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Monday, 26 September 2016

'Murdered' by the pathway: How Margaret's doctors told her family she had terminal cancer, then put her on a death pathway

Sharing this article is intrinsic to finding answers to how we can ensure that people and their families have the right choices when our frail and vulnerable citizens are admitted to hospital with complex health issues, or in care. 

Margaret Hesketh died at Wigan Hospital in November 2014, having been diagnosed with cancer. A post-mortem examination revealed she died of pneumonia

Recently the Foundation has been talking about the different types of abuse on our Blog, and yesterday it lead to discussions amongst ourselves as to how we believed that person Centre Care needs to be the norm, not the lip service we see on so many different occasions. 

In 2010 The White Paper, Equity and Excellence: Liberating the NHS1 set out the Government’s vision of an NHS that puts patients and the public first, where “no decision about me, without me” is the norm. It included proposals to give everyone more say over their care and treatment with more opportunity to make informed choices, as a means of securing better care and better outcomes. 

In December 2015 Nice issued new guidelines to improve care for people at end of life, but who should make the decision a person is at end of life? It is not easy, but it should never be taken for convenience, only for best practices in dignity, compassion and kindness. 

However much care starts out with good intentions, it seems that poor health education and ignorance can sometimes get in the way, and it might result in organisational abuse of our loved ones. 

For instance, if a person has restricted swallowing and risk of choking, but has Mental Capacity, it has to been in their best interests to have them involved in discussion, presented with all the facts, and for them to lead on their own views and choices. It is not simply acceptable to take people’s choices away and impose a curtain treatment that might only be best for health practitioner, nurses or care staff that sees someone being left to starve and an unnecessary early death when they wanted, and could have easy had more and improved.

Staff should never assume they know best and dictate their own personal views and outcomes. 

These decisions simply have to involve everyone. If not the patient, then staff should listen to and include those who know the patient well enough to give an informed insight into their complex health conditions. Many families understand what levels of food nutrition and hydration their loved ones can tolerate without risk of further complications. 

The NHS and Care needs to understand people have the right to be involved, not excluded, and that they and their families’ choices should be in full agreement with any decisions.
Here at the Foundation would like to see records of meetings more rigorous concluded. No one should agree to any sign off any documentation until all parties are happy that the contents are a true reflection of all conversations taken place. 

Maybe if we addressed these types of problems with Kindness in Care, and if staff in isolation stopped making such critical decisions, we might see the rising numbers of deaths documented as “Dementia Frail and Vulnerable “ and people being admitted to hospital with infections in and around the area of “Peg feeds”, drop dramatically, and fewer families would be left feeling so devastated that they have lost their loved ones?

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