Police asked to investigate death in care home of dementia patient who 'gave her entire life in the service of caring for others'

Joan Ash's son claims she was deemed 'no longer worth treating'

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The Independent Online

She devoted her life to the service of others as an NHS nurse but, when Joan Ash needed help as a 90-year-old with dementia, she was deemed “no longer worth treating”, her son has claimed.

Now Cambridge academic Dr John Ash has asked the police to investigate the circumstances of his mother’s death from bleeding within her skull, while she was staying at a privately run care home regulated by the Care Quality Commission.

Mrs Ash worked for four decades as a nurse, serving in India during the Second World War before spending some time as a prisoner of the Japanese. She later wrote Catch Me a Nightingale, an autobiography which “confronts the myths and realities” of the NHS.

While staying at Cranham Court home in Havering, Essex, she fell several times despite an assessment that she had a “high risk of falling”. She was often found sitting on the floor, according to her medical notes, seen by the IoS. Her walking frame was left beside her bed at night within reach, which Dr Ash believed contributed to her falling repeatedly.

Joan Ash died aged 90 at Cranham Court

He also said she did not get the treatment he believes she needed for a number of physical and psychological ailments and instead “was simply offered palliative care”.

The case comes as a harrowing report revealed last week that hundreds of thousands of people endure a painful, undignified or lonely death because of “appalling” end-of-life care across the health service. The health service ombudsman said too often treatment “falls short” as patients near death.

Dr Ash said: “What we are facing is a system in which you eventually reach a point where a judgement is made that you are no longer worth treating – and when that happens you are farmed out to a location where you receive palliative care, and that is all.

“Those in my mother’s situation are just considered bed-blockers in hospital and moved on. Joan gave her entire life in the service of caring for others, but when the time came for her to receive care she was let down.”

Mrs Ash died in September 2011 at Cranham Court, seven months after her council decided she needed residential care following periods in hospital. She had been twice rejected for NHS Continuing Care, which provides free support outside hospital.

Her son, a retired lieutenant commander in the Royal Navy who works at Cambridge University’s Scott Polar Research Institute, waited more than a year after her death before obtaining her medical notes. Dr Ash said only then did he discover the full details of his mother’s condition.


“I also don’t believe she was checked by an appropriate person to see if the broken pelvis she suffered a few months earlier [at her home] had healed,” he said. “She was supposed to be moved by carers and not to be allowed to move independently. That was dangerous.”

His mother’s weight plummeted while in acute care in hospital, from a dress size 18 to 10, Dr Ash said. And although it improved in Cranham Court, she was supposed to see a dietician in the care home, but he claimed this never happened.

“There is also no record in her medical notes that her psychological treatment was followed up on. In other words, she was just quietly given palliative care and that was the limit of her treatment,” he said.

Dr Ash said he did not understand how his mother could have died from an intracranial bleed, and is considering approaching the coroner to request an inquest. He is also calling for an independent inquiry into his mother’s treatment.

Scotland Yard confirmed it was reviewing the documents Dr Ash has passed to them. He previously complained to both the Local Government Ombudsman and the Parliamentary and Health Service Ombudsman, but neither accepted his call for further investigation.

A spokesman for Havering Council said: “We have every sympathy with Dr Ash for the loss of his mother, but we refute his accusations that our care for his mother was in any way inappropriate. Once the Health Service had decided that Mrs Ash was not eligible for NHS continuing health care, the decision to look after Mrs Ash in a care home was appropriate to her needs, and she received a good standard of care there.

“It’s true that she had falls during her time in the home, as she remained mobile despite her age and condition – but in each case she was examined by the nurse and her care and safety were the priority.”