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Elderly Abuse in Australia ? Patient's relatives tell their story Involuntary euthanasia in public hospitals is being discussed in the U.K., but I would like to inform people that something very similar appears to be taking place in Australia. My darling mother had to be hospitalised late June this year, for treatment of a bedsore, which had developed after she became immobile in April. Mum appears to have suffered a series of mini-strokes over the past couple of years, although she was not diagnosed as such. "Alzheimers " is the "one size fits all" diagnosis for mental disturbances in the elderly here, as elsewhere. Despite eating three solid meals per day, plus morning and afternoon tea and plenty of chocolates, my mother was placed on a "pureed" diet within 48 hours of her admission, because the Speech Pathologist decided Mum had a "swallow problem". This diet weakened Mum considerably. On the eleventh day, Mum was fed by the nursing staff and, from her medical records, it would seem she aspirated on her evening meal and spiked a temperature. This caused the Speech Pathologist to put my mother on a "Nothing By Mouth" diet(?), with not even a drip for sustenance. Forty-eight hours later, due to family concern, Mum was placed on a drip. The following evening, the hospital staff mistakenly gave Mum a solid meal (which was not recorded) and insisted my father feed it to her, despite his many protests. This caused Mum's temperature to spike again, but the Speech Pathologist was not advised about the meal and she seems to have believed trialling of thickened fluid, which she had left in the fridge, had caused Mum's temperature to spike. This caused the Speech Pathologist to once again place Mum on "Nothing By Mouth". Mum continued on a drip for two days, getting weaker all the while. Having Enduring Power of Attorney for Mum, I requested an investigation begin as to why she had been given the solid meal. I was informed it was not noted in the reports, but that an investigation would begin when the evening staff came on duty. My request for an investigation was not recorded. My mother was then fed through a nasogastric tube for two days. No x-rays were taken to establish proper placement of the tube. On the second day of nose-feeding, I found my mother drenched in feed, as the suction cap had not been connected. On the third day, a nurse claimed Mum pulled out the tube and that she was, therefore, placing it in Mum's other nostril. When the nurse started to leave the room, another nurse in attendance had to call her back to do up the suction cap. I found the nightie I had expected Mum to be wearing on the floor, covered in feeding. This made me believe the suction cap had not been done up earlier that morning either, and that this was probably the real reason the tube was now being inserted in the other nostril. Immediately the feed began, Mum choked and gagged for several minutes and I ran desperately to the nurses, begging them to come check the tube. Without any x-ray or serious attempt to find the problem, my Dad and I were informed Mum's nostril was probably feeling a bit irritated from the insertion of the tube. The feeding was allowed to continue and my concern was not included in the medical records. A couple of hours later, Mum was gasping for air. A couple of hours after that, she was placed on oxygen. For the next twenty-four hours she received no sustenance, not even a drip, and she choked to death that evening. Fortunately, we went to Administration on Mum's final day and forced the x-raying of the NG tube (which staff had told us she was going to have that morning, but which had not happened by lunch-time). Subsequent to the x-ray, the tube was taken out and re-inserted into the original nostril and x-rayed again prior to a decision being made about feeding. Although we were not officially given the x-ray reports at the time, I attended the second x-ray with Mum and was told by the x-ray technician that the tube was in the wrong place "AGAIN". By sheer perseverance, we forced the hospital to arrange a Post Mortem, and discovered Mum's left lung had an empyaema with 700ml of turbid pink fluid being aspirated. We are still awaiting the microbiological analysis of this fluid. We now have the medical records from the hospital, and both x-rays show the NG tubes were in Mum's lung. From the day Mum was mistakenly given a solid meal, when she was severely dehydrated and had a mouth and throat like sandpaper, certain staff at the hospital behaved in a hostile and intimidatory fashion towards the family. On Mum's last night we were even told to take the chairs out of Palliative Care Ward, where Mum had been placed. The staff knew at this point that if Mum survived until the next morning (a Monday), I would get to see the Speech Pathologist and ask about the meal Mum had been given. Without even asking permission, I remained at Mum's bedside overnight, and saw the Speech Pathologist in the morning. She became furious when I asked her about the meal, and insisted she had never ordered it. A huge argument broke out at the Nurses' Desk and I overheard one nurse state that she had asked the "dietarist"(dietician?) who the meal was for… Yet, now that we have the Speech Pathologist's report, it simply states that the nurses denied any meal was given to Mum. My mother was rightfully scared of going to this public hospital. She had been admitted to hospital about 14 months prior to this admission for a suspected urinary tract infection, which never showed up in tests, and had become an hallucinating lunatic within a few days. Now that we have all medical records, the family is aware that not only was Mum given sedatives for at least four days during that stay, but she was also given morphine. I had noticed a drug I didn't know on her chart within forty-eight hours of her admission and enquired about it. I was told it was a sedative (Normison 10mg) and I explained Mum never took any form of sedative. I was told it was not a required drug, and that it would be stopped. However, it is now clear it was not stopped and that the morphine was administered on a night when the sedative had also been administered. Mum was only in hospital a few days during that admission to hospital yet, when her own brother and sister-in-law visited, they could not even recognise her, although they saw her very regularly. It took my father and I months to overcome some of the damage done. It is true Mum had some mental deterioration in the past two years, but she had been playing indoor and outdoor bowls weekly up until that admission to hospital in April 1999, and had enjoyed lunch in town with me just days prior to admission. Her own mother is 101 years old and alive and well, and Mum's autopsy report shows just how healthy a person she was. Indeed, my mother's strong immune system was a constant topic of conversation in our family. Perhaps what was saddest of all was not being able to have Mum's mother speak to her on the telephone before she passed away. There was no way we could believe she would die in hospital, when she only went in there at our request to have a bedsore treated. Mum's GP had made a home visit just a few days prior to admission, and he did not believe she required hospitalisation at all. However, I reluctantly decided there was no other way to properly heal the bedsore. I took my Mum for a long walk along the beach esplanade outside where we live, and sat by the playground, watching children on the swings. I promised her the hospital would not damage her this time. I promised her we would be with her every day….which we were. But the situation got out of control. It ended up a race against time, and Mum and the family lost. Our investigation continues, in the hope that no-one admitted to that hospital in the future is fed through a nasogastric tube without prior x-ray. The author's name is withheld by request as this matter is still under investigation.
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