"Shortage of end of life care in the NHS for Alzheimer patient’s"

About: Victoria Hospital / Geriatric Assessment

(as a carer),

My wife is in the latter stages of the disease, and currently resident in a Psychiatric ward, from which the Doctors wish to discharge her back into the care sector where in my experience the level of care for her present condition is totally inadequate.

Her condition is such that she is bed ridden, has no communication or cognitive ability and is totally dependent on a high level of care to meet her mental and physical needs. The only place that this is available is in the NHS. She greatly benefits from the ambiance, high professional standards, good carer patient ratios and continuity of nursing staff. However due to the shortage of provision and current push to reduce “bed blocking" we are being pressured into selecting a care home where the care standard and continuity cannot be guaranteed. I say this after her being resident in one of the best care homes in Fife for over two years

This will be the third time my wife will have been discharged from this hospital on each occasion any minimal improvement has been short lived and it has been a long and laborious process to have her re-admitted. The reason for her admission was the care home could no longer meet her needs this after trying many therapies including a period of one to one care.

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Responses

Response from Louise Ewing, Patient Relations Manager, NHS Fife

picture of Louise Ewing

Dear DollyMixtures

Thank you for taking the time to tell us about your wife's situation which I was very saddened to read, it must be very difficult for you. I appreciate your concern in moving your wife from an area that you regard highly, where you feel confident in the level of care provision.

There is an Appeal Against Discharge process which you can enact, if you have not already done so. The Charge Nurse on the ward will be able to provide you with more details. My understanding is that the process involves the review of your wife's clinical needs and you should expect to be involved in the process.

Please do get in touch if you thin there is anything else I can do to assist.

Regards

Louise Ewing

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Update posted by DollyMixtures (a carer)

I am well aware of the appeals process, and at present am awaiting the outcome.

However I do not have a great deal of faith in the process.

The response did not answer the core question re the lack of provision.

Response from Gordon Birnie, Medical Director, Acute Services, NHS Fife

Dear Dollymixtures

I appreciate that this is a very difficult and distressing time for you.

The Scottish Government strategy is that patients should, wherever possible be looked after at home or in community settings. The processes and criteria for NHS long term Healthcare are set out by Scottish Government within CEL 8 2008. It is not a condition specific type of care but it for a small group of patients who have unstable conditions which require frequent assessment and input from multiple different professions ie nursing, medical and AHPs.

NHS Fife has no one waiting for NHS long term care where the multidisciplinary team (MDT) has recommended it and therefore provision is adequate for the current demand.

I recognise that there are a very small number of cases were there is a difference of opinion between the MDT and the carers / relatives. As Louise says there is an appeals process to resolve this small number of cases. The appeals process involves individuals independent of those who are caring or who have assessed the individual.

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