Archive for December 8th, 2008

The needs of the living

My friends Mother has been very ill for the past three weeks. A year ago she was diagnosed with throat cancer but due to her age, 87, the doctors advised against aggressive treatment and ‘solved’ the problems she was experiencing with swallowing by the use of an oesophagial stent. It didn’t really solve her problems as she had diabetes, was elderly and somewhat confused so would eat foods unsuitable for a person with a stent, it would block and then once it had been sorted out she would then be too frightened to eat for a few days and so would then become hypoglycaemic and collapse. So, over the past year she had multiple hospital admissions, gradually lost half her body-weight and started to ‘give-up’. Three weeks ago there was a crisis when she developed severe diarrhoea and, after a protracted argument with on-call G.Ps and palliative care nurses, she was admitted to hospital. Obviously the hospital were concerned about the cause of her GI upset, they were thinking C Difficile, so she was barrier nursed until there were 3 samples which showed no infection, eventually she was pronounced clear but the cause remained unknown. During this time more tests and scans were carried out which showed that her cancer had spread to her liver, also her mental state was deteriorating, the morphine now being used probably didn’t help, but at least she was more comfortable.

On Friday she was transferred from the acute hospital to a more local, low-risk unit, the family were pleased as it was a relaxed atmosphere and closer to home. They all knew that she wasn’t going to ‘get better’, that it was unlikely she would be going home but they were totally unprepared for her death in the early hours of Sunday morning. 3 am the phone rang and the nurse broke the news that when they had gone in to check on Edith she was dead. My friend asked what she should do, the nurse said that she could go and see her Mum then, or wait until the morning, the decision she made was to go in the morning with her sisters, there are 4 of them.

In the morning they phoned the ward to find out when would be the earliest they could go in, they were told that they couldn’t, they would have to wait until Edith was taken back to the main hospital and that wouldn’t be until today, Monday.

This morning a bereavement nurse contacted my friend, they don’t work weekends as people don’t die then, apologised for the fact that the family had not been allowed to see Edith yesterday, and then gave her a lot of flannel (my interpretation). Unfortunately they couldn’t go today either because a doctor hadn’t seen Edith yet and there was a lot of paperwork that needed to be done before she was taken to the main hospital. Friend is now devastated and condemning herself for not going when the hospital rang to tell her about her Mother’s death.

Guess who I’m condemning? I shall say no more, just quote here an excerpt from Confirming and Certifying death in Community Hospitals from West Devon PCT.

“Dealing with the loss of a patient in a community hospital is undertaken in a caring,  compassionate and professional manner……. Arrangements following death are carried out sensitively and respectfully, in order to comfort the bereaved and ease their suffering at their time of loss.”


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