"Reducing the anxiety of carers when their loved one becomes an in patient"
About: Royal Bournemouth General Hospital / General surgery Royal Bournemouth General Hospital General surgery BH7 7DW
Posted by Scotch daughter (as ),
My mother's fear is that my father will die or become more permanently disabled not due to medical error but due to a lack of joined up care. As a retired social care professional herself she is well aware of the difficulties of public sector work and also the idiocyncracies of individual employees but it is systemic failings that unnerve her the most.
Fantastic surgical care and thorough intensive treatment brought my father back from the brink of death. His initial recover was partly due to his sheer determination to survive and partly due to the expertise of clinicians who know how important positive calm action is in critical care. Little personal touches like the daily diary providing the link between unconscious patient, relatives and hospital staff show that the patient is a person and not just a set of symptoms and help to create a bond of trust. This is then undermined when the patient is transferred into an ordinary ward where care is not so critical or intensive and the diary and relative contact information disappears.
In patients in ordinary wards have limited contact with their relatives ostensibly so they can rest and recuperate. This can cause anxiety for a carer who suddenly has to hand over care to strangers with whom they have little contact. When this leads to mistrust the anxiety of carer is transmitted to the patient which can have serious negative outcomes for both.
In a gastrointestinal case, confidence in the care of adequate nutrition seems obvious to most lay people. However my mother, together with two willing but ill informed healthcare assistants tried to navigate the menu choices on offer for my father today so that he could have the low residue diet instructed by the paperwork. One of the healthcare assistants suggested to my mother that the advice of a dietician would be useful! My father has been eating in the hospital for the past 6 days! Today the only obviously safe choice was macaroni chees which he does not like. Meals like "cottage pie" and "fruit salad" have no ingredient list with them and no indication if they are low residue or contain restricted items like onions, mushrooms or even apple peel.
My father cannot be the only patient that has been given a stoma whilst suffering from damaged kidneys. He cannot be the only patient on a low residue diet. He cannot be the only patient who is still in hospital in order to balance his digestive system and ensure adequate nutrition. So why is the system causing my mother so much anxiety and raising her blood pressure to such an extent that as a family we are all concerned (including my father) that she is at risk of an imminent stroke?
Surely if a hospital can get the signage right on all its toilets to aid people with a dementia diagnosis, it can provide inpatients and staff with more information on what ingredients the daily meal choices comprise and which would be the best for those on a low residue diet. Sweetcorn that highly indigestible vegetable that is often used to determine digestive transit has appeared in various disguises including "mixed vegetables" which could be difficult to easily pick out.
The healthcare assistant was great, trying to find options like scrambled egg and jelly but the anxiety caused was all so uneccessary and should not be part of the healthcare assistants responsibilities. Managing the nutrition of patients should have more importance as my mother commented "What is the point of all the critical care team spending so much effort and no doubt expense in keeping him alive only for lack of nutritional support to kill him off ".
If she could take him home and feed him according to the recommended list my mother would do so. My father is working so hard to get out of hospital to return balance and harmony to his life. My sister and I are just so frustrated by the lack of effective communication between departments that should be working together to facilitate this. Catering in hospitals should not be an added extra for in patients but a necessarily important part of the healing process. In patients cannot opt out and choose to eat elsewhere so what is the management issue?