News

Death of Paula Francomb

It is with g sadness that we have been informed that Paula Francomb,died on Easter Sunday. Her funeral was held on April 15th She was a founder member of CCOA and hugely supportive of its work and the people involved in it. She will be greatly missed and our thoughts and prayers are with her family and friends.

CCOA acts on human rights issue

CCOA has sent a submission to the UK Parliament Joint Committee on Human Rights regarding the human rights of older persons in healthcare. In it we have presented details from an actual case discovered by one of the members of our Executive.

The executive committee of the Christian Council on Ageing (CCOA) at its meeting in Birmingham on 14 February, 2007, welcomed the timely concern of the Joint Committee regarding the human rights of older persons in healthcare and wished to make a submission. The CCOA is the major ecumenical (i.e. inter-church) body in the UK concerned with the care and continued personal development of older people.

The executive committee considered a profile submitted by a member of its current issues group detailing the recent experience of an 88 year old widow whose only close family lived 200 miles away or worked abroad. She lived on her own until a fall and major stroke necessitated her admission to the local teaching hospital from which she recently moved to a nursing home near to where she lived. During the ten weeks, her treatment was on the whole quite acceptable from a diagnostic and medical treatment point of view: for example she had two brain scans, and drips and catheters etc were set up efficiently. However, the following less commendable factors were noted:

Following admission through the accident and emergency department, she was moved between hospitals, between wards and between sections of wards a total of six times. This was very disorientating for the patient. (Articles 2 and 8)
She was left for long periods lying or sitting in awkward positions without good use of pillows or a suitable head-supporting chair; she was also left with her night clothes ridden up her body, or without extra clothing or slippers in a cold atmosphere. When such things were pointed out to staff they were very slow in rectifying matters and visitors were left propping her up as best they could. (Articles 2, 3 and 8)
She grew very thin and it was obvious to visitors that, although she has always had an excellent appetite, she found great physical difficulty in feeding herself and using a cup. Visitors would have been only too willing to help her but they were discouraged from staying during meal times. She appeared to be slowly starving to death. (Articles 2 and 8)
When she was moved from a side room back onto the main stroke ward it was noted by visitors that her arms were greatly swollen through fluid retention. Because by moving the dedicated nurse had changed, this had not been picked up by staff until it was pointed out - whereupon medical help was summoned. (Articles 3 and 8)
It was frequently the case that she was left without her spectacles and false teeth, which affected her self-image and impaired communication and quality of life. (Articles 2, 3 and 8)
It was by no means evident that staff members were assiduous in washing their hands, and it was not pointed out to visitors that they should do this or where the alcohol gel was situated. (Articles 2 and 8)
A low level of physiotherapy appeared to be offered but no speech therapy - both were greatly needed by this patient, as by many on such wards. (Articles 2 and 8)
There was no evidence that contact had been made by hospital chaplains, and it may sadly be that stroke wards (where patients are liable to stay for quite a long time) are regarded as a low priority. Fortunately, the patient had visits from her own ministers and church members.
From observation on the ward, it seemed that staff found particular difficulty in understanding and caring for patients with dementia.
The contrast when this patient moved into a private nursing home was striking: the staff were very much hands-on, appropriate seating, lifting equipment etc was provided, help was given with feeding and drinking, there was a convivial atmosphere, the offices of a local chaplain, and the home manager asked for a profile of the patient so that staff could understand and communicate with her better.

CCOA executive committee members confirmed that the profiled experience was all too common in both hospitals and nursing homes (the levels of care in some of which appear to be very low), further examples were forthcoming (such as the loss or non-use of hearing aids) and the following examples of good practice shared:

Hospital wards where the help of relatives and visitors at meal times is positively encouraged.
The more ready use of straws, beakers and alternative eating utensils for meals.
‘High tech' help in the form of devices that alert re patients tilting into dangerous positions risking falls.
Churches encouraging visitors to hospitals and homes to look out for good practice to affirm and bad practice to point out, especially on behalf of those who have no close relatives or obvious advocates.

It was agreed that the main problem (apart from geriatric care remaining the ‘Cinderella' of medical and social care) would appear to lie in the increasing emphasis in hospitals upon ‘paper work'. This has led to staff staying within the nurses station where records are kept and doctors consulted, and to staff going onto the ward areas with specific tasks to perform and largely oblivious of anything that may distract them even if it clearly relates to the well-being of patients.

It would appear that the situation would be greatly ameliorated by better nursing and ancillary staff training (including dementia care) which is truly person-centred and holistic. All too often ‘common sense' solutions are not considered over against ‘technically correct' ones. This mindset needs to be challenged for the greater well-being of older patients. Levels of vigilance are palpably not high enough and this could be remedied by this becoming the responsibility of a specific staff member or members.

The CCOA has produced a helpful booklet, Guidelines for Care Plans (which is currently being revised), which provides a holistic context within which staff can feel free to operate. CCOA would also be very willing to endeavour to mobilise local churches to be of help in visiting, vigilance and pastoral capacities on behalf of older people in hospitals and care homes.

Ends.