The ‘crisis’ of Accident and Emergency (A&E) is a very hot topic in Ireland at present and it sends shivers down my spine.
Basically, there is a log jam in our hospitals with lots of people waiting for hours and hours, days and days on chairs and trolleys in A&E while there are hundreds of people in hospital beds who are ready for discharge but who are deemed to have nowhere to go.
The shivery bit for me relates to my experiences with both ends of this scenario with my late parents and, indeed, my work as a social researcher on health service reform over many, many years.
The discussion keeps coming back to the fact that we have an ageing population. This fact was flagged years back but it seems like nobody was prepared to plan for it and now we are in a ‘crisis.’
At one level, this makes me wonder whether there was any point in the wide earthly world taking a very, very conscious decision to work in social policy and planning as opposed to social work, which is about patching up problems as they arise.
At a personal level, I know what it is to be ‘the family’ of older people. I came to know Accident and Emergency all too well when one or other, or both of, my parents suffered serious problems like heart attacks/strokes in the middle of the night.
I reckon one of the loneliest places in the whole world is sitting in the waiting-room of A&E, knowing that this could be the end. Hearing your name called by a tired-looking doctor who has to break whatever news has to be broken …..
To this day, the worst flashbacks I have about my parents last years relate to Accident and Emergency Departments ~ seeing their absolute vulnerability, frailty and need for my hand in theirs.
Mercifully neither of them died in the hustle, bustle, bright-lighted, sweatiness of an A&E Department but they did end up as ‘bed-blockers’ at the other end of the hospital system.
So many times I was called in to discuss the ‘discharge plan’ and had to plead for a few extra days of hospitalisation as I knew they simply weren’t ready for home and would be straight back in to A&E if discharged too soon.
Other times, I knew they were way beyond their discharge time but were tied up in knots by red tape and lack of co-ordination.
My plea today is that over-stretched health services recognise:
1. That A&E is terrifying for vulnerable, ill people and their loved ones. There is definitely a case to be made for liaison people to be employed to help alleviate this.
2. That family care-givers have a depth of knowledge about their elderly relatives and should be seen as friends, not foe, in the whole discharge scenario.
3. That massive emphasis be placed on co-ordination of services both within hospitals (e.g. guidelines of speech therapists re food requirements of those with restricted swallow must be observed by all) and between hospitals and the available community care services.
4. That illness is a 24/7 situation that doesn’t take holidays at key times like Christmas/New Year.
While extra funding is clearly important for the health services, I would argue that a huge amount could be achieved with a change in thinking, perceptions and work practices.
Finally, I would ask that the ‘powers that be’ question if they would act any differently if the ‘elderly patient’ in A&E or ‘blocking a bed’ happened to be their very own beloved mother or father.
I am delighted that this post has been Shortlisted in The 2015 Irish Blog Awards ‘Best Post Category.’ The subject matter means a huge amount to me as the A&E Crisis impacts on so many people ~ all those patients, families, hard-working care staff who are embroiled in it today, tomorrow and all our tomorrows.