More Of The (Shameful) Usual

As is normal these days the nursing home that we went to was 'well known' to us. The patient had the normal 'difficulty in breathing' which I have learnt means anything from a cold to the patient not breathing at all.

As we arrived I spotted two Healthcare Assistants standing outside smoking. “Another ambulance”, one of them commented, “This place is a right dump”.

I couldn't really disagree with them.

So we made our way up to the patient – no-one was there to show us where to go, again not unusual. Our FRU was already there, he's a good bloke and I trust his clinical skills completely. He'd already done a full assessment and was talking to the nurse in charge. From the sound of the patient's breathing and his high temperature it was obvious that he had pneumonia.

So I asked the nurse how long he had been coughing and having trouble with his breathing.

“Ten minutes”, she replied.

Now, you don't need to be a medical genius to realise that his breathing must have been horrible for quite some time. But given the amount of times I've heard that “the patient was fine until five minutes ago” from a nursing home nurse I suspect that there is a whole load of medical books that need rewriting.

The patient was seriously ill, and you don't get like that in ten minutes. My guess would have been that he was unwell for at least a day, yet no-one thought to call a doctor or us until it looked like the patient might die.

Yet again the nurse in charge of his care didn't seem to know anything about the patient, when I asked about the patient the nurse seemed to think that giving me a list of their medicines counts for this. Sadly this is also not unusual. I did my usual trick of pretending not to know what a certain drug does, then ask the nurse to see if they know. It is essential that a nurse knows about the medication that they are giving someone so that they understand the effects and side effects that can occur. Unfortunately in many of the nursing homes we go to this is a rarity.

In this case she was unsure as to why he had been recently prescribed some antibiotics.

I used my 'ex-nurse' knowledge to write a quick entry in the patient's nursing notes – that way nothing can be added after we have left. It's a little trick of mine that satisfies my bloody-mindedness.

So we moved the rather ill patient to the ambulance and while treating him waited for the accompanying member of staff. We waited and we waited, I was considering just driving off. Eventually one of the usual foot-shuffler 'nurses' made an appearance and we left for the hospital.

It's depressing, and I've written about this before, but it's all too common to find this sort of neglect going on in nursing homes. The companies who run these places make huge amounts of profits, yet the care is what I, in fact what most people, would call sub-standard. If the number of people with dementia continue to increase, then more people will need nursing care, and if the care isn't there at the moment I dread to think what it will be like in the future.

Two links to finish off – one is to Inspector Gadget who tells us of a terrible story where two scum who left a police officer brain-damaged have just had their sentences reduced. The other link is to a great work of fiction by Rocky Mountain Medic.

Oh, and hello if you came here from the Daily Mirror.

30 thoughts on “More Of The (Shameful) Usual”

  1. Hi Tom,One time when I was doing “LAS Support” as a Johnnie, we got sent to a nursing home for “?broken hip post fall”. All the classic signs – leg shortening, foot turned out etc etc. Post fall was about right though…the poor old boy had fallen in the shower THREE DAYS previously, they'd picked him up and stuck him in bed and only just thought of phoning 999!

    Appalling!

  2. I was only 16 when I discovered how awful some 'care' homes can be. It was my first day on placement at this place, and already I'd seen some horrific abuse that I had to tell social services about. Needless to say, I didn't return. I then went to a second care home, in my own village, owned by people I know. They treated their residents equally badly, and that left a very negative view of care homes in my head. I'm now 19 and have worked in one of the best in the area since I was 17.While it's great to know that the residents in my care home are being looked after to the best of our abilities, it makes me feel absolutely terrible knowing that there are some elderly people being treated absolutely disgustingly. Whatever happened to 'treat others as you would like to be treated'?

  3. Thanks for the comment.Perhaps I should have been more specific, it's mainly the 'chain' nursing homes that are rubbish. While the best ones are (shamefully for an atheist like me) faith homes.

  4. In the 8 months that I worked in one care home, I seen many sights that made me wonder why I did it.A quadriplegic who fell out of bed, they couldn't explain that.

    A resident who managed to near suffocate themselves on the bedside bumpers as the door was shut as they were being to noisy.

    An unexplained fracture to the arm, even though the resident did not walk anywhere or move due to the nature of their dementia

    A qualified nurse who did not know how to take a pulse, BP or notice the signs of a fractured femur.

    I could go on and on, but hasten to add, they were reported, police investigated and a few members of staff were dismissed. I felt I had to leave as it was common knowledge I was the grass and could not work in such conditions where frail elderly were treated like that, I felt I wasn't doing my job properly.

    It put me off doing that job for a while, even going to nursing college, glad to say now that I am doing nursing now and dreading my placement at a nursing home.

  5. My family recently had to find a home for my Grandfather. Mum took a week off work to go round all the local ones with my Gran and after a surprise visit to the first home on their list Gran told her they could stop looking. Luckily this place had a space and Granddad is now as happy as larry in there. Mum just will not stop going on about how amazingly great this home is.It's sad that this seemingly not the norm. If all homes were this great then it would be better for everyone.

  6. Desire for more profit rofit + low paid staff + shit job – incentive = Bad care.Surely these places are accountable to a government department.

  7. Hi Tom, I don't wish to be controversial but in this case you're wrong, not all private nursing homes make a lot of money. My father set up a 21 bed nursing home in 1989. For 5 years it made a loss and the family savings and a loan from my grandfather kept it open. For a further 10 years it broke even and then the business loan taken out to start it up was paid off and it began to slowly make small amounts of money. My dad used to work 90 hour weeks because he would work without pay. Before it filled up we lived there because my folks couldn't afford to run the home and a house. I know people think it is easy and a licence to print money but it isn't. It's a bloody hard slog, it's 24 hours, the staff are a pain in the arse and if anyone doesn't come in then family members have to make up the staff. Our home cares about residents, we know their likes, dislikes, hobbies, favourite foods. We talk to them, we take them on day trips, we try to find ways to entertain them. We know if they are ill and an illness will never be ignored. Most importantly my father doesn't believe in giving drugs to people to keep them quiet. They frequently arrive from hospital doped up to the eyeballs but he weans them off the tranquilisers and their personality reappears. I don't doubt there are some horrific homes out there run purely for profit and you probably see more than most but please don't think they are all like that because they aren't. The big thing at the moment is for the media to slag off nursing homes and I seem to spend hours defending them to various people. They aren't all bad, ours isn't and some people really put effort into making the final years of their resident's lives fulfilling, interesting and happy.

  8. i work as a carer in a home with a excellent reputation, and it disgusts me that there are nursing homes like this. it makes me want to cry when i hear stories like this. i just finished your book and it was excellent.

  9. I don't want to cause a fracas, but who here would admit that they worked at a crap care home anyway?!I think like everything else, you get good and bad examples of care homes. And unfortunately, it's the bad ones that you tend to remember, and are the ones that make it into the media. My grandfather was in a care home for the last 3 years of his life, and we never had any problem with the home or it's staff. But that might just be because we were lucky and could afford to shop around for a decent home, even if it did cost a bit more.

    Regards

    Nick

    http://nickhough.blogspot.com

  10. I have worked in a council run residential home for 6 years , we too know our residents favourite foods, have activities 4 days a week, Involvement with local schools, we know the names of their relatives, have 2 budgies!! staff have regular training, very low staff turnover, show respect and dignity in all areas of our care, and when we lose one of our residents, we too shed tears with their relatives, We have a heart, so as you say there is some lovely homes that dont usually get mentioned.

  11. Tom,I felt compelled to write. I am a quality manager for a very large independant chain of homes (80 homes). We audit 100% clinical, activities, medication, personnel twice a year. We also ask views of residents/families doctors/social services and also look at meal/music/TV perferences etc once per year to see if there are any problems. I have worked this company since the beginning and there are so many controls that it would make you weep. I also change my audit trail all the time i.e. looking at weight decrease and increase. I ask for resident views at time of visit to see if they are content and happy. I have recently asked all staff to taken photos and all baseline obs of all residents being admitted to hospital as sometimes the deterioration in their condition whilst in hospital is great and the blame is always put on the homes. Yes i do sometimes have rogue managers however as with any other large organisation we talk all the time and can see straight away when the home is not performing and we can put pressure on that manager to perform or get out. That is the benefit of a large organisation – I can put a performing manager straight away in one of the underperforming homes.

    I always say that if the home manager is good then they will lead from above.

    I recently had my mother last year in hospital with two strokes and two leg amputations. The care was atrocious, I requested care notes six times and none came through. In the end both myself and the consultant (another female!) were in tears as to her condition. To end it all she got MRSA. I did not see any controls once or hand washing.

    I am passionate about what I do and I feel so are my colleagues. I worked for the owners when they had two homes and they never took out a penny for years. Yes they are beginning to reap some benefits but if you look at any of the homes ou will see improvements taking place. We have quality system – inviting external inspectors into the company on a monthly basis and are starting to go green! as well as CSCI

    And I do not earn that much!

    And none of my homes are in your area!

    And I bought your book and have been reading your blog for ages!

  12. I'd say plenty of people would if they'd left to work in a better one. If it was the first care home they'd worked in, they might not know what a good one was like. Obviously if they witnessed abusive behaviour they should be suspicious, but if it was 'just' neglect – for example not washing the residents as often as they should – they may well think it was normal.

  13. To quote the Who – “Hope I die before I get old”, or preferably never stuck in one onf those awful places. I want to die on my feet if what you describe is the alternative, because that ain't living.RegardsBill

  14. I have just returned from a three day visit to see my 90 year old Grandmother in the Yorkshire Dales.She lives on her own and does everything she can to remain independent.

    Her absolute worst nightmare is to longer be able to look after herself and to be made to leave the home she has lived in for 67 years and in which she shared her life with my Grandfather for nearly 60 of those.

    Over the years she has seen many people, quite literally, wither and die in various care homes. The sad fact is that the demand for quality care for the elderly in our society vastly outstrips the supply- market forces inevitably mean that those with the ability to pay slightly more often end up in the best homes while those who cannot don't.

  15. What if you have to physically struggle with someone in order to wash them? Or feed them? Or get them to take their medication? Or simply to get them to stop hitting you every time you come near? People with dementia can be quite combatative and persuasion and encouragement may very well not work.Anyone from the outside looking at a physical struggle would probably think “that 'carer' is abusing that poor frail elderly person!” and class it as abuse, even if the carer is doing their best to use the safest holds and so on.

    But if the carer opts to NOT struggle, and patient goes unwashed, unmedicated, unfed, etc, then people from the outside will view that as neglect/abuse too.

    There's no easy solution. Often there is more to a situation than meets the eye.

    Of course this doesn't excuse people who aren't making any effort to do their jobs, like the nurse mentioned by Tom who didn't know why her patient had antibiotics, and it certainly doesn't excuse people who take out their bad mood on a patient in the form of abuse or neglect.

  16. My mums neighbour of 42 years (aged 93) was living in very poor conditions, her home was thread bear and stark, she looked unkempt and malnourished, she had two visits a day from home helps who were having to bring in extra food in for (her family supposedly did all her shopping.) The home helps wanted to come at lunch times to make her a hot drink and something to eat, the family wouldnt allow it they said “if she had a good breakfast, she didnt need anything else till tea time. All in all a pretty miserable existence.The situation came to a head when my mum (aged 81 herself) found the neighbour in a very confused state, at one in the morning, in the pouring rain sat in middle of her front garden. She was cold muddy and bedraggled (the crew reckoned she had been out side for some time before my mum heard her cries for help.)

    She is now living in a new, purpose built, local authority care home. I went to see her a couple of weeks ago, she looked fantastic, she was clean and well dressed, her hair was done, the big dark rings from under her eyes had vanished, her face fuller, she was cheerful and happy with her new situation.

    The home is beautiful, with each en suite room having French windows on to their own balcony, with views across the open country side, Its more like Centre Parks than a care home, (I didnt see many of residents out riding bikes or ponies round the grounds though :))

    This lady is fortunate to be in such a place, shame not everyone is so lucky.

  17. Brings back the horrors seeing my Gran suffer in a badly run home (aggressive dementia was too tough to handle at home) – she broke he leg despite not being able to walk for two years and the home covered up how it happened. We campaigned and eventually got the manager sacked but it was a hard job convincing the management company that their star employee with record financial figures was an uncaring unfeeling b*tc& and was having an affair with her assistant manager.It reminds us all why we need to have children, they are the ones that choose our nursing home and hopefully will fight our corner.

  18. It gets worse. Most of the top 20 presribed drugs commonly prescribed by psychistrists and doctors to the eldlerly in homes have side effects that effect breathing and casue stomach cramps and create intense tiredness. Even if youa re told your relative is not doped you can not be sure that the cocktail of side effects for medicine for what she has does not as a side effect produce a dizzy, dulled intense physical tiredness in your relative as a KNOWN by product. It amkes them easier to looka fter for the home so it doesn`t infefere in their efficient running of what is to all purposes state sanctioned final solution for the eledly in out society where the Mental Health Act and Social Servcies powers allow people to be taken away by their own will taken from their friends and neighbours and community and home and posessions to experience a drug induced stupoour often poor diet in a living room where the tv is never off given often substandard cheap food and told to sit out the rest of their days in a public kind of death row. Unlike you or I many are not allowed to go outside…the view from that window to you and I is one second and with our car keys were down the road. They are stuck there, stupified and at the mercy of some carers. Not all But it only takes a few. I knew one who was such touchy feely and partonisingly happy to everyone and she had this habit of coming up unawares behind old ladies and making them jump out of their skin. Seriously traumatising them as many pre war English ladies wer enot sued to be touched unawares by people. I had a quiet word to her twice.. Nothing doing and complained. No wrong doing was seen. This is the next worst aspect. Fist after powerful drugs that I would like to see a psychaistrict take themselves tos ee the side efffects for themselves before they gave them to weaker bodies. ( i`m telling you THEY would not be able to do their job proeprly or feel so well either ). People put far too much down to people being old and that includes it doesn`t matter so much anyway as they are old.This is wrong. The second worst aspect after the ignorance of prescrbing drugs pushed for profit is the sheer complacency of social services in answer abuse and your concerns. if you get too angry and upset at the intense suffering of your relative from these infallible people as it seems to themselves often.. you may even get a mental health review your door. I know someone who did and they were just upset about their relative in care. These people do not and will not lsiten and they will not move enless you have a good solicitor. if you do not have legal aid then you are going to find quite a bill that is alot for your average working family to pay. Either be rich or be poor with no income. As the middle income and low income bracket is going to hit you hard. And you want a solcitor who has no fear taking on social servcies and the NHS and preferably you want someone outsdie of your county as often the solcitors are too close to many of the people they live and work near. Just a word of advice. There is also a shortage of mental health solicitors. Advocates are there…. and they do care they just don`t have any legal clout.Nothing moves without a dedicated lawyer. Only thing that makes anyone take any notice. Trust me. I have been there. Social servcies and even carers and hoems fail to realise often what someone has lost. amny of the old are not only losing their minds a bit and skills and energy but have lost their home and community, friends, posessions andoften many of these people have been sectioned against their will all in the name of their best interests..You`ll come across that alot… Drugged for their best interests, taken from home against their best interests . All of these people were brought up not to question doctos in an age that had more integrity than now and to trust in NHS fromt he cradle to the grave.. ( This is in the UK ) and never having to pay for health care. To many then it comes as a shock they are charged like 600 a week in care and have their hosued remoraged and all their money taken as their care is run as a business! What is doubly shoicking ehre is that in many of these psychic prisons they calls homes people are paying weekly through the nose to be abused at a scandalous rate a day for pure profit. Like alot of their symptoms and side effects is the result of drug companies also being run for profit. The legal system is stacked in favour of the goivernment and accountants and health care and social servcies ideaology you`ll find makes far too many assumptions with their legal guidelines and liability clauses that their idea of doing god i.e thier duty is to match paramteters where someone is SAFE, warm etc etc… Nowhere does a kind of spiritual wellbeing or anything with regard to happienss follow too much The homenever know what you were like before…. You soon learn to settle in as if you protest too much they WILL and they DO sedate you. Many side effects lead to aloss of appetite as well and a dry mouth. If you do not believe me take a lsit of the top 20 prescribed drugs and look them up on Google for their sideeffects and make a list….. If your relative is on say about 8 drugs… and some may even be anti-psychotic…. then yua dd up the number of pills that add drowsiness and tiredness and breathing difficulties and stocmach cramps as side effects. They`ll tell you your realtvie is not on dope but the combined effect of the mediciens they are on is the same effect as. You KNOW you are being spoken to inj half truths..you know the home is sellingitself t you with it`s great menu and all and ” All our ladies are happy here ” the mangeress will say until you disciver too late that is actually the mindset of the manager who cannot think any other way other than the fact of idealogical fanticism All her ladies are indeed happy here….. It is prejudice upon assumption. You trust the doctors and you know maybe it is unavoidable or advisable… that you have a relative needing care maybe.. You want the best for your relative..and before you know it…they ahve already sectioned them and drugged them and a few months down the line they are not the same person you knew. Drugs, de skiled, de-individualsied and like sat on public deathrow..with breathing difficulties, dry mouth, stomach cramps and all else… The trauma of leaving home and community and in many cases NOT allowed to visit your old home ever again. ( might even be inthe process of being sold off to pay for your care/abuse. That should be one word. As it is both.Noone gets away without even mild abuse even if that is kind patronmising and neglect as others need help more than you and whatever…You can add my name to the anti-psychiatry movement. the need to train carers better, for a rigorous complaints procedure to be set up in UK social services like they have in the Police and in many other businesses, for the rethinking of Western medicine in general and retesting of drugs and dosages…… Drugs are used out of conveininace in drugginga and stupifying people. Not in making them better. This is a LIE. I urge all people with relatives to get the list of medciation they ar eon and look everythign up on google and for side effects and make a list. You WILL get a shock.

    I also urge people if they want any chanhge you got to use solcitors as they will not lsiten.Only solcitors can change anything and the only thing medical or social services that egts them scared. same with private homes. Until you get solicitors involved you are just a voice to them. Homes don`t know anyoen from adam.new face in.They don`t know you or your home or your wardrobe, what you did, your friends or nothing. ou arrive… you are person X and you are there to take x pills and y and they ahve your medcial records and keep an eye on you. It`s warm. There`s a tv . it might be nicely decorated and all on the surface looks well and normal. What people forget is that we visotors can look out the window grab out car keys say goodbye… and go. They are legally trapped there. often not able legally to leave the grounds.I have known palces where on Summer days they were not allowed out as they were eaiser to supervise in their chairs. This is not a rule. But abuses do happen and some individuals it is just a day job. Some people are genuine veitable saints of hands on real care with a eprsonal relationship with people which must be seriously emotionally exhausting and then see many of them die. Takes alot of faith and hard work. I applud these people and without them many lives would be alot worse.

    It is shameful…. few would think many of the drugs create weakened lung lining and weaker tissues and leave people prine to chest infections.it all seems WARM in the home and all else.. and you cannot fault it on the surface notr the doctors..You presume they know what they are all doing. They do not know what theya re doing and least of all they do not know to WHOM they are doing it too.You know your relative better than any of them and I suggest to anyone who feels strongly about things and to immediatly get a solicitor and make a case ebfore it is too late. Social servcies and care DO mess up old peoples lives and not just a fair few….. MANY…. Millions infact… They make far too many assumptions in their ideaology and medication and they fail to understand a generation that was more patient and trusting and had repsect for doctors and the state…. And because of this they are being absued all the more.

    As the truth come sout over the web and all like it has done for bank charges… it shows you people CAN make a difference. I read someone 1.7million will have dementia inthe UK by 2025 was it? Don`t quote me on that but is is a huge leap inthe demographics in the UK…The Government know this.

    It is shokcing, No doubt politically it suits the complacne tto sweep mold people out of the way and imprison them so they don`t fall down in your local shops on us and their helaht care can be paid for by the selling of their own homes and all. This is the conspiracy of our age and the real political truth of ourselves and the silenet majority it seems. And it seems to me ALL of us are OK with the drugging of the elderly recued to second class citizens and cut and shut off from society and havign their rights taken away in many cases by mental health law ans their homes seized as WE and we are all guilty don`t do anything about this. We prefer them to pay than us. We as a society must want them put away on public death row camps for their 2best interests” and we just hope it`s OK and that they are ok and not drugged p too much and reasonably OK and happy. This reflects on us as a society.

    MAny of these people ahve no choice. They have to go to a home. They ahve to go to a certain home with thier condition and they have to pay for it. End of. And the price is what is is 100 a day or not far off..

    It`s the one thing in the UK in the 21st C that reminds me of Nazi`s and the Communists. I draw a serious parallel… and many of these people especially the oens abandoned by their relatives or without any relatives in some places where they know no relatives come in to visit them are even more vunerbale and open to abuse. Noone to check their medcial dose. Noone to visit, no pressure on service as noone is going to ask about you……… OK if you land in a good place and all….. But if not…. and you are traumatised by your experience and drugs and entrappment and condition and all else then there is noone to help you…….You will literally be a dizzy , doped, dry mouthed, side effect ridden, struggling mass of tired limbs waiting to die with a surface level of normality and care…. But you leanredf long ago that noone treats you very much as you any more and your self identiy went with your cdeclinging cognition and your dignity and self worth and much else as it was slowly eroded away from you from the first day you went away.. whether that was hospital first, rehab or eventual care… It is a slow process and few relatives can see it…… You got to be there 6,7 days a week and sometimes more than once a day and dtay for many hours to see it…… and one day you suddenly KNOW that your relatives condition has got worse and they are far less themselves..They will all say it is Alzheimers or something else and you do not fully understand… thye know everythign remeber They REALLY care they are the carers… you know nothing…… but you know… you know inside they have and are slowly killing them off cleanly in adrugged stuppour and there is nothign you can do about it and you wish you got that solcitor day one when they took them away.

    Care is a dififcult issue.I know it is. Some people are bette roff and happy in care but many are not. And social servcies treats allthe same with the ideaology that everyone is the same and they are not. People..have very diffierent needs and what really matters in some peoples lives and is needed ro them to be happy is ignored and the increasing of dosages and all for people and the cocktail of drugs they are put on is scandal in itself.

    Look it up yourself…. The number of drugs that produce breathing difficulties, dizziness and stomach cramps …. It is licensed social control of the elderly for profit….. their hoems taken as we promised to pay for their health care but changed our mind and decided politcally we didn`t really care enough to want to pay extra taxes ourselves for it. That`s the truth of it. We should all be ashamed.

    Seems we don`t really care enough to change the real suffering people go through. The govt. goes to such lengths to ignore your complaints off record they force you to pay for a solcitor…. You must pay out real money to make changes happen. I urge everyone to protest really….. As this is a wrongness….. Hopefully when enough people cry out about it and more and more concerns are raised on the web not just about the drugs people are forced to take but the entire procedure of decision making and stripping of peoples rights and property and all… It is the final solution for the aged…… And it is the Western society`s answer…. Maybe it would not be so bad if they were all given soma tablets and happy pills. It is just in my experience..the drugs they are given make their lives ALOT worse. Not better. And this is the one area of fact and medcine that people could start to change right now. Without costing the state any more money but saving it money. Drug companies are too powerful. And the side effects too strong. The prescribe far too much with doping consequences.It is a silent conspiracy for profit and they are not bothered if x % develop more severe breathing difficulties and side effects than other are die prematurely with their drug cocktails. Shame indeed. It is a CRIME of the 21st C and in 200 years time s we shall look back and see it as the barbaric primitivisma nd stupid ignorance alot of it is. It is unfounded the science and the money pressures and profit motive and social service idealogy the second rate training… There is ALOT that is immoral and just plain obviously wrong to decent people. More people should protest till the Govt gets the message and peoples lives start to improve and complaints and legal cases go through the roof. Again. I urge everyone to write about it, talk about, go to the press, publish, contact solictiros wirte to thier MP and cause as much trouble as possible! You need to be as relentlessly persistently proactive as the combined social servcies machine is to get anywhere at all!! The battle of the ONE v the MANY is always worth fighting.. The one individual in care or you yourself on their behalf to make changes… and the more people doing this nationwide the better for the aged and their conditions. Drugs are a round the clock side effect…. every hour of every day effecting peoples mind and limbs and breathing and all.It`s an evil we could do without. The psychaitrist and doctors should know better….. they do not. The drug companies LIE. I request any psychitrists concerned about this to research more and do what they can and even treat themselves as ahuman Guinea pig ( I would if Iw as a psychiatrist ) then take it to the press. People might then take some notice. The side effects of drugs given to old people cause them more suffering than good in MANY cases.That is my line and I`m sticking to it. And there is much else wrong with the system..Write and protest and take them to court!! That is what freedom is for.Individual rights and change and justice for all! Especially the vunerable. They ahave a wrong headed ideaology.It is about time greater numbers of people started to put these so called experts into a state of self doubt. They after all are in power and meant to be serving us. Power without awareness and when not listening to other peoples real concerns is a form of corruption. When it flies in the face of scintific fact, objective observation and the will of the people as a whole it is a kind of ideaological dictatorship… it is and one being run by profit and conveiniance for doping people in homes.It`s WRONG. And it should be stopped. The facts are there.even the breathing difficulties and reactions in many residents. I JUST URGE PEOPLE TO DO SOMETHING ABOUT THIS…. ON MASS… as this is something that we can and should be able to change ……just the sooner the better for people on the reciving end of it.

    Prof Sir Harvey Crichton

    Fellow of the Royal Institute of Philosophy

  19. I have a suspicion that you are neither a 'Professor' or a 'Sir' based on the spelling and grammar of your comment and on the basis of Google research.I'm leaving the comment because you have as much right as anyone to comment here, but I would warn you that some people take (legal) offense to the probable misrepresentation that you are making here.

    If you were to provide proof of your identity (and email from an academic address for instance) then I will of course make a full apology.

  20. There is a care home (more correctly DON'T care home) in West London where a local crew went about 18 months ago. The call they were attending was given as a 90 years old lady with severe difficulty breathing. The crew called up later to say that – on arrival – their professional estimate was that the lady had been dead for at least three hours.

  21. Hi, if our residents, with dementia, do not want food, medication or a bath, we do not struggle with them as this is abusive. They still have the human rights act they are entitled to, so we document everything in there care plans, and speak to the next of kin.You cannot force anyone even those with dementia, to do something they dont want to.

  22. I come across some equally bad 'care homes' on a daily basis, a lot of them seem to be more interested in the money than the people themselves, maybe its a synical view, but when you go to the umpteenth home in a shift to find a patient who is clearly in a very bad way, with staff unsure which is their a@#e and which their elbow you really do dispair.However there are some very good homes out there, several in my area which have trained staff night and day, staff that once they have dialed the nines actually come out to the front door and meet you, rather than leave you ringing the doorbell at 3am for 10 minutes (just what are they doing? they dialled 999 and reported someone with chest pain – but its ok as we got to the job within the 8 minutes so it was a success in the governments book)

  23. Wow, I thought this was mostly a local problem. But you practically describe half of my daily calls and your not in the same country!As a Paramedic in Fort Worth, TX, i've had many a patient like this. We had one patient from a nursing home who had been there a week and they didnt even know there name! and were unable to find it for me!!! all they had was her social security number (used to bill her insurance company so they could get money from her!!!) fortunately I recognised the patient from my other job at a local hospital and upon returning her to that hospital they knew her name! What a crock! How can you provide decent care for an individual and not know anything about them? They could not have been giving her her prescribed medicine because they had no medicine record, but by god they were getting paid! I cant say that the fact that you have this problem too makes me feel better, I was really hoping it was just a local thing. Damn.

    – Jason B. FF / EMT-P

  24. I apologise. I was going on the basis of a friend's experience and what he was told – evidently he was misinformed. He WAS the sole next of kin, the buck stopped there. He was caring for his mother at home, and his mother got to a stage where she basically punched anyone who came near. My friend asked the family GP what he was supposed to do about his mother simultaneously complaining about being hungry and losing weight at an alarming rate, but also being incapable of feeding herself and violently refusing to let anyone else feed her. He was told “just make her eat, she doesn't know what she's doing any more. You have a duty of care now that she can't make decisions, and you can't let her starve any more than you would a baby.”

  25. Dear Tom!This posting is a little bit off topic, sorry, but I wanted to post it anyway.

    My name's Vlad Kim. I live in Almaty, Kazakhstan. I've just finished your book “Blood, sweat&tea” and still under impression of it. It's so sincere and truthful.

    Thank you so much.

    Vlad

  26. On the issue raised by one of the links you included at the end of this piece: please don't be so quick to condemn the reduction of a criminal sentence without checking the facts. The attack in question was both vicious and terrible. The victim was an off-duty police officer who'd spent the evening clubbing and decided to remonstrate with the two defendants, one of whom had spat at his car. The attack that followed was utterly unforgivable but the decision to reduce the original prison sentences was based on cogent reasons carefully set out by the appeal judge in question. No one, including the judiciary, is beyond fair criticism. But it does no one any credit to lambast the judiciary if they can't be bothered to check the facts or to take seriously the arguments put forward to justify a particular decision.

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