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"Insufficient care for an older person"

About: Sir Charles Gairdner Hospital

(as a friend),

I am the primary contact (and hold POA) for an elderly patient (longtime family friend) and therefore speak on their behalf, as they have no family to do this for them. The patient was admitted to Sir Charles Gairdner Hospital (SCGH) recently one morning, at the request of their GP. On admission, it was determined that the patient had very low hemoglobin (around 50), low blood pressure, and was frail. The patient was shifted from the ED to the Medical Assessment Unit. When I saw the patient that night, they were about to receive a second unit of blood and was on a drip to bring their fluid levels up. I was informed that the patient was scheduled for an endoscopy which would be conducted as soon as possible, likely the next morning. The patient was having a clear soup when I arrived, which was their only food intake for that day. When I visited the following night, the patient had not had the procedure, was on nil by mouth, and no-one had informed them about anything. I asked the allocated nurse to speak with a doctor, but was informed no doctors were available. I asked what was happening with the procedure. The nurse did not know, but went to find out. I asked about the patient's medications (which the patient was concerned they had not taken since the previous morning) and was informed that as they were on nil by mouth the metformin was not required, and regular glucose monitoring was taking place. I asked when the patient might be allowed to eat and was told that as they were waiting for the procedure they could not eat, and it is possible for a patient to go several days without food. The patient is in their 80's and weighs in their mid 40's, is frail and unwell, which is why their GP has sent them to the ED. I believe this is completely unsatisfactory. At my request, a doctor was contacted and it was advised that the patient could be given food. What would have happened if I had not been there to intervene? The other issue is in regards to the endoscopy. The patient had been informed during the day of the intended procedure that if they were a private patient they would have had the procedure quicker. This is completely unacceptable. I repeat, the patient is in their 80's with low hemoglobin that 2 units of blood has only raised their level to around 78. The patient has been given very little information about their situation. The patient's cognition is fine, as assessed by the nurse at their doctor's surgery around 2 weeks ago during an annual assessment. The patient sometimes takes a little time to respond to questions but understands everything that is said to them. I find the lack of care for this patient is an indictment on the public health system and want the issues I have raised addressed by someone.

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Responses

Response from Janet Zagari, Executive Director, Sir Charles Gairdner Osborne Park Health Care Group 4 years ago
Janet Zagari
Executive Director,
Sir Charles Gairdner Osborne Park Health Care Group
Submitted on 26/04/2019 at 10:38 AM
Published on Care Opinion at 10:51 AM


picture of Janet Zagari

Dear hydrusff52,

Thank you for taking the time to raise your concerns about the treatment of your friend. The care you outline is not in keeping with our values. I would like to investigate this so that I can address these issues for you, and ask that you please contact our Patient Liaison Service on (08) 6457 2867.

The public health system treats all patients according to their clinical need to make sure the sickest patients receive care first. Patients who choose to use their private health insurance while in a public hospital are able to choose their doctor but they not to receive care any faster simply for being a private patient. I am concerned that you were advised otherwise. Because we prioritise according to urgency, it does mean that sometimes procedures such as endoscopies do not go ahead as originally planned. This can mean that patients need to fast again before the rescheduled procedure. I am sorry that your friend was not provided with a meal until after you requested that the doctor be contacted and that this was not provided once it was apparent that the endoscopy would not go ahead that day.

Thank you again for bringing this to my attention and for supporting your friend whilst under our care. We encourage carer’s and other friends and family who provide support to be involved as much as possible. I hope you will contact our Patient Liaison Service.

Kind regards,

Janet Zagari

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