What does our Health System do to Old People?

What does our Health System do to Old People?

My mother is 94 and still lives alone with wonderful support from Healthcare Services, who come in three times a day to shower her, give her the right pills and serve her meals.  My sister-in-law, who deserves sainthood, prepares all Mum's meals and freezes them in single portions so the caregivers only have to microwave them and serve them to Mum.  She does this so Mum can retain her independence and stay in her own home. 

However, Mum tripped over earlier this week and was admitted to hospital.  This is the third time in the last 18 months that she has fallen and hurt herself and ended up in hospital.  Firstly, she fell down the stairs at our beach house and broke her pelvis, then she fell at home and broke her thigh bone.  This latest fall didn't result in any broken bones thank goodness, but she did bruise her lower back.

The sad thing is that a frightening pattern has emerged with these hospital stays.  This fiercely independent woman who insists on staying in her own home against all good advice from well meaning neighbours and friends, becomes totally institutionalised within 24 hours of being in a hospital bed.  Having been through this twice before, I could have written the script of what would happen, before I got to the hospital carpark and sure enough it's happening again.  When the nurse from A and E called me to say Mum had been brought in, she said not to worry because nothing was broken and Mum could probably go home after she had seen the doctor.  Worst case scenario, they would keep her in overnight.  That was Tuesday afternoon.  This is Sunday night and she is still there and not looking like leaving.

Now the last two times this happened, I very unkindly blamed my mother because once she got settled into the hospital routine, she wouldn't leave.  Not only that, she wouldn't do anything the social workers or physios wanted her to do.  In fact once she got up to the geriatric rehab ward, she was extremely disruptive.  She lorded it over everyone, from the cleaners to the senior house doctors and wouldn't do anything she was asked to.  She organised the whole ward and told everyone which bed they should be in.  Very embarrassing.  Every time anyone mentioned going home, she burst into tears and said she wasn't ready. In the end I had to put my foot down (with my bothers full support God bless them!) and tell her she was leaving as more deserving souls needed the bed.

So it was with some trepidation I went up to the hospital on Tuesday to see her and sure enough there she was all tucked up in bed and not looking like going anywhere.  The first thing she said to me was "If they think I'm getting up tomorrow they have another thing coming".  My brother arrived and we carefully explained to her that maybe she should think about going into "care" as an interim measure until she was well anough to go home.  She thought that was a good idea and then completely changed her mind two minutes later.  Then she told us something which made us realise that she was hallucinating so we talked to the ward nurse and asked what medication they were giving her.  Sure enough, that pain killer of all evil painkillers, morphine.

This is what I believe happens and I'm sure it's not a deliberate plan.The hospital staff are wonderful, but they are understaffed so they put people like Mum on high doses of painkillers (morphine) to make them comfortable.  They have to supervise her when she wants to use the toilet in case she falls again, so it's easier to give her a bedpan and put an adult nappy on her.  At this point, I'm very grateful that she is in la la land because if she knew she had an incontinence pad on she would be mortified. 

So this fiercely independent woman, who has been in control of her destiny all her life, is suddenly reduced to a little old lady not able to lift her head off the pillow.  Worse than that, she actually doesn't want to.  She just gives up.  And it's not just her, we see it being repeated over and over with the other patients as well.  It's scary how quickly old people succumb to being institutionalised.  It must be costing the health system and the country a fortune.  Surely there is a better way, but if there is I don't know about it and certainly Auckland City Hospital doesn't either. 

The scariest thing is that as our population ages this problem is only going to get worse.  I couldn't have Mum live with me because I can't provide the amount of care she needs.  She was 32 when I was born and I can't help thinking about the current trend of having children much later, well into their 30's and early 40's.  The grandchildren will still be living at home when these current parents are elderly, so they won't be able to expect their children to look after them either.  I remember my lovely grandmother coming to live with us when I was a teenager and Mum was menopausal.  What a nightmare that was with Mum and I at each others throats and Grandma trying to be the peacemaker.  Then Dad piping up and telling me to be tolerant of Mum because she was "going through the change".  I remember vividly thinking "what about me?" 

So somehow, I have to talk the hospital into taking Mum off Morphine and quickly so she gets her life back.