Carers call on hospitals to increase awareness

Advocacy groups working with people with physical and intellectual disabilities have called for the introduction of disability…

Advocacy groups working with people with physical and intellectual disabilities have called for the introduction of disability awareness training at Irish hospitals.

The call for action followed an inquest last week into the death of a woman with cerebral palsy at a Dublin hospital. The woman was not fed for three days because of a communication breakdown at James Connolly Memorial Hospital, Dublin County Coroner's Court heard.

Michelle Tallon (38), Kilcock, Co Kildare, died at the hospital of acute respiratory distress syndrome (Ards) on July 23rd last year, two-and-a-half weeks after she was admitted.

As well as cerebral palsy, Ms Tallon was unable to speak due to an intellectual disability.

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A jury at the inquest returned a verdict of death by medical misadventure and recommended that the hospital set up a team to deal specifically with patients with special needs.

They also recommended that the hospital improve its communications protocol.

Ms Tallon was initially admitted suffering from constipation, vomiting and was unable to eat.

An internal investigation following Ms Tallon's death revealed a number of systems failures at the hospital, coroner Dr Kieran Geraghty told the inquest last week.

Cliona Ni Chualain, research and information officer at Inclusion Ireland, said disabled people who could not communicate were extremely vulnerable in hospital situations and this case highlighted that they may not receive the same standard of care as everyone else.

"If this was someone who was able to assert and communicate their own needs, this may not have happened. Healthcare professionals in hospitals and everywhere else should have disability awareness training. They need to be trained in how to specifically communicate with people with intellectual disabilities," she said.

Michael Ryan, development officer with the Centre for Independent Living, said Ms Tallon's tragic death highlighted the difficulties facing disabled people when they accessed health services if they could not communicate or were immobilised.

"The HSE now needs to examine how disabled people can be catered for in the health service. Advocacy support needs to be put in place within medical structures to ensure disabled persons' voices are heard."

One of the senior doctors involved in Ms Tallon's care told the inquest the internal investigation "identified several weaknesses" with communication in the hospital. Dr Joseph Galvin went on to say that while several things had been suggested since the internal investigation, "I'm not aware of any changes yet."

Doctors initially believed Ms Tallon was suffering from a gastro-intestinal infection and she was found to have a blocked and swollen bowel, which the hospital attempted to relieve through use of enemas and laxatives.

Initial instructions by doctors were that Ms Tallon should not be fed but she did receive fluids and nutrients through a drip, the inquest heard. But four days after admittance, medical staff decided that she could begin to take solids again but failed to remove a NPO (nil per oral) order from her bedside, which indicated to nursing staff that the patient was not to be fed. While medical staff gave verbal instructions to withdraw the NPO orders, this also was not documented in the clinical record, the inquest heard.

Bernard Tallon told the inquest the family constantly tried to raise the issue of his daughter's lack of feeding but it was difficult to get a doctor involved in his daughter's care to meet him.

Mr Ryan said "society values disabled people's lives less than able-bodied persons" and urgent action within the health service was needed to tackle this.

Ms Ni Chualain added that research indicated that people with intellectual disabilities had a lower health status than the general population.