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Sue Arnold: God help you if you're elderly and sick

My mother waited the statutory four hours on a trolley in A&E, but there was only one doctor on duty

Saturday 22 April 2006 00:00 BST
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"Good evening, ladies," said the young man in the white coat surveying the room with the purposeful air of a captain on the bridge of a warship about to engage with the enemy. "How are we all tonight?" No one answered. The woman in the bed by the window was, as usual, lying back against her three pillows clapping her hands together singing "Bye Bye Johnny, Bye Bye Johnny" over and over again. The beds next to hers were empty. Their occupants, Mrs Bryson and Mrs Macoun, were engaged in their nightly routine of struggling like rutting stags, antlers interlocked, to manoeuvre their zimmer frames past each other as Mrs B went into the lavatory and Mrs M came out.

From the bed opposite, which had its curtains drawn for privacy, alarming and not very private noises were escaping which were reminiscent of that sucking sound you get when you squeeze the last drop of washing up liquid from the bottle. The woman in the bed beside my mother was asleep or at any rate she was snoring, which in the normal way of things indicates sleep although her eyes were wide open. Earlier on she had tried to get into bed with my mother insisting that she had recognised her, the moment she set eyes on her, as Jason's wife.

"I said good evening ladies, didn't you hear me?" repeated the young man moving into the middle of the ward. He was wearing a white coat but he didn't look like a doctor, too young and not nearly knackered enough. A few of the patients whispered good evening and the young man began his round.

"Well Mrs Rush, how are we tonight?" he asked. "Not too bad but I wonder could you just pull the blanket back up over my foot. It keeps slipping off." The young man didn't move. "You must understand, Mrs Rush, that I am the assistant night duty ward manager. I have 24 patients under my supervision and I have been allotted a maximum of two minutes to deal with their individual medical needs. If you require special assistance outside my medical remit you must press your buzzer and call for the nurse." But she didn't need special assistance, she just wanted her blanket pulled up, said Mrs Rush. But the assistant night duty ward manager had moved on.

Visiting my mother in hospital over the past month, I can't honestly say that the Government's new NHS guidelines concerning care for the elderly fill me with much hope. Geriatric wards are depressing places unless you're gaga which, fortunately for them, most of the inmates of my mother's ward seemed to be. Treating elderly patients with far more dignity and respect is the crux of the advice, although it does of course help to ensure that they aren't kept waiting for four hours on a trolley in A&E if they have fallen over and broken their legs.

It does seem extraordinary that this sort of thing has to be spelled out to health service employees - or that old people have to be properly fed and not have their meals whipped away before they have had a chance to scrape the skin off the top of the soup.

I'm all for dignity and respect, but who are we supposed to be teaching them to in those hospitals where NHS cuts have reduced nursing staff levels to a bare minimum? My mother waited the statutory four hours on a trolley to see the doctor in A&E, but there was only one doctor on duty and all the people ahead of her were also elderly with heart conditions.

Except for Mr Benson. He was only 68 but sleeping rough and smoking 50 a day had made him look a lot older. What about alcohol, asked the doctor. What about it, said Mr Benson. He was on the trolley opposite so we had ringside seats. How much do you drink? As much as I can get. What have you drunk today? Four litres of vodka. And you say you have a sharp stabbing pain in your chest. That's right. So who brought you in? I was picked up, someone must have called the ambulance. I'd never have come in by myself. I don't hold with hospitals. Well, we're going to have to give you a chest X-ray. Wait here.

And while he waited Mr Benson made himself a roll-up. You can't smoke that here, the woman on the trolley next to him protested. So I'll go outside then, said Mr Benson and wandered off. We didn't see him again.

Respect for old people is not something that societies like ours, obsessed with youth culture, go in for much. Ironically, with so many immigrants from Third World countries where age is still venerated, working in the health service, you'd think these latest guidelines would be teaching your grandmother to suck eggs. Alas, not.

It's the whole hospital ethos that's to blame: it's iatrogenic, which is why we got my mother out ASAP. Please God, in, say, 30 years' time, when I'm rushed into A&E with a heart condition, I'll remember Mr Benson and get the hell out quick.

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