My father was diagnosed with vascular dementia in 2016 and lived very successfully with this condition and adjusted to his changing abilities and needs with dignity and resilience, along with some limited frustration. In March 2021 my father had a minor stroke, in so far as he was still able to speak and walk with assistance. However, the biggest challenge was that he had vascular dementia for the previous four years and did not understand that he had a stroke and was no longer able to walk unaided.
Ambulance staff
He was assessed and supported by paramedics at home in a person-centred and supportive manner and they felt he needed to go to hospital.
Care staff
My father was taken to the Emergency Department during the Covid restrictions on visiting, and was very well supported in the department. His need to have someone familiar with him was recognised and one family members at a time was stayed with him until he was admitted to a ward in the hospital.
Staff attitude
Involved in decisions
Although I was allowed to accompany my father on his admission, the process of his admission became a challenge. My father was alert and able to be involved to some degree in his admission, despite this a registered nurse accompanied by a student nurse largely completed the assessment by asking me questions, and filled in the assessment whilst leaning on the windowsill with their back turned to my father. Despite me asking my father several questions and showing he could be involved, he was not actively engaged with by the nursing staff on admission.
A major concern highlighted on admission was the risk of my father falling, this was of concern because he did not understand he could not walk after his stroke without help, but had enjoyed walking every day before then. My view was at a high risk of falling. On leaving the ward that evening I had limited confidence in the degree of person centred care my father would receive.
Unfortunately the next day my father had an 'unwitnessed' fall in the ward and sustained a brain haemorrhage. From that point on his condition deteriorated quickly. Although some of this was explained as confusion from a chest infection, over the next six weeks my father was very distressed on many occasions, required increased medication and constant supervision from staff. His fall was both predictable and avoidable. I firmly believe contributed to many of the difficulties he experienced from then on.
Although a few staff were person focused in their approach and took an interest in my father as a person and attempted to have a conversation with him about his interests, family and previous career, these were the exception. Although nursing, medical and AHP staff had physical care skills and my father's personal care was reasonable well looked after when in hospital the ability and at times the willingness of nursing and medical staff to recognise my father as a person seem limited. We had provided books of photos to support communication about his family, which rarely moved from one day to the next.
To my extreme frustration my father's fall was presented to me as something that was almost inevitable, in some ways his fault, despite his dementia and stroke. Staff accepted no real responsibility for the fact my father had fallen.
As the days passed I started to believe that my father was viewed as a difficult and challenging patient, and the staff focus seemed to be on getting him moved to another hospital.
Responses
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Update posted by SeeHim (a relative) 3 years ago
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