The following notes indicate the contradictions/inconsistencies that I found in the Staff evidence given to the Ombudsman's office.
Evidence of Trust Medical Staff
In Paragraph 8, I do not recall being extremely concerned about the fortified liquid food. It was only sometime after my mother's death when I discovered from her medical records that she had diabetes Type 2 that I had some misgivings about such products.
In Paragraph 9, the A & E consultant did not definitely explain that staff would not resuscitate nor did he refer to "no active treatment". Nor did he have a discussion, as referred to in Local Resolution 1d letter of 23 August 1999, about my mother dying which he claims that I was aware of and somehow confirmed to him. This I can only look upon as total imaginings. He referred to the fact that, as we age, the epiglottis loses sealing efficiency allowing food to slip down into the lungs and cause infection to arise and that had happened. My mother was being admitted regarding treatment for a lung infection.
In Paragraph 10, the communication failure between hospital units is shown regarding "NO CPR" at A & E, and the ward consultant's unawareness of this. Although it is stated that CPR would have been given if required, I wonder if that SHO who decided "no active treatment to be performed" made that decision without consultation with colleagues. Having said that, I recognise that it was probably the only decision since shortly before my mother's death, she had displayed Cheyne-Stokes respiration and cyanosis which is invariably a precursor to death and is indicative of an attack upon that brain section named the "medulla oblongata", wherein are the electro-chemical computers regulating respiratory and pulse rates. I doubt if even the myelin sheathing around the brain stem can be unwrapped and the stem cannot be touched.
In Paragraph 11, another doctor, the JHO on the ward, also states the falsity that I should have understood my mother was dying. Like the A & E consultant, he did not explain that to me quite clearly. His saying that I used a lot of technical medical terms is a nonsense since I do not know them.
Evidence of Trust Nursing Staff
In Paragraphs 12/13/14/15/16, the evidence shows the contradictions and false assumptions. As the report shows, I was never advised that I could visit at any time for as long as I liked nor mention made of a side room.
These paragraphs are full of waffle. It is a puzzle as to how nursing staff tended to know from the family when it was appropriate to contact, and also for who it was difficult to know when a significant deterioration had occurred. They seemed to expect that I should have known, while, at the same time, they state and the Report accepts their claim that they had difficulties getting me to understand my mother's problems and to focus my mind on issues. The medical/nursing evidence along with the Trust response's further waffle is a pack of contradictory hogwash.
In comparison to their claims about dying, there were two occasions which caused me to think the opposite. The staff nurse, with a Bachelor of Science degree in nursing, who did not report my mother's response to doctors, said on one occasion that he could see that I was very worried about my mother. He went on to say that he felt that she would be OK but that it would be a long haul. Another female nurse told me that the doctors appeared to be quite happy with my mother. These words did not lead me into thinking that my mother was dying.
In Paragraphs 18/19, again the Trust Executive repeats the erroneous statement that I was advised that my mother would not respond to resuscitation. It further says that it was decided that the JHO should speak to me about "no resuscitation", which contradicts Report Paragraph 10 where the consultant did not intend that the JHO should discuss resuscitation with the family. The reference to "the son needs to be spoken to again" could just as easily have been triggered by my confirming to a staff nurse on the evening of the 16th, that aggressive treatment was my wish, as against it having been caused by the JHO's possible discussion with the SHO.
The requirements of the Trust's policy manual on "Do Not Resuscitate Orders" in Paragraph 19 were barely, if at all, complied with.
In the letters of the previous pages detailing the scenario surrounding my mother's last days, the nurse who had breezed past me with the comment "Your Mums gone - 10 minutes ago", was the same nurse who had on a previous occasion displayed to me a lack of appreciation of the possible state of mind of an elderly patient. In the previous July (1997), my mother was in hospital with a border line Urinary Tract Infection (UTI). During my afternoon visit I was told that the nurses had asked my mother if she wanted some item of food. My mother had agreed and then when the nurses brought it to her she rejected it. That same nurse had told me of this in a similar off-hand manner as she walked away. They did not appear to recognise that my mother was experiencing extreme confusion caused by the UTI. As a young doctor on the team had said to me, "You and I would shrug the infection off, but at your mother's age it knocks them sideways".
On another previous occasion, when my mother was admitted and was in standard isolation with both a UTI and a potentially fatal faecal infection, Clostridium Difficile, my mother had threatened to report nurses to a higher level. I could hear her extremely angry voice from within the isolation room as I talked to one of the nurses outside, and the nurse was saying that they had to report incidents where a patient was behaving in this manner. I got the impression that they considered my mother was being an awkward patient and found myself wondering who had taught them nursing practice. They seemed unaware of the effects of such infections upon the elderly. My mother's actions were totally foreign to her normal behaviour and personality.
For all that there were undoubtedly numerous occasions when nursing staff treated my mother and other elderly patients kindly, it is so often not that which remains in the elderly person's memory. As a child we do not expect to be physically or psychologically abused. There is that child that remains within us, all of our lives, who does not expect to be abused in any way and it is that psychological abuse which society deals out to the elderly within this despicably sick United Kingdom today that I consider damaged my mother's will to live. With hindsight, I recognise that that was the child's feelings of hurt and rejection being expressed when my mother said that nobody wanted her. That is New Labour's despicable treatment of the elderly in practice and it continues today and appears to be getting worse with their utterly imbecilic cult of youth, immaturity, and foul political correctness.
In the London Sunday Times of 7 May 2000, a Consultant Physician and Geriatrician of Harrow, Middlesex, England had her letter published. In it she stated that elderly people were mistakenly regarded as a population defined on the basis of age. They were being measured in terms of productivity and not in terms of self-awareness which distinguishes individuals. As a result of this, it was difficult to recruit nurses to work on geriatric wards. She ended her letter with noting that this specious categorisation of the elderly had and has its consequence in that it institutionalises the ageism which is deeply entrenched within society. I suspect that there is within the NHS an attitude that states that those who choose to work with the elderly are not quite good enough to work at the cutting edge of modern medicine and only work with the old fogies. That mentality has to recognise, that with advancing knowledge of the DNA, the elderly ARE one of the cutting edges of modern medicine.
Professor Tom Kirkwood (Britain's first biological gerontologist) is the author of a book titled "Time of our Lives - The aging process is neither necessary nor inevitable". It is necessary for such medical and non-medical people, with those closed minds, to read that book. The bibliography in Professor Kirkwood's book will provide a list of other worthy material regarding ageism.
Material with regard to the future and the increasing lifespan that is to come and which are all worthy of study and deep reflection have been written by such academics as:-
Ray Kurzweil (Massachusetts Institute of Technology) in his books titled "Age of Intelligent Machines", "Age of Spiritual Machines" and "The Singularity is Near - When humans transcend biology".
Ian Pearson was, prior to 2008, a British Telecom futurologist and his Guide to the Future can be read on the web, with his views on "the aged (Nov 1995)" and "ageing (March 2002)". At the end of 2007, he became an independent futurologist.
Dr.K.Eric Drexler - the human father of the science of nanotechnology, in his books titled "Engines of Creation" and "Unbounding the Future".
Professor Michio Kaku - one of today's leading theoretical nuclear physicists, in his book "Visions : How science will revolutionise the 21st century".
Baroness Professor Susan Greenfield in her latest book "Tomorrow's People".
All such material will impact heavily upon the medical profession in the years ahead, requiring a huge change in attitude towards the elderly, and a greater respect for the sanctity of life. I personally believe that the ultimate insult to every human being and the reason for being of the medical profession to counter it, namely that hateful thing called DEATH, will eventually be conquered. I do not reject Ray Kurzweil's prophecy in "The Age of Spiritual Machines" that the sentient beings of the future will only manifest a physical body as and when they need one, and this will just be one aspect of the fact that such humans will have long passed that point where we will have merged with the computer and their brain structure will be a combination of biology and implanted software.
The failings that were highlighted by this report, and the other shortcomings that I experienced as a carer were, and are, certainly not unique to the hospital concerned. These failings are common throughout the United Kingdom, the NHS (National Health Service), and the globe, due to a growing lack of respect for life and an increasingly idiotic ageism caused by society, which so often seems to lack the intellectual capacity to recognise these global demographic changes. It is hardly an ideal situation to produce the ideal frame of mind necessary for the future changes required. I found it heartening that recently the BMA (British Medical Association) had majority voted to reject euthanasia and assisted dying, which is a major step towards a greater respect for life.
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