Geriatric ward treatment for Gerry Feeney dismaying

Muiris Houston: Failure of basic care should be taken as seriously as medical problems

The allegations made by the family of Gerry Feeney about the care provided for him at Beaumont Hospital are serious ones. The complaint does not involve allegations of medical error; rather they focus on a failure to offer Mr Feeney the most basic of nursing care.

It might be tempting to view the allegations as in some way less serious because of this. That would be a mistake.

Healthcare may have become highly technical in recent years; however doing the basics correctly remains a valid and sensitive measure of how well we actually care for patients.

Mr Feeney was a typical 21st century patient. He had multiple morbidities. Many diseases of old age are not amenable to cure; the presence or absence of high quality care of chronic illness becomes the metric of choice.

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As an 81-year-old with Parkinson’s disease, “breathing problems” and a history of coronary heart disease, who resided in a nursing home, Mr Feeney was someone who was likely to experience episodic flare-ups of his conditions.

A key issue in his story is whether a major teaching hospital was the appropriate place to deal with these acute exacerbations. To Beaumont’s credit, the care he received in the emergency department and in St Patrick’s overflow unit was a positive experience.

His niece Ann-Maria Feeney says he was well nursed with regular washing, feeding and cleaning. However – and this is one of the most worrying features of this case – the care Mr Feeney received when he was transferred to a “geriatric” ward seems to have fallen well below even the most basic standard.

Allegedly left with the bottom half of his body uncovered, his niece describes a man left sitting out beside the bed in a soiled state with a “full” incontinence pad visible to passers by. She alleges he was not washed and did not receive oral care.

Although fresh clothes and pyjamas were available in his bedside locker, his relative alleges these were never used. Instead she says he was dressed in a hospital gown for most of his two-week-plus stay on the ward.

How could such disparity in the quality of care arise in two different areas of a hospital?

With emergency department overcrowding such a problem, are Beaumont hospital managers overly focused on this?

Surely, even if this is the case, a proper nursing ethos should be evident across all wards and departments. And even if, as seems likely, nurse staffing levels were less than ideal, it is a source of serious concern for basic care to fail so badly.

Our public health system is in crisis. It is dangerously sclerotic, with many acute beds occupied by patients who no longer require acute care.

When the dust has settled on the investigations into Mr Feeney’s care, there can only be one real measure of whether the family’s complaints have made a difference: will the Government finally wake up, acknowledge and begin to treat our alarmingly dangerous public hospital system as the emergency it clearly is?