Thursday, November 11, 2010

An Age Old Problem - Confidential enquiry into care of the elderly

Today the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published An Age Old Problem.

The report examines all deaths of patients over 80 occurring within 30 days of surgery.  The report which covers deaths in both NHS and private hospitals covers a three month period from April to June 2008.  In that period there were 1752 deaths.

The report highlights the lack of consideration of the patients’ pre-operative condition which in turn leads to poor outcomes after surgery.  It lists nutrition, deafness, poor sight and dementia amongst the possible pre-operative problems in elderly patients and recommends that before surgery they are assessed by specialists in medicine for the care of older people.  Other key factors in the high death rate in this age group are delays of more than 24 hours in carrying out emergency surgery and poor post operative observation.

Time and again AvMA sees problems arising with care of the elderly in our hospitals.  We see failure to allow for their special needs and a general attitude that elderly people’s health problems are just part of the aging process but that little can be done.  Whereas, as the report concludes, recognition of the problems and properly addressing them before surgery can lead to significantly better outcomes for this group of patients.

We have also seen terrible examples of poor basic care of the elderly.  We have assisted relatives of patients at the Gosport War Memorial Hospital where an inquest last year found that in some cases there was inappropriate use of sedation that may have contributed to the person’s death.  And now at the Stafford Inquiry we hear accounts of (not exclusively elderly) patients lying in soiled beds, so thirsty one patient was seen to drink from a flower vase,.

The evidence cited in the NCEPOD report and currently being heard at the Stafford Inquiry is nothing short of a disgrace, elderly people are being let down by healthcare providers in every possible way.  By the accounts of the nursing care at Stafford the patients were being denied even the most basic care in relation to nutrition and hygiene and by this report there is a failure to provide the specialist help these patients need for their complex health needs.

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