Saturday, 19 December 2009

Sober and lonely

Night shift: Four calls: One assisted-only; one false alarm and two by ambulance.

Stats: 1 High BP; 1 fall; 2 eTOH

It’s shameful the way we ignore and neglect our old folk and I have said this again and again over the years. Nothing will change because there isn’t the will to do anything. Social Services in this country fall way below the standard expected of our long-time tax-paying, war-fighting elderly and it’s very frustrating.

The first call of the night, when there are no ambulances available due to the demands of London’s drunken revellers, was for a 91 year-old woman who had pressed her Careline alarm. I arrived to find no access because, even when I pressed all the buzzers for the block of flats, nobody would let me in – everyone in the building seemed to be out. I was concerned that the lady was trapped behind locked doors because she didn’t answer me initially either. Control arranged for the police as I waited outside in the minus zero temperatures but luckily someone came out and I let myself in and took the lift to her flat.

She didn’t answer the bell or my voice when I shouted through the letterbox but I could hear the extremely loud voice of the Careline person speaking to her over the phone system, so she was inside and alive at least but what was stopping her from opening the front door? After a lot of repeated commands from the phone voice for her to let me in, she eventually scooted into view behind the frosted glass of her front door, using a Zimmer frame to get to me.

I got her back into the front room and she seemed fine but it became obvious almost immediately that she had a major problem with her hearing. She wore an aid but the battery was flat and she had no spare, so I spent almost an hour in her house writing messages on a pad to communicate and trying to get transport for her because she was very vulnerable and could not stay there on her own.

She had no TV and no radio – nothing to listen to in fact. Her bedroom was a mess and I don’t think she used her bed at all. She had no food in her fridge and the place was generally untidy, with her less than 5 foot frame in the middle of it. She was a tiny, lovely lady who was abandoned by society. Her 'care' records stated that she didn’t take her medicines (her BP was high as a result) and she was frequently visited by police, fire and ambulance personnel because she pressed her button for help, couldn’t hear it when it was there and had to have her door broken in each time. Her flat was littered with hand-written notes from various people who’d found it impossible to get her to hear them.

Social Services had been told about her but nothing was done. Her own sister-in-law apparently didn’t care (according to a friend who phoned when I was there) and she had no immediate family left. This poor, smiling deaf woman was very alone and very vulnerable. I would have adopted her as my granny if I could.

The crew arrived after a long wait and she was taken to hospital after I’d made sure that Social Services were alerted, yet again, to her plight. I don’t expect miracles.

A few false alarms later and I was stuck with a 25 year-old man who’d fallen down metal steps at work and hurt his leg. It didn’t look badly damaged but he was in some pain, so I gave him entonox, which instantly helped. In fact, he became wildly drunk on the gas and I wondered why it was having such an effect on him. It wasn’t until I considered the weather outside and the fact that the cylinder had been sitting in the back of the car that I remembered something important about entonox – the gases (nitrous oxide and oxygen) separate at minus four degrees, leaving nitrous oxide at the top. No wonder he was off his head. I quickly mixed the gases back together by rotating the cylinder an few times. It won’t have done him any harm i the short period he was breathing it.

I waited for more than 30 minutes until I got a SJA crew and they splinted him and took him to hospital. He was still grinning like a Cheshire cat when I left him in the back of their ambulance.

It started snowing, as predicted for the night but somewhere along the way the temperature lifted and the fluffy white stuff became sleet. So, obviously I was sent to a 25 year-old drunken female. She was in a doorway with her friends and the first words to greet me were ‘she doesn’t really need you’. The doormen of the local club had called us, so after checking that the drunken woman was just that and no more (she was fit enough to go home by taxi), I asked the door staff if they could please try not to call us tonight if the person they were concerned about was just inebriated but could still walk. We were far too busy for this and sometimes they just call to clear human debris from their club’s vicinity. We are already London’s great human garbage removal service, so it’s time to give us a break for people like my last two patients, I thought.

Drunken women all over the place as usual. Why can’t they get the point and control their drinking? This one, a 25 year-old found ‘collapsed’ in the toilet of a club at chucking out time, was lolling about on the settee when I got there. She was drunk enough to be a nuisance but sober enough to know she was. I got her to the car after her fifth appeal for me to give her ‘just one more minute’- which is a standard line given to us by drunks who want to go to sleep and not be harassed by yellow jackets.

I offered her the chance to go to hospital to sober up but she asked me to take her home, miles away in north London instead. I told her I wasn’t a taxi and she opened her door and stormed off, only to return a few minutes later, climb back into the car and say ‘please take me home’. In fact she pleaded over and over to be taken home but the best I could do for her was to drive her to Kings Cross station and drop her off – at least she was a few miles closer to home and she would be less vulnerable, hopefully.

I went into Leicester Square on the hunt for good coffee and warm apple pie (which I found and consumed) and I had an epiphany as I sat in the car watching a young man vomiting his alcohol into a wheelie bin (a least he held the lid open as he threw up inside it). Wouldn’t it be cool if we could fine every drunk, say £50, once they’d sobered up in hospital, if an ambulance had to be called for them? The money could then be given directly to the elderly of society – the ones who are lonely and vulnerable, like my first patient tonight. I don’t think there’s a drunk in the country who’d object too strongly to that. If I had the time and support, I would campaign for it. Instead, the reality is that they get me, ambulances and ‘Booze buses’ laid on especially for them... for free. And old people get nothing but broken doors and hand-written messages.

Be safe.


Anonymous said...

Just a quick comment about your deaf old lady.... could it be that she wanted to live alone? If she had mental capacity, then Social Services would be powerless to intervene if she had the capacity to understand??

I think many of us would find the conditions that many elderly people live in totally unacceptable, but many choose to live alone and don't want to go into a care home. Shouldn't society respect their wishes even if we don't agree with the choices these people make??

Anonymous said...

I share your frustration about the treatment of the elderly, I work in a service that works along side social services and I know how overworked they are and how they have pointless targets to meet too, but i still find myself banging my head against the wall with them when they say its not a social need. The majority of the older generation don't want to be any bother to GP's/ambulance/hospital/anyone so suffer in silence, it is disgraceful.

Xf said...


That's a fair comment and I completely agree with free choice but the fact that she keeps pressing her alert button suggests that something isn't right and she was very keen to go to hospital. I think she could live well enough on her own if she was provided for in other ways...a visitor every now and then, food shopping, proper heating, etc.

Anonymous said...

With so many resources tied up with drunks, can someone advise me what has happened to the offenses of Drunk and Incapable/Disorderly etc?
If the police are scared of them dying whilst in custody, how about a secure place, with both police and medical staff, purely for drunks who could then, as soon as they have been sobered up enough, be wheeled in front of a magistrate, fined (or for persistant offenders jailed) and sent on their way?

Mark said...

I think anyone arrested or in need of any emergency service while intoxicated (above the drink limit is as good as any measure) should get an immediate 500 pound fine. If there are extenuating circumstances they can apply to get the money back through the courts. Night in a cell? 500 quid. DOB? 500 nicker. Pissing all over someone's front garden? 500 pounds. You were breaking up with your girl at the time? No refund. It was a works party and you didn't realise how strong eggnog is? No refund. It genuinely wasn't you and the police/ambulance/fireman will testify to that? Have your money back.

Deborah said...

I must be in a funny mood - that one almost made me cry and I can usually read these sort of objectively.

Rick said...

Given that the NHS can charge for people in RTAs who use ambulances I can't see why they shouldn't charge drunks. I'm all for it.

stefafra said...

Talking about drunken people, I recently moved to England from Switzerland, via Italy and the Netherlands, and I've seen my share of people dressed "to kill", especially to kill a few pints. I was appaled seeing how people, girls in particular, go around at night here, even in winter: they are basically naked, in their undies, with high heels ready to make them fall and in general make them extra vulnerable because they can't even walk normally when sober, add a couple of drinks and disaster is near.
The boys tend to be slightly more sensible, but going around in a T-shirt in the snow is all and good if you just go from taxi to pub to taxi, but if something go even so slightly wrong you risk to freeze in the gutter.
I might be getting old, I guess...