This post was originally published on the Guardian’s Comment is Free.
Mrs H was an independent woman who lived on her own until the age of 88 and loved literature and crosswords. This picture of this strong, dignified woman contrasts with the appalling treatment she suffered at the hands of the NHS. After a spell in hospital following a fall, she arrived at a care home with numerous injuries, soaked with urine and dressed in clothing that did not belong to her held up with paper clips. She had several bags of dirty clothing with her, much of which did not belong to her and just a few possessions left of her own. She was highly distressed, dishevelled and confused and had lost 5kg (11lb) since her admission to hospital. She died in August 2010.
This is just one of 10 shocking stories of people aged over 65 documented in a new report by the health service ombudsman. It highlights a range of clinical and operational failures; people at the end of life being discharged from hospital without correct pain relief, failure to deal with infection properly, malnutrition and dehydration. These are by no means isolated cases – 18% of complaints to the ombudsman last year were about care of older people and they investigated more than twice as many as for all other age groups put together.
Yet, as the ombudsman, Ann Abraham, reflects, this report reveals that at the heart of the problem is an attitude – both personal and institutional – which fails to treat older patients compassionately or respond to their individual emotional and social needs. One family was not informed when their father’s life support machine was switched off; a husband was left in a waiting room, forgotten about while his wife lay dying in the ward next door; a man with advanced stomach cancer was left behind a drawn curtains desperate to go to the toilet and unable to ask for help because he was so dehydrated he could not speak properly or swallow.
It’s difficult to imagine us allowing any other group of people to suffer this indignity and neglect, yet when it comes to older people it’s commonplace; as a society we often fail to value or treat older people equally. History shows fundamentally shifting people’s attitudes to overcome discrimination isn’t easy – it takes time and concerted effort – but nowhere is this more important than in the NHS where people over 65 make up 60% of all admissions. Only by casting these prejudices aside can we start seeing older people like Mrs H as individuals and respond properly to their needs.
Equality legislation outlawing age discrimination – due to come into force in 2012 – will certainly help. But in a period of huge reorganisation, support needs to be given to translate this into action on the ground. We also need better training of health professionals to care for growing numbers of people living with multiple health conditions and frailty. To end the scandal of malnutrition, we are calling for a commission to bring renewed focus to this issue and a strategy for change.
But this report also demands answers to some difficult questions to those leading the NHS through the proposed set of reforms. Will this huge shake-up reduce the risk of older people receiving this sort of treatment? Do they promise any positive change for vulnerable, frail patients?
I remain unconvinced that, as the reforms stand, they will deliver the improvements to the health outcomes and care of older people that are so urgently needed. For the sake of all the people featured in this report and all of us who need NHS care now and in the future, the secretary of state needs to answer these questions.