Just out of interest re infected wound on 95 year old lady

[Delainie]

Was told this morning her wound is infected , district nurse been dealing with it twice a week. I was told when he gets back to clinic he would request antibiotics from GP. Told it would not be till 4 today, anyhow I called clinic to check at 4.30 as didn't want her left all over weekend, he said he can't do request now till Monday as he has other clients to see. Now does anyone think this is acceptable or not. I don't, so getting tablets now as I called GP to get them, as I don't think you leave anyone with an infection to get worse. Opinions please?? I'm beginning to think I expect too much.

[Mystic Mog]

Delainie, what a dreadful situation, I would call the GPs out of hours service and explain the situation. Surely they can provide the prescription, if not call them out, no way should this person be left to suffer.

Just read your post again and it looks like you did get the antibiotics, I replyed in haste as I am a carer and know only too well the stress involved! Hope it gets better soon.

[Sue]

Glad you got the antibiotics, but why could the distric nurse not phone the GP, instead of waiting till he got back to the clinic? Particularly as it's a Friday?

[stringvest]

Hello, the wound/infection should be treated with antibiotics asap. The nurse should/could have got a prescription from the GP by phone. With technology now the patients GPs can fax/email the pharmacy so the pills can be collected by relative, carer etc. If out of hours SELDOC can give prescriptions usually involves lengthy (many hours) wait for visit to assess, if you are not fobbed off and told to go to A&E!! My mum had multiple health problems, but it was SEPSIS that we lost her to, so any infection should be treated very seriously. Thanks.

I am not a medical person, but carer for elderly parents for many years with Alzheimers, vascular dementia, copd, pacemakers, heart failure, emphysema, cataract operations, nebulisers, UTIs etc etc.

[intexasatthe moment]

I think you need to make a formal complaint re treatment . I'm really no longer sure who manages district nurses . But I imagine the GP surgery would tell you .

[stringvest]

ALSO SOME THINGS TO LOOK OUT FOR:

Heart Block - requiring a pacemaker. The person can be tired and "not themselves" they may say things that don't make sense and act a bit more senile (I mean that nicely), if they already suffer dementia you can think its worse and they might be having a bad day and ignore it BUT DON'T, I thought a person was just acting a bit strange and not right, they said they were ok just a bit tired but I wasn't convinced. I called the GP in who listened to their chest and got straight on to the hospital for an admission.

UTIs: If left can cause more confusion and even delirium and other problems. If someone you care for again seems vague or stranger than usual, if you can, check their pee it may be cloudy, you will need to take a pee sample (or the nurse will) and get antibiotics. A lot of UTIs can be missed or ignored and put down to senility when IT ISN'T.

[Delainie]

Thank you all, it's nice to get some feedback on this.intexasatthe moment, I think it's still guys and st Thomas ,I would have to contact to complain, as I had to complain a few years back re another elderly neighbours treatment of nurses from Townley road, it actually went to court as a solicitor wanted a witness statement from me.yes, Sue,why didn't the nurse just phone the GP,funny thing was, he wasn't expecting me to be there and before he took dressing of he said he was worried about wound, I asked why, he said because it's infected, did that mean he knew from Monday and this was Friday, he also asked if it was a house or flat and if she owned it or was it council, I said council, any reason why you are asking , he said she should go into a home, so I just said why because she's elderly she shouldn't be taking up a council flat, and anyhow she has mental capacity and even if she didn't I have a Lpa so you'd have to go through me before that happened and it isn't happening. Bloody cheek.maybe it's just me, I don't know, I just think a lot of people resent the elderly getting anything yet they have done their time paying their contributions, people seem to forget and think they are a burden, it's shove them in a home put a pad on sit in the chair all day don't move because if you fall I will have to do some caring! Sorry I'm ranting now. My heart really does go out to this woman, when she was 93 she was out everyday, even though she has macular degeneration, it didn't stop her, she walked for miles everyday, then she was robbed in her own home, some bitch talked her way in, knocked her to the floor and stole her money. She or they were never caught. The poor women was 93, 4 foot nothing, evil thing that done this turned her world upside down, she is now 95 and has not been out since, is able to potter indoors usually but as you say string vest, she had a uti, got confused, had a fall, hence the wound to her arm. As you and turtle and anyone that has or is looking after someone, you know how hard it is re seldoc , getting home visits from GP, though paramedics are always great. She is now just fearful of walking indoors on her own, so as like before its just trying to feel confident enough to do it. I'm trying to get the GP to sort out a physiotherapist as she agrees to this, just to make sure she stays as active as possible. She is a very strong minded woman and doesn't take kindly to anyone telling her she has to try and drink/ eat more!

The last fall she had was Feb last year, and the only reason she fell this time was it was during the night she was walking without her walking trolley as she forgot she needed it because of being confused,Now only a week after finishing antibiotics for the uti shes on more for her arm. The paramedics checked her heart lungs and blood pressure a few weeks ago , all are good, I think she comes from good stock, her sister died one month before her 109th Birthday. I'm relieved the GP gave the tablets, not at all happy with nurse leaving it till Monday, I'm concerned that she was dehydrated and that's why she got uti, now that is clear and she isn't confused, she has upset stomach, which I'm thinking is tablets, though she says she doesn't feel sick, I'm just thinking is she going to get dehydrated again, how do I get her to drink more? The GP said use salt on her food? Not too sure about that. She is or was doing great and usually only on one blood pressure tablet a day, which is great going for a 95 year old. I will pm string vest and turtle tomorrow.

[intexasatthe moment]

Yes ,I've had trouble with some of the nurses or health care assistants from Townley Rd .A complaint did improve matters .The comments you report are appalling .

There's an assesment unit for elderly at Kings .It can be very good if you are seen by one of the good doctors/consultants and can be very bad if you are unlucky and allocated a doctor who is just passing through as part of training and doesn't want to be there . They look at the person as a whole ( ie don't just concentrate on the UTI but would check other things and review meds ) and it might be worth seeing if the GP would refer.

The unit https://www.kch.nhs.uk/service/a-z/clinical-gerontology could refer her to their falls clinic - my mum went for a bit and they do supervised exercises in small groups to improve/retain mobility and balance .

As for drinking more fluid ......all you can do is try and find out what she likes and make sure it's available and to hand . Would using a straw help ? A flask of tea ? Or a thermal mug to keep it warm ? Milk and honey ?Warer with lemon or a lime slice added? Or a slice of cucumber? Cold ? room temp ? Frozen lollies ?

And explain re the connection dehydration /UTI /mental fog and that she should regard drinking liquid as taking medicine to prevent an illness ?

I hope things improve .Good luck with the complaint .

[stringvest]

SALT ON THE FOOD? we do need salt but it can affect hydration and blood pressure. Lots of tea, even coffee, milk or juice, cornflakes etc ...

If it comes to a home: I can PM you where dad is (he too was intruded upon so I keep it private) , had to sell his house to fund it when mum passed. I have nothing but praise for the place. Its not like you think, all sitting about in wee. It has a really nice garden, a lounge, a proper dining room with fresh cooked meals from fresh ingredients, not frozen packets etc. placemats and table cloths. The residents there think they have are in a restaurant and have to pay to dine there! 2 chefs all day.Activities, Tea, coffee and biscuits. You can walk in make tea and visit whenever you want. All the rooms are spacious with ensuite shower! Perhaps its worth considering before its enforced by Social Services and they put them somewhere really crappy just because theres a space available. This happened to dad, he lost 2 stone and went downhill, I moved him just in time!!!

My dad is checked on helped to shave and shower, always looks happy and well dressed, enjoys the food and company. The staff are brilliant. HE IS SAFE.

I have little faith in NHS brilliant at tines, DIRE rubbish at times seriously affecting outcomes for patients and relatives. Mum was assessed to have capacity although demented and went HOME because she insisted to sit and sleep in a chair in her own mess, get robbed, get sepsis, bad carers and die, even with my 24/7 care that made me ill. They come up with these ideas like pendant alarms, someone is supposed to come and check if it goes off, THEY PHONE YOU at whatever time, because its 3am and they don't want to send a lone woman. I am a lone woman. I was getting 10 phone calls a day and 10 a night for months from social services, doctors, ambulance, carers, hospitals, police, concerned neighbours that had found her outside in a state.

Whilst at home dad was "being groomed" by a friendly neighbour. Thought nice that neighbour would pop in for a chat with milk!!! But he started going to far and didn't know when to leave, or wouldn't when asked. It got very strange. Had to get the police 3 times, as he decided he was the next of kin, new son, best friend and telling my dad with moderate alzheimer's diagnosed 2 years previous that he had nothing wrong with him and didn't need anyones help including MINE!! Dad would get all ratty with me and say "thingy says this and thingy says this, thingy says your just being nasty and lying to me (for calling GP), thingy helps me, he put cream on" ... Even the district nurses were phoning thingy instead of me, to discuss my mothers incontinence pads etc and whether thingy could help her on a commode .... it nearly finished me off.

You can only trust yourself.

[Delainie]

Pm'd you string vest. Sounds just absolutely awful.

[Delainie]

Intexasatthe moment, as she is very sharp she refuses to go to hospital, so getting her referred to the clinic would be good but she would not go, even usually getting her to speak to a dr is a challenge as she says she had spent so much time in hospitals she doesn't want to go back. I know of course if this infection doesn't heal she will have to go,as she may need to , just have to play by ear. Thanks re complaint, not sure to do yet,as I am fearful he might take it out on her, if that makes sense.

[intexasatthe moment]

Whenever I've made a complaint about care that has also been my fear but I can honestly say that the response has always been effective .

You have a very clear case to put - this was said ,this was asked ,this was the response .

" he said he was worried about wound, I asked why, he said because it's infected, did that mean he knew from Monday and this was Friday, he also asked if it was a house or flat and if she owned it or was it council. He said she should go into a home."

" I was told when he gets back to clinic he would request antibiotics from GP. Told it would not be till 4 today,I called clinic to check at 4.30 as didn't want her left all over weekend, he said he can't do request now till Monday as he has other clients to see."

Write it down and ask what the procedure should be where infection is suspected and it is thought antibiotics are needed . Say you do not feel the situation was correctly dealt with and you would like to know what procedures are in place to prevent this happening again .

And I understand about not wanting to go and see a GP or go to hospital . I rather feel I'll be the same .

[Delainie]

And I understand about not wanting to go and see a GP or go to hospital . I rather feel I'll be the same .

Now I'm sure that wasn't meant to be funny, however that did make me laugh!!

I'm with you on that one.

Yes I will make a call tomorrow to guys.

He had called me Friday when he went to visit and said he couldn't open lock. I'm only 2 minutes around corner so I let him in, he moaned about lock and said we are nurses and busy we can't waste time trying to get in, that he has to report it to social services. I said it was social services that installed the lock through the visual impairment team at Southwark . He wants me to not lock door, I'm not just closing it to make her vulnerable just because he doesn't know how to use lock. So he will be calling me again tomorrow to get access, unless he tries to use keys correctly. Depending on what he says, once he does dressing I will call to ask for different nurse maybe. Also , I'm not sure, I have a feeling he won't like finding out that I asked GP to give tablets, he gives me the impression he likes the control, regardless of the consequences. We'll see.

[Pugwash]

Does she have a keysafe? These are essential for those living alone and require carers/DNs regularly.

If someone has a pendant alarm - the alarm scheme likes to have 2 or more key holders who live ideally within walking distance who will be able to respond to being called out. If no keyholders available or live too far away, the alarm scheme insists on key safes and their PIN number will be given to ambulance crews or police to attend.

GP can make contact with the Rapid Response Team which consists of nurses, OT, Physio and carers to go into the home for a few days to prevent hospitalisation.

[Delainie]

Yes pug wash, the neighbour upstairs from her and the one next door are key holders, I am just 2 minutes around the corner. There is a key safe and yes the nurse has the code and did get keys out, though he couldn't open door as there is a special lock that is for visually impaired and he didn't know how to use it, although he did use it on the previous visit. She doesn't have carers as such,one neighbour sees her and does dinner Sunday eve, the other neighbour does Tuesday morning, a friend of mine and the ladies, who has known her as long as me, is doing mornings at the moment, then it's me, afternoon eve and night, She usually sorts herself out in the morning, feeding her cats, doing breakfast and tea and having a wash, it's only been in the last 2 weeks since the fall, she is worried about walking on her own. This has happened last year Feb, when she had her last fall prior to this one,it took a few weeks for her to feel confident again and she walks when I am with her,without me holding her, just for reassurance.

She does not want the keys out in safe box so I put them in the eve before nurse is due and will do the same when physiotherapist booked. also when the visual impairment officer visits he can get access with key. Though this is only a temporary thing re key in key safe. She doesn't like anyone letting there self in especially as she cannot see who they are and is somewhat deaf. The neighbours and myself also shout as we open door. She did have the pendant alarm but could not press it so an extra gadget was attached to make it easier , however it was then over sensitive and she kept getting called through the night, which was no good. She insisted it was taken away and I didn't arrange this, she told then when the alarm went off, that she didn't want it and too arrange to cancel and collect! I know they can be a really good thing to have , though not for her as she wasn't happy at all getting woke up . When she had her fall last year she did have the pendant though she never pressed it, she just called out to neighbours. Her situation isn't ideal I know but whilst she knows what she wants, I respect her wishes, within reason. I wish she could use the alarm as that would make me feel better too. Thanks to everyone for advice, it really is appreciated .

[intexasatthe moment]

Oh Delainie you sound so nice .Quite brought tears to my eyes .

I think you should write to Guys rather than phone ,or when you're speaking to them ask who you should address a formal complaint to .This health professional will be visiting other vulnerable people and they won't all have people like you to watch out for them .He needs training ,or something .And his managers might be waiting for a reason to take some action ,your complaint might be expected and they might be glad of a reason to take some action with this person .