Hello there,

               my name is Keighly and I am a first year university student. I am doing an essay on ageism in the UK and particually health care and if possible, I was wondering if I could ask for some opinions on the treatment of older poeple by the NHS? Anything you would like to contribute will be greatly appreciated.

thank you very much for your time,

Keighly

Hi Keighly

I am 71.  Just a year ago I had a second revision of left hip replacement in the local hospital.  I found no ageism or discrimination at all.

My husband, just coming up to 72, recently had a third knee replacement on the same knee - 2003, 2004 and September 2006! He didn't find any ageism or discrimination either.

However, what both of us find applies in health treatment as in the whole of life - it's essential to be alert, aware, articulate and assertive, able to ask questions and to insist if you don't get a sensible answer - like the time I was told 'oh, you can't have a shower, you have to manage with a bowl'.  I was stinky and sweaty and I eventually succeeded in being taken to the shower, helped by the junior sister, and it felt marvellous to be able to wash my hair, feel clean and put on clean clothes.  Other women in the ward just accepted what they were told.  I didn't. 

Same with my husband.  When he was told 'you're making good progress' he said 'When can I go home?'  Staff were surprised - they expect patients to wait to be told, and no one expects us to be assertive.  He was wheeled down to the front of the hospital, got into the first taxi on the rank and was home within minutes.  Our little car hasn't got enough leg-room in front so I couldn't pick him up.

This, I feel, is the root of much of the problem.  People are not assertive enough, are too willing to sit back and accept what they're given - could this be a throwback to the days when you were expected to be 'grateful' for what you got? Like the recent BBC TV drama 'Casualty 1906' which described the Royal London Hospital's A&E department a century ago?  People will grumble and complain to their relatives, to their friends once they get home, but do they direct their concerns to the right place?

Best wishes with your research.  I have to do some course-work for GCSE Maths over Christmas, and we're away from 22nd to 27th!

Margaret

Hi Margaret,

            Sorry I've taken so long to reply, I'm sure you'll fell the same, it has been a rather hectic time! Would like to say thank you very much for your response, your views have been very useful.

I hope you had a merry christmas and your maths all went ok, and enjoy a happy new years,

Yours,

Keighly

Hi

I think the writer of your first reply is spot on when she says you have to be assertive.  My parents, both in their 70s, are not very assertive and are of the older generation that just accept anything their doctor does or says without question or chasing up.  One example: my mother has had a problem with frequent vomiting and IBS-type symptoms (amongst other things) which has made her weaker and weaker over the last few years and particularly the last several months.  As you can imagine this makes her pretty much housebound most of the time and no one chased up when she had to miss appointments, including regular blood tests and certain injections she has to have.  I had to contact her GP who then got in touch with her.  This culminated in a hospital stay.  However, they sent her home in the same state when the surgeon could not find out what was wrong.  The hospital form that went to the GP asked him to make an appointment at outpatients.  My parents waited patiently despite my protests and several weeks later my father phoned the GP and it transpired that he had apparently not read the form.  She now has an outpatient appointment four months after she came out of hospital.  In the meantime she has had to miss several appointments for a cataract problem and she has been trying to go for an X-ray for her back as she fell several weeks back and has severe osteoporosis.  It must be costing the NHS more in missed appointments that if they had kept her in hospital to find out once and for all what was wrong with her.  The whole story is too long and I could write all day.  Maybe I am being unreasonable and shouldn't expect so much, but it seems that for both my parents' problems over the last few years their GP prefers to give them a multitude of different tablets and only refers them when he absolutely has to.  As regards the hospital stay, that was ok, though my mother had to struggle to the bathroom and take care of herself with difficulty, though she didn't blame the nurses as they always seemed too busy to ask.

Hi Keighly and Kaz

Further to my earlier posts, and sympathy to Kaz's parents, it now appears that I also need cataract surgery.

   I won't bore you with the details, except to say that I was much reassured on reading that link my husband sent me and which I sent you, Kaz.  There is no longer the idea that 'you have to wait until the cataract becomes ripe'  - the criterion now is whether it affects your normal activities.  There can be a difference between e.g. a person whose hobby is watching birds and another whose hobby is listening to music.  As my hobby is watching wildlife, I spend a lot of time looking at a computer screen AND I'm doing GCSE Maths (the person who laughs shall leave the room!!!) I am being referred for cataract surgery because it IS affecting all the things that I normally do.

   What you were asking about age discrimination, Keighly.  I have found NO discrimination whatsoever.  I saw the optometrist back in November and was told then there is a 'small' cataract, let them know if I notice it getting worse.  Now I'm revising for maths exams, it seems to be a strain looking at figures and my eyes get 'tired'...to cut a long story short, the optometrist can refer me to an opthalmological surgeon, the referral is going through today by fax, without having to see the GP again or anybody, and I was asked where I preferred to go. My husband is going to the ophthalmology department at the hospital, but then he's different, they have his records there - he goes every year to have his eyes checked for diabetic retinopathy.  I said I'd prefer not to go to the hospital because parking is impossible there.  So I'm being referred to a private ophthalmology hospital not far away, fairly new and very modern.  I could also have gone to the local BUPA hospital which does work for the NHS.

   Neither my husband nor I have noticed any form of age discrimination either when being investigated and treated for bone and joint problems or in ophthalmology.  No one has even hinted at 'oh well you've got to expect it at your age' etc etc.  In fact we have been well pleased with all the care we've had.

   Margaret

Hi, further to my earlier post, I felt I ought to add a postcript.

My mother had cataract surgery yesterday.  She was very anxious beforehand and was given a temazapan (?) tablet which made her more relaxed.  Her cataract had become very bad and the surgeon said it was quite complicated and could take an hour and she might have to have another op after that.  It actually took around 45 mins and everything went well and my mother was fine.  I was very proud of her.

I also wish to say that I was very impressed with the the day care eye ward.  The majority of patients were getting on a bit and all the staff, surgeons and nursing staff, were absolutely lovely and so efficient.  I left the ward feeling very impressed compared to the time that my mother stayed in another ward as an in-patient.

 

The successful treatment of Kaz's mother (cataract surgery) is really good news.  My husband is to have cataract surgery under local anaesthetic in a couple of weeks' time, early April, a month earlier than was originally suggested.  My daughter's father-in-law, in his mid-70s, has recently had cataract surgery and it has been very successful.  I was given the choice of a private hospital under the 'Choose and Book' scheme and I've opted for that - just because the parking is better!!!  I have an initial appointment there early May.

   At no time have any of us found any discrimination in health-care so far. My husband and I have had the whole 'in sickness and in health' thing over the last 10 years and we've never experienced any age discrimination.

   Best wishes, Margaret

Another postscript, not really about discrimination, just that I am amazed at the incompetence of the NHS administration and have to record it somewhere!

The eye surgery seems successful but she was too unwell to attend the post-surgery so my father telephoned to arrange a new appointment.  The next appointment was then postponed by the hospital (one letter received).  The hospital then postponed a second time (two identical letters received) then a third time (another two identical letters received).  So between the surgery and first follow-up there would have been over four months.  To make matters more confusing the last four letters referred to bringing an optician's letter as though this was a pre-surgery appointment.  My father had to telephone the hospital several times (no one returned answephone messages) and eventually got the appointment brought forward slightly.  My mother's eye seems ok except she still has the feeling of 'sticks' in her eye and both are slightly mattery. 

One last slightly worrying aspect - when my father asked about my mother's second eye (in which she has another quite bad cataract) he was told that she won't hear about that one for ages - as long as someone has one good eye they won't bother about the second one unless the patient is in pain or in serious danger of going blind ...

Margaret:  I notice your surgery is coming up soon and I hope all goes well.

 

 

 

Hi Kaz

   There are a number of disquieting points in your last post, about your Mum's eye surgery.

   First, she needs a follow-up appointment.  So the hospital admin can't get it right - what's stopping you taking Mum along to the eye clinic and getting something sorted out face-to-face?  They're less likely then to make the error of thinking she hasn't had her surgery yet!

   The comment about 'sticks' in her eye and that it's 'mattery'.  This suggests infection, which is a huge danger, in fact it's the biggest danger.  Was she not given a regime to follow -chloramphenicol drops plus Maxidex drops 4 times a day? The chloramphenicol is an antibiotic, and it has to be inserted 4 times daily.  Following the first review appointment, which should have been 3-4 weeks after surgery max, there's another regime of eye-drops to follow.  My husband was given printed sheets in large print and was told specifically and in no uncertain terms, that if he noticed anything untoward, any undue redness, anything at all, there was a direct phone no. to ring and named people to contact.  He received a phone call the day after the surgery, from the senior nurse practitioner in ophthalmology, just to ask if all was OK.

   Another point - your father being told that 'she won't hear for ages about the other one'.  This is absolute bullsh*t and is completely the opposite to what we were told.  My husband was told that once the first eye was done, there would be such a difference between them that he might find it 'intolerable', in which case they'd do the second one quicker.  In fact the second one is planned to be done in 2 weeks' time on 14th May, the first one was on 2nd April, so that's 7 weeks later.  What has impressed him, and surprised him, is that although he's worn glasses for short sight since he was 12, he no longer needs to wear glasses at all, and in fact one of the things he had to do within days of the surgery was to go to the optician's and buy a pair of good quality non-prescription sun-glasses.

   I am seeing the consultant at the Phoenix Hospital this Thursday, preliminary consultation, and we'll see what he/she says.  I can't have anything done before the GCSE Maths exams early June, because I just could not cope with 2 eyes being so different.  I don't know how B copes with the computer, but certainly, he can't read the paper or anything like that because one eye still has short sight and the other one hasn't.  He can drive OK though. 

   Please take your Mum to the eye clinic ASAP!  If there's the slightest possibility of infection - eye is 'mattery' - she could lose the sight in that eye altogether.

   Best wishes, Margaret

Thanks for that, Margaret.  I must admit that I am rather worried.  My mum wouldn't agree to my just taking her along (she is stubborn despite being not in the best of health, plus it takes her a while to get ready to go - assuming her other problem isn't playing up at the time (IBS type symptoms).

I will give the clinic a call though and talk to them.  My mum says her eyes have always been a bit on the mattery side and she has always rubbed them a lot.  My dad still has some of the eye drops they gave her at the time of surgery and he is still putting them in for her. She wore glasses anyway so the 'new' eye needs a new lens now but of course she has been waiting for the follow-up.  Her vision in the other eye is darkish grey so I think it is bad enough to be operated on now.  The clinic did phone her the day after the surgery.

I dare not mention the name of the hospital but unfortunately I think it has gone downhill in recent years.  They certainly have a hygiene problem and a morale problem amongst the nurses (the British ones, anyway).  I am sure the 'water' infection my mum had towards the end of last year was picked up from her stay in the hospital shortly before.  She was taken back to the hospital by ambulance and suffered very badly with nightmares and hallucinations and it frightened her a lot.  During the first stay she struggled with the bathroom and although a nurse said to remind her later to rinse the white socks they put on her (they had got dirty through an accident) my mum didn't like to mention it again.  (I would have done it but she was worried in case she wasn't supposed to take them off etc - as I said, she is very stubborn).  It was difficult because she was there for investigative tests (IBS and vomiting frequently) but she also had bad osteoporosis and of course she couldn't see well because of the cataracts.  Every evening I wiped around the table with antibacterial wipes and kept drumming it into her to be careful in the bathroom.  A friend of mine stayed at the same hospital last year and also said the area around her bed was less than clean and she was given a bedsheet with dried blood on it.  The nurses were so busy she just pushed it to one side and used the blanket.  Visitors are supposed to use the gel every time they enter and leave the ward but you never see the hospital staff complying.  Although one or two of the nurses annoyed me a little and seemed less than caring, I do feel a bit sorry for them as they complete their training and are then told there are no jobs for them and the wards are closing down - yet there are a lot of foreign accented nurses there (I'm not racist - it just seems a silly situation).

Originally, about a year or so ago, I was told by the hospital waiting list manager that the second eye would take a year to 18 months after the first eye.  However, that would be from the time the second eye had been referred and the consultant putting the patient on the waiting list.

Your husband must be thrilled with his vision - what a great result, not having to wear glasses anymore.  They told us that my mum should wait six weeks before having a sight test for new glasses. 

Good luck with the maths exam

Best wishes

Kaz

Hi Kaz

   I think you have reason to worry.  Your mum should NOT be rubibng her eyes!  B was warned against this specifically - if you need to touch your eyes at all do it only with a CLEAN tissue and don't re-use the same tissue.

   I think what you were told by the waiting-list manager is rubbish.  Do you mean to say that one eye is done, oh right, go back to your GP and be referred all over again for the second one, waiting list, the whole shebang - when they have her in the system and already know that the second eye has gotta be done.  Going to the optician for new glasses, while the second eye still needs doing, is going to be a complete waste of time, money and effort.

   Here's what I suggest.  Get your Mum's GP to refer her under the 'Choose and Book' scheme.  http://www.chooseandbook.nhs.uk/  Alternatively, she doesn't even need the GP to refer her - I was referred directly from my optician.  I was given 3 options: the local hospital, a private eye hospital, and the local BUPA hospital which does NHS work.  I chose the specialist eye hospital.  This 'Choose and Book' scheme is a Government initiative.  Our GP surgery is excellent, but they hadn't heard of it whereas the optician had it all at her fingertips.

   It goes back to what I wrote originally - the need to be assertive! 

   Don't even get me started about foreigners in jobs that our qualified people can and should do - don't even go there!

   Best wishes,  Margaret

Hi

Just an update.  My experience with the gubbmint's 'Choose and Book' initiative has not been a happy one.  Not that I feel discriminated against on age grounds, but I certainly do on grounds of being an NHS patient in the private sector!

   Basically, I felt that I was being patronised.  I do need cataract surgery on both eyes, the consultant went through all his investigations (without explaining to me what he was doing and without even introducing himself!) He said that he would do the surgery, left eye first, would put me on the NHS waiting-list to be done there at the Phoenix Hospital in Southend-on-Sea.  I asked how long the waiting list is.  3 months.  I began to explain that this is very inconvenient given that in 3 months' time is just the time we'll be taking off on our long-planned and anticipated flight across the pond for a get-together and sightseeing at Niagara.  I asked what would happen if the date was inconvenient.  'You go back to the bottom of the waiting-list, that's how the NHS works'.  (Actually he's wrong there - they're much more human now and do recognise that, even if retired, we do have a life.) I started to explain. 'Don't have a go at me, that's how the system works, if you can't afford to pay.'  I asked the cost.  £1905 per eye.  He again mentioned 'if you can't afford it'.  I said 'It's not the point, I could afford it, I can't justify that sort of outlay - there's a difference'.  This mention of 'if you can't afford it' and the lack of understanding was what got my back up.  My husband has found that there's such a difference between the eye that has been done and the one still to be done - I couldn't imagine me sightseeing at Niagara if that was the case with me.  What that consultant said about 'you go back to the bottom of the list if you can't accept the date offered' is how it used to be long ago, not now.

   The upshot of all that is that I've cancelled the Phoenix booking, went back to the optician and I've asked to be referred all over again to the local hospital.  My husband has nothing but praise for the treatment he's received and is confident about second eye to be done on the 14th.  It's just that parking there is so dire, but he was treated like a human being, detailed explanations given, all his questions answered politely and without haste, and was asked if the date was all right for him.  That's what I expected from the Phoenix - it didn't happen.

   I phoned the Phoenix to cancel and was asked 'why?'  I said that I don't like being patronised and I explained about the lack of understanding about our holiday.  I also quoted the comment 'if you can't afford to pay'.  The lady I spoke to said my comments would be passed on.

   There were several other older people in the waiting room for appointments - I wonder what they thought of it all?  Many people are just too passive.  My husband and my daughter (she used to be a med sec) understood and agreed with what I'd done.

   Margaret

Very patronising and how irritating.  On a slight tangent your comment about parking reminded me about the hospital my mother stayed in a few months back.  My father is 77 and has had two hip replacements but is still in pain and limps with a stick, plus he has had a heart by-pass and is still pretty unhealthy on the whole.  He had to use the hospital car park as he cannot walk far, which cost a few pounds per day as he stayed about 3-4 hours each day with my mum.  To get to the ward he had to walk down two very long corridors and then get a lift up to the ward floor.  The nearest visitor toilets are back down at the foyer.  He had to rest a couple of times between the ward and the foyer and again on the way back to the car.  I know that the patients come first not visitors, but the hospital does not seem to be very disabled-friendly. I even mentioned the toilet issue to a nurse on the floor but she wasn't interested.  If my mum (who is a bit of an insomniac) wanted to watch TV it cost £3 per day (she couldn't really get to the day room easily) and when I telephoned her via the Hospicom phone the kiosk took about £2 worth of coins in less than 45 seconds. 

Unfortunately she won't bring her eye follow-up appointment forward but I will be attending with her on the 17th and will be asking a few polite questions about the postponements etc and will post the response.

Kaz

Oh-oh.  The hospital your parents use does NOT seem to be very disability-friendly at all!  Oh those new TV/phone/internet things they have all over the place.  I can live without TV so long as I have a radio, earphones and a good book, and I found those bright orange screens very intrusive.  How B and I have coped is to sneakily use our mobile phones!!  He snuck into the loo every morning and evening to say 'good night' or 'good morning' - it was what kept us going.  I didn't like having to listen to everyone else's conversation on the phones that they have. 

   Good luck for the 17th - make sure you ask all the right questions, because it doesn't seem that your mum will do so for herself.

   Regarding my eyes, I'd prefer to have them done during the winter when we're not going away and no exams!!

   Best wishes,  Margaret

I can't believe I allowed this to happen!  The last time I saw a GP, March 2007, he talked to his computer throughout the appointment and I talked to the side of his head!  I must admit I was too poorly at the time to comment on his rudeness.  I am 69