We received a call from the care home - she's very poorly. I asked the manager if the granny would be better off either in hospital or in a hospice. I was told she would be with people she knew in the care home and less confused.
We went in to see her. She is sitting up and bleeding from her mouth, pleased to see us but has dementia and doesn't say anything coherent and keeps shutting her eyes.
The next day we receive another call. She is worse. I wonder whether they mean she is dead and don't want to tell us in case we crash the car on the way to see her. But it's not quite that bad.
We go in to visit again. She is now in a bed on wheels with high sides. The care home assistant tells us he has sat with 'granny' for an hour putting water in her mouth with a syringe because she cannot swallow.
The care home manager thinks the hospital staff won't have time to give the patient so much attention.
Mattress And Bed Sores
The care home bed has been given a mattress designed to reduce pressure sores, because the patient now has frail skin and even sitting up or pressing down on heels causes problems. The patient has to be moved to prevent too much pressure continually on the same spot.
They have called the GP. We ring the GP. The receptionist tells us that the GP is away for the weekend, back Monday. The home manager tells us she has called the GP/Ambulance service and said it's urgent that the patient gets a visit for morphine and diagnosis.
GP
The weekend is a bad time because the GP is not on call and the out of hours GP tells us that without knowing the patient's history and without a Do Not resuscitate form there are certain procedures he cannot authorise. (I presume any amount of morphine which would cause the patient to relapse, because the staff are reluctant to risk having to keep calling all hands on deck to resuscitate constantly. Maybe they need two to four or more staff attempting to resuscitate for a minimum of fifteen minutes before they can conclude that attempts to resuscitate are unsuccessful.)
Our on call doctor arrives in a car marked on call. Not the old system of a GP in a banger.
He seems very efficient. He checks heart, mouth, chest, back for heartbeat. He checks oxygen levels with a prick of the finger of the patient and says her oxygen levels are low. (Is that why she is gasping for breath. Must be most unpleasant, and a strain on the heart.) This can easily be corrected in hospital by supplying oxygen.
Treatable?
He says that her lung condition is treatable. And antibiotics can solve the mouth infection. But until she recovers her strength enough to eat she needs to be on a drip so he calls on ambulance to take her to hospital. He says the patient's condition is reversible and rings for an ambulance to be sent urgently.
The care home manager is not pleased. She thinks the patient will die anyway and will be surrounded by strangers who do not care as much as the staff who have known the patient day and night for nearly ten years. The staff can remember when granny was first admitted downstairs (the floor for those who can walk unaided and need less attention). Granny was a jolly lady who occasionally fell over and had occasional bad days of memory lapses but in between was her old chatty, friendly self.
Hospital Visit
Weekend afternoon - we go to the hospital. Granny has her eyes shut and does not respond at all. Her breathing is shallow but regular. She is on oxygen.
Rose Symbol Requesting Silence
I read the notice about the Rose symbol in the wards. If you see this symbol, somebody is dying or dead, so please be quiet for the benefit of those who are sick or grieving.
We went in to see her. She is sitting up and bleeding from her mouth, pleased to see us but has dementia and doesn't say anything coherent and keeps shutting her eyes.
The next day we receive another call. She is worse. I wonder whether they mean she is dead and don't want to tell us in case we crash the car on the way to see her. But it's not quite that bad.
We go in to visit again. She is now in a bed on wheels with high sides. The care home assistant tells us he has sat with 'granny' for an hour putting water in her mouth with a syringe because she cannot swallow.
The care home manager thinks the hospital staff won't have time to give the patient so much attention.
Mattress And Bed Sores
The care home bed has been given a mattress designed to reduce pressure sores, because the patient now has frail skin and even sitting up or pressing down on heels causes problems. The patient has to be moved to prevent too much pressure continually on the same spot.
They have called the GP. We ring the GP. The receptionist tells us that the GP is away for the weekend, back Monday. The home manager tells us she has called the GP/Ambulance service and said it's urgent that the patient gets a visit for morphine and diagnosis.
GP
The weekend is a bad time because the GP is not on call and the out of hours GP tells us that without knowing the patient's history and without a Do Not resuscitate form there are certain procedures he cannot authorise. (I presume any amount of morphine which would cause the patient to relapse, because the staff are reluctant to risk having to keep calling all hands on deck to resuscitate constantly. Maybe they need two to four or more staff attempting to resuscitate for a minimum of fifteen minutes before they can conclude that attempts to resuscitate are unsuccessful.)
Our on call doctor arrives in a car marked on call. Not the old system of a GP in a banger.
He seems very efficient. He checks heart, mouth, chest, back for heartbeat. He checks oxygen levels with a prick of the finger of the patient and says her oxygen levels are low. (Is that why she is gasping for breath. Must be most unpleasant, and a strain on the heart.) This can easily be corrected in hospital by supplying oxygen.
Treatable?
He says that her lung condition is treatable. And antibiotics can solve the mouth infection. But until she recovers her strength enough to eat she needs to be on a drip so he calls on ambulance to take her to hospital. He says the patient's condition is reversible and rings for an ambulance to be sent urgently.
The care home manager is not pleased. She thinks the patient will die anyway and will be surrounded by strangers who do not care as much as the staff who have known the patient day and night for nearly ten years. The staff can remember when granny was first admitted downstairs (the floor for those who can walk unaided and need less attention). Granny was a jolly lady who occasionally fell over and had occasional bad days of memory lapses but in between was her old chatty, friendly self.
Hospital Visit
Weekend afternoon - we go to the hospital. Granny has her eyes shut and does not respond at all. Her breathing is shallow but regular. She is on oxygen.
Rose Symbol Requesting Silence
I read the notice about the Rose symbol in the wards. If you see this symbol, somebody is dying or dead, so please be quiet for the benefit of those who are sick or grieving.
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