Moving woman (82) at 4am ‘bordered on inhumane’

President of High Court questions wisdom in timing of transfer of patient to nursing home

Mr Justice Peter Kelly also described as “completely unacceptable” the failure of the hospital’s discharge note for the 82-year-old, who has Alzheimer’s disease and impaired capacity to swallow, to state how she was to be fed. File photograph: John Stillwell/PA Wire

Mr Justice Peter Kelly also described as “completely unacceptable” the failure of the hospital’s discharge note for the 82-year-old, who has Alzheimer’s disease and impaired capacity to swallow, to state how she was to be fed. File photograph: John Stillwell/PA Wire

 

The transfer last week of an “elderly, frail and unwell” woman from a hospital to a nursing home at 4am “in the dead of winter” was “bordering on the inhumane”, the President of the High Court has said.

Mr Justice Peter Kelly also described as “completely unacceptable” the failure of the hospital’s discharge note for the 82-year-old, who has Alzheimer’s disease and impaired capacity to swallow, to state how she was to be fed.

That failure led to her GP, after seeing the woman on January 15th, hours after her discharge, being concerned she would starve to death.

The HSE apologised for the “oversight”.

As a result of her various conditions, and concern about her breathing if she received food orally, the woman had been on a glucose drip since being admitted to hospital on January 4th.

After the GP unsuccessfully tried last Monday to contact a hospital doctor to clarify the position on feeding, solicitors for the woman’s family correctly brought court proceedings on her behalf on Monday afternoon, the judge said. Later on Monday, the hospital contacted the nursing home to clarify the position on feeding.

The judge said he wondered what would have happened had the woman not had a committed family, a committed GP, committed solicitors and, as a ward of court, easy access to the court.

He expected the hospital to review its discharge procedures to ensure this situation would never happen again as it was “unacceptable” and could have “fatal consequences”. He also questioned the wisdom of having a normal transfer from hospital at 4am especially where a patient was “elderly, frail and unwell”.

While the HSE said the 4am transfer was due to non-availability of ambulances any earlier, that was “an explanation, not an excuse”. He accepted it was in the woman’s best interests to return to the nursing home but queried if doing so at 4am was in her best interests.

Doing well

However, he was happy the situation had resolved, a “comfort feeding” plan was in place since Tuesday, the woman was doing well and her GP and family would be involved with a hospital multidisciplinary team in devising a care plan for her into the future.

He also noted the woman had been “very well looked after” in the hospital, her family had no criticism of her treatment there and the problem arose rather from the time she was to be discharged.

The judge noted the HSE and hospital had apologised for the failure of communications and accepted it was regrettable the woman’s transfer back to the nursing home took place at 4am and not at a more normal hour.

A hospital consultant who dealt with her described as “unacceptable” the failure to address the feeding issue in the discharge summary, he noted.

He awarded costs against the HSE to the lawyers representing the woman’s ward of court committee and paid tribute to the woman’s husband, son and daughter, who were in court, for their concern for her. He also expressed sympathy to them, saying this situation must have added to the stress they were already experiencing.