Sir, - Padraig O'Morain, quoting Dr Des O'Neill (The Irish Times, January 3rd) advocates the provision of extra acute beds as a means of providing enhanced care for the elderly. This is a simplistic solution to a complex medical and social problem.
Acute hospitals are dangerous places for the elderly. In acute illness immediate expert attention is required with holistic care from arrival at casualty. Too often there is a long delay, in unsuitable surroundings, with inadequate help in providing food, toilet facilities, mobilising or altering one's position, contacting relatives or explaining procedures and tests and the necessary time involved.
From the initial delay in casualty to the lack of in-patient help with such basic requirements as mobilising, washing, sitting up to see to one's food and ensuring that it is suitably cut up or liquidised, the older person is on the slippery slope to dependency. Too many visitors to hospital have seen the unsuitable pork chop left out of reach of the patient and in due course removed untouched.
Two simple innovations would go a long way to maintaining independence. First, an appreciation that help is required in the basic activities of daily living and a decision by staff that it is their duty to provide it from the initial arrival in casualty. Second, the provision of a dining table in each ward. This would serve the dual purpose of seeing that patients are mobilised regularly and that one member of staff could see that diet provided is suitable and accessible.
Until such basic help is provided, complications will prolong hospital stays and cause unnecessary suffering among our elderly population. The preventable complications we see nowadays are loss of mobility, pressure sores, incontinence and infection caused by injudicious use of catheterisation, and difficulty in feeding which can lead to inappropriate tube feeding.
Enhanced support in the community with adapted housing, home help, and adequate community nursing, physiotherapy and general practitioner services would be a more humane way forward. Nursing homes and regularly inspected health board homes are necessary for more dependent people.
More rapid access to specialist help in an emergency and shorter and more efficient hospital stays would free beds and provide an improved quality of life for our seniors - which must be the aim of all who work in health care. - Yours, etc.,
Daphne Morgan, BNS, Bushy Park Road, Dublin 6.