Edinburgh hospital put man on controversial Liverpool Care Pathway

A widow has claimed doctors put her terminally ill husband on an 'end of life pathway' without telling her, denying her the chance to share his final days with him. Liz Watson, whose husband George was admitted to a Marie Curie Hospice for respite care, hit out at doctors after his condition deteriorated rapidly.

She says Mr Watson was the 'love of her life' and 'didn't deserve to die like he did' on the pathway, which sometimes involves depriving patients of food and water. Mr Watson was diagnosed with a brain tumour 17 months before he was admitted to the hospice. from which he never came home.

His family said the 64-year-old from Liberton in Edinburgh was going shopping and 'eating three-course meals' before he rapidly declined in the centre in Fairmilehead.Mrs Watson said she only realised George was on the controversial Liverpool Care Pathway - which involves withdrawal of medication, food and fluids - when her mother recognised the signs.

A later inspection by Healthcare Improvement Scotland upheld several complaints about care standards, including poor communication about his worsening condition, and made a list of recommendations...But following a recent unannounced inspection last month, it was found many improvements had still not been carried out. The watchdog made five requirements and 11 recommendations that must be addressed 'as a matter of priority'

A spokeswoman for NHS Lothian said: 'Like every health board in Scotland, NHS Lothian is following Scottish Government guidance on the Liverpool Care Pathway and phasing it out.'

Read more: http://www.dailymail.co.uk/health/article-2785401/Widow-claims-husband-s-days-stolen-doctors-banned-Liverpool-Care-Pathway-without-knowledge.html#ixzz3GtTPggfU

`Phasing it out` means it is still going on.

Doctors and nurses still using LCP

Some doctors and nurses are still using the Liverpool Care Pathway (LCP) for dying patients, an expert has claimed, despite an NHS decision to scrap the controversial care plan.

A major review recommended last year that the LCP should be phased out, following widespread criticism from the media and some patients.

The care plan, which gives doctors and nurses guidance on the management of terminally ill patients, was dubbed a "death pathway" amid allegations that patients were being placed on it without their families being told.

The Neuberger review said it should be abolished after finding many examples of poor implementation of the LCP’s guidance.

However, Dr Anthony Wrigley, a senior lecturer and specialist in medical ethics and palliative care at Keele University, said he was aware "certain institutions have gone back to relying on it"...

In June a group of leading nursing and end-of-life care organisations – the Leadership Alliance for Care of the Dying – proposed new guidelines, which placed greater emphasis on individual care plans.

http://www.independent.co.uk/life-style/health-and-families/health-news/controversial-care-plan-still-in-use-despite-nhs-decision-to-scrap-it-expert-claims-9768095.html

While the NHS is being dismantled and run down this type of abuse will continue.

The NHS is under threat

The National Health Service has provided world class care, free at the point of use, to the British people for 66 years. It was recently rated as the most effective and most efficient healthcare system in the developed world, outperforming 10 of the world’s richest countries, despite the UK spending only 9.6 per cent of GDP on health – much less than most of those countries.

Under the Coalition government, the health budget has been maintained in an era of unprecedented austerity. However, historic annual increases in the health budget, designed to keep pace with a growing and ageing population, have been severely reduced – meaning that our NHS has just been through the longest, and most damaging budget squeeze in its history.

Thousands of patients are facing longer and even unacceptable waits to find out whether or not they have cancer, because services are under extreme pressure and referral targets are being missed. In mental health, patients in need of emergency support are being moved to hospitals hundreds of miles away because there simply are not enough beds in their area.

http://www.independent.co.uk/life-style/health-and-families/health-news/the-nhs-timebomb-nhs-and-social-care-services-areat-breaking-point-it-cannot-go-on-9775928.html

More than 100 elderly a week are forced to give up their house

More than 100 homes a week are being seized from elderly people by councils to pay for their care home fees.

 

Families have been forced to hand over properties because local authorities are refusing to pay for the care.

 

The scale of the confiscations – revealed yesterday by a Freedom of Information request – will pile pressure on the Government to help the thousands of families forced to pay ruinous care fees.

 

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The Coalition promised a cap on care costs by 2016, but this will only apply to bills of £72,000 or more.

 

Up to that point, all those with assets of more than £23,250 are expected to pay their own way – even if that means selling the family home or agreeing to surrender it when their relative dies.

Read more: http://www.dailymail.co.uk/news/article-2770156/More-100-elderly-week-having-properties-seized-pay-care-home-fees.html#ixzz3FJvUflT5

Silver Line

 

The staggering volume of calls to 24-hour service The Silver Line reveals how a helpless army of the elderly has been suffering in silence. Now celebrity campaigner Esther Rantzen is demanding the shocking statistics act as a "wake-up call".

The veteran TV host, who set up the free and confidential line, has been stunned at the numbers phoning in, with roughly one pensioner every three minutes seeking someone to speak to.

Esther, 73, said: "This has to be a wake-up call because this is, and will continue to be, a huge ongoing issue. "I have unearthed a huge problem.

http://www.express.co.uk/life-style/retirement/478400/100-000-pensioners-flood-Esther-Rantzen-s-helpline-for-the-elderly

Childline has been accused of filtering out children making sexual abuse complaints against well known people. If that happens the children are ignored.

Those telephoning Silver Line for a chat had better take care. This phone-line could have been set up to gain access to vulnerable and solitary elderly people who might then have social workers knocking on their door, especially if they are living in their own home. Local authorities can always arrange a diagnosis of dementia and then ship an old person off to a care home.  The house will be sold off to pay for their care.

Controversial guidelines to be reviewed

Dr Peter Carter, general secretary of the Royal College of Nursing

 

The NHS has agreed to review controversial guidelines that instruct nurses to ask the elderly whether they would agree to a ‘do not resuscitate’ order.

The Mail revealed yesterday how patients are being visited at home by nurses they have never met before, and asked sensitive questions. These include where they want to die, and if they want doctors to try to resuscitate them should their hearts stop.

Following criticism of the initiative, the NHS’s Chief Nursing Officer for England, Jane Cummings, said yesterday: ‘We will review the [questions] again, with patients and clinical staff, in the light of the poor experiences described in the media, and make any changes that are needed.’

She added that the revised guidelines will make sure certain questions are only asked as ‘part of an ongoing discussion’ once a ‘meaningful relationship’ has been established between a nurse and patient. This could mean that nurses will only be allowed to discuss the do not resuscitate (DNR) orders if patients bring the topic up first.

The new guidelines on home interviews were introduced by NHS England in June as part of a drive to improve care of the elderly at home. District nurses have been sent to visit those aged over 75 and with long-term conditions, armed with a list of questions.

http://www.dailymail.co.uk/news/article-2730380/NHS-agrees-review-nurses-not-resuscitate-interviews-Nursing-chief-says-look-guidelines-criticism-initiative.html


The language is deceptive. The NHS keeps equating `allowing a patient to die` with `improved care`.  Whatever new guidelines are put forward, this topic is not going away because the elderly are viewed as a drain on the NHS.

What is an Advance Care Directive?

You fill out a form when you are competent so that should the time come when you are not competent you have a set of instructions about how you would wish to be treated. Advance directives can deal with health care, where you want to live, organ donation, cremation - a whole variety of things.

You can also have a proxy directive called a power of attorney. You nominate somebody else.to make decisions on your behalf when the time comes.

You don`t have to fill them out.

There may be advantages for some people in filling out advance directives and powers of attorney but there are also disadvantages.

If you are assessed as being incompetent you are not allowed to change your mind, although still having mind enough to know what you want. Your  power of attorney can stick you in a care home against your will and run away with your finances. Your house can be taken over by the local authority to pay for you being in the care home where you do not want to be. So there are lots of advantages for other people, but none for you.

Professor Molloy paints a rosy picture but it is only half of the story.

Then it is often the case that doctors and other professionals will make decisions on your behalf without informing your relatives and these days they tend not to want to prolong your life. See the post below.

One chance to get it right

The approach to replace the Liverpool Care Pathway was set out in the LACDP report, One Chance To Get It Right. The alliance accepted recommendations for a named GP to take overall responsibility for the care of patients nearing the end of their lives in the community.

Dr Maureen Baker, chairwoman of the RCGP, one of the LACDP bodies, said: 'Today’s announcement should provide much-needed clarity for doctors and, most importantly, much-needed reassurance for patients and their families and carers.

'By setting out clear principles of what is expected, it should increase the confidence of doctors, nurses and other health professionals in confronting sensitive issues around end-of-life care, as well as reducing the potential for confusion or misinterpretation.'

OK. What do they mean by `setting out clear principles of what is expected?`

For instance, why don`t they say who is supposed to be expecting what, and why? Using language in this vague way gives the strong impression that they are reluctant to come out clearly with what they mean.

Then we might wonder who has the potential for confusion or misinterpretation?  Is it the health professionals who lack confidence in confronting sensitive issues around end-of-life care, or the patients? It`s vital to know. Why don`t they say?

What are the sensitive issues around end-of-life care? Are they talking about the withholding of food and liquids? Get that wrong and you kill people. Isn`t that what all the scandals have been about and calling that a care plan an outrageous distortion of the truth?

Are we really expected to be reassured by another round of the same old gobbledygook that attempts to disguise the euthanising of our old folk?

I don`t think so.

http://www.gponline.com/liverpool-care-pathway-successor-clarifies-gp-role-says-rcgp/palliative-end-of-life-care/article/1300789

Palliative care. Has anything really changed?

Scotland`s Patient Association 





It is worth reflecting back on the following article from the Daily Record given that nothing much has changed and the current emphasis in the care of the elderly is still to encourage them to contemplate their decline and death:

A DRUG given to US Death Row prisoners is being used on dying old folk in Scotland's hospitals. Medics use the sedative midazolam as part of a highly controversial "pathway to death" care plan for people judged by doctors to be in the last hours of their lives.

But patients' leaders warned yesterday that the widespread use of the Liverpool Care Pathway (LCP) in Scotland's NHS is robbing pensioners of the chance of life. They claim that, for some old folk, being put on the LCP is effectively a death sentence.

And research has found that many doctors decided to put patients on the pathway WITHOUT the consent of their loved-ones. Margaret Watt, chairwoman of the Scotland Patients Association, told the Record: "The LCP can be used to bring patients' lives to a premature end.

"We have patients on our records who should be dead but are not. Their families had to fight to get them appropriate treatment. "If the relatives had not had power of attorney, it would have been 'ta ta' to the patients. And we're convinced this is only the tip of the iceberg.

"How many people's lives have been taken that should have been here today?" "We're concerned to hear about cases where patients have been given drugs used on Death Row without properly consulting the patient or their family. "Doctors are meant to save lives, not take them. If they do, that's murder."

http://www.dailyrecord.co.uk/news/health/death-row-drug-fed-to-dying-1093688

Planning for decline, dying and death

The Scottish Partnership for Palliative Care is a charitable company limited by guarantee, and is registered as a Scottish charity with the Office of the Scottish Charity Regulator.
You can download a copy of the Partnership's constitution here.

"The Partnership is a membership organisation, and criteria for membership are defined in the Memorandum and Articles of Association. The Partnership has around 54 member organisations, comprising NHS Boards, voluntary hospices, national charities and support organisations and professional associations" - in other words everybody who wants to push forward the palliative care agenda. So no conflict of interest there?

These unelected people have a vision for the rest of us. They want Scotland to be a place where:

Information is readily available on planning for decline, dying, death and bereavement.

People have access to legal, financial and spiritual support for end of life planning (including wills, Power of Attorney, funeral arrangements).

Families, communities and professions support and encourage each other to plan ahead for decline, death, dying and bereavement.

People have the opportunity to discuss and plan for their decline and death with health and social care professionals.

Health and social care professionals feel able to engage and initiate end of life care planning discussions with older people and their families.

People have anticipatory care plans.

As a result of planning and preparation people have fewer concerns about the practical, legal, financial and emotional aspects of decline, dying and death.

Do you get the feeling they are trying to push forward a particular agenda?