots for clinical teams and can identify patient and family concerns with ther service. Patients can asked for feedback every time we have a clinical contact. It is possible to obtain feedback in real clinical settings some examples from from different specialities at www.patientinvolvement.org.
My husband has had two difficult experiences within a year at two neighboring hospitals in the Allegheny region of the US. At one point I described the odd placement of VP shunt valves that extended into his neck along with a third valve to a person in the field. The person murmured: "breathing cadaver", and then would say no more. I have googled this term and gotten no entries with the terminology but I am wondering if in your research you have come across medical schools that use elderly patients to teach inexperienced residents in surgery? My husband has suffered greatly and when his VP shunt was repaired at Cleveland Clinic, the Surgeon there said nothing critical about the original valves. However, the placement of the original valves was odd, and extremely painful. And as I said, the original valves needed to be replaced. Again, in 2019 my husband's gallbladder became septic, and after a drain was inserted, John was left with no further instruction or even a discussion as to the disposition of his gallbladder. The disconnect between the severity of his illness and the fluffy way that it was dismissed is very odd. My husband has Parkinson's disease, which seems to make him a target. Apparently, he is not expected to get "well" so the quality of the life that he was able to lead prior to the original VP shunt surgery, is glaringly ignored. In other words, he is being treated as though he were already on death's door. Yes, he would not be receiving this kind of treatment if he were younger, and I am dismayed that I have even heard the words, "breathing cadaver" spoken in reference to him or anyone else. Is there a source you could direct me to that has been looking into this situation and how to avoid being targeted as such? I would like my husband to be able to receive treatment that is appropriate for his illness. Taking into account his underlying disease I would think would call for caution, but apparently in this day and time, it is just the opposite. His "dire" underlying disease has made him the object of mistreatment and abuse.