Sunday 17 May 2009


I've a lady who has a mood disorder who I've been seeing for a few years, now. As time's ticked by, she's also developed dementia. She recently had an acute admission, onto a medical ward that's busy, rather like this.

Staff are largely well meaning but care's not as you'd wish since the wards don't have enough staff to optimally support the patients' needs.

This was rather brought home when, last week, I was in their hospital seeing other folk but had heard my lady with dementia had been admitted. I popped on to her ward, to see how she was being cared for and to let the ward team know what support we'd be able to put in place on discharge. I saw her, she didn't look good. She was thirsty. She was very thirsty.

Her bedside looked like this. I've not moved a thing, this is exactly as I found it :

This was all well outside of her reach.

5 drinks, if you count them. There was water there from the morning. Orange juice that came with lunch. Then coffee. Then a dietary supplement. Finally, some more water from the afternoon.

5 drinks, all on the tray of a lady with dementia, all still there for hours and not drunk as drink after drink is added.

She was discharged back home that afternoon, on antibiotics for her exacerbation of COPD, where she's getting a couple hours of home care and 2 visits a day from daughters to support her. Tragically, this episodic care 4 to 6 times a day results in far better care for her than being on an in-patient unit where there are staff there continuously, 24 hours a day.

As Nurse Anne says, something's very wrong on our acute medical wards . . .


Dr Grumble said...

An all to familiar scenario if you work in the acute sector.

Cat said...

I have to say, although I wish so much I could say I'm surprised, I've seen very similar situations.

Oliver Smith said...

My recent stay in hospital was okay, apart from the fact I ended up on the burns and plastic surgery ward when really I should have been on the Neurology ward.

Some people are not so lucky though, which really is a shame.

Merys said...

This doesnt surprise me, the acute medical wards desperately need more staff or at least some volunteers (our hospital has hundreds) to help feed and water the patients. A lot of our hospital volunteers are trained to feed and give oral fluids to patients (with direction from nursing staff) but instead the hospital uses them for administrative work instead. Nice.

Anyway, this wasn't why I dropped by.

Lovely Dr Shrink, I was wondering if you could drop me a line at as I feel I need to pick your expansive brains on something.

The Shrink said...

Dr Grumble, tragic, isn't it?

CB, it's far too common a theme, now.

Oliver, glad you had a good experience. Most of the time most for most people most experiences in the NHS are. But I'm frustrated by other Trusts delivering poor care to vulnerable folk.

Merys, done :)

Oliver Smith said...

Dr Shrink,

I was doing some research on child and adolescent mental health, but it randomly through up an article on "doll therapy". Just wondered if you had come accross this and if so, what your opinions on it were.

Lady Pippa Jemima Fortesque Smyth said...

I have made my husband promise not to leave me alone in hospital if I am unable to care for myself. Although only in my early 40s I have a serious & life threatening heart condition that means I spend more time in hospital than any sane person would want. I was a staff nurse before re-training as a teacher and I think that the 'care' provided now is a travesty.

Lady Pippa Jemima Fortesque Smyth said...

Great interview on radio four this morning with a nursing lecturer who has written a book on the need for compassion in nurses. Now if only someone would write one on making sure that your patients have had something to eat and drink....

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