The Liverpool Care Pathway was designed by the Marie Curie Hospice in Liverpool. It was designed to stop Cancer patients who expected to die within 33 hours, receiving unnecessary and often painful treatment. It was developed to help a patient die with dignity... that was until greedy hospital administrators and British Government officials got hold of it.
The Liverpool Care Pathway is now readily being used throughout England and Wales to help hospitals cut back on expensive treatments of the young, disabled and elderly patients, it is simply being used to free up hospital beds and cut costs.
Here is my Mum's story - please be aware that this is not an isolated incident of cruelty and deliberate abuse. if after reading this you want to know more, or know how you can help fight against this happening to other vulnerable people please feel free to contact me.
Florence May Holmes 20.8.32 - 20.3.12
Up to 29th November 2011 my Mum was fit and well, she commuted alone to and from Fleetwood every week , and lived independently despite having a disability.
In November 2011 one of my mums kidneys stopped working and she acquired pneumonia, Mum was admitted to the Medical Assessment Unit (MAU) at Aintree University Hospital on 30.11.11. My sister and I were informed that our Mum might die. We made it known to all medical staff that Mum was scared of hospitals (how right she was) and would often use the phrase "I'm fine" even when she was ill. Mum also had a fear of doctors and because of her genuine fear (her lack of visits to her GP is evidence of this) my mum, my sister and I requested in writing, that we should be present at all ward rounds and consultations,, both my sister and I took time off work to facilitate this.
This request was blatantly ignored. on 1.11.11 one doctor argued with me in front of my mum and said they would only allow us to stay with her IF she was dying which she was clearly not! . I later met with this doctor who informed me Mum was not dying.
Mum had lost her left hand in an accident many years ago and her right shoulder had been broken some years ago when doctors at Aintree were fixing a dislocated shoulder, because of this mum struggled to cut up food open containers etc. My sister and I made this known to staff and requested that we stay with Mum to help her eat. This request was refused and we were told that we would have to leave during meal times. I was already concerned about the poor standard of care and conflicting information on the MAU and made excuses to have to "call back in to collect something" and on more than one occasion Mum was sitting in front of a cold tray of food with the food uncut, and tops left on desserts and drinks. When I challenged this Nurses replied that they were busy and they would get round to it. This type of neglect was consistent .
Mum was then sent to Ward 22 where she stayed for approximately 2 weeks and discharged (approximately 15.12.10) She was discharged without an aftercare plan despite my telling staff mum lived alone. Mum had also developed a pressure sore on one heal on ward 22. (This is more evidence of neglect) The night Mum got home, she fell on the stairs on her way to bed and she was readmitted to ward 32, we were informed that Mum was still ill and the pneumonia had not cleared.
On January 5.1.12 she was discharged with a full aftercare package and still requiring a nurse to dress her pressure sore. Mum was readmitted on 20.1.12 to ward 15 with community and hospital acquired pneumonia that had not cleared.
It was at this point my sister and I decided we should catalogue the abuse.
22/1/12 Tablets left on her table in a dispensing cup Mum had restricted use of her arm and had poor eyesight. We Informed staff of this and were told they would make sure she had her tablets.
23/1/12 Tablets left on her table in a dispensing cup
26/1/12 tablets left on a table in a dispensing cup
We requested a meeting with The doctor and the Consultant. Again we raised our concerns about mums treatment and her fear of hospitals and doctors and it was agreed there should be 3 way communication.
26/1/12 Mum had water retention and her ankles were swollen . The footstool provided was far too high and it was causing mum pain. The physiotherapist said they would get mum a lower footstool.
27/1/12 My sister and I noticed that Mum was not eating but Mums foodchart stated that she was eating almost everything. We informed the nurse. We were told they would monitor her food intake.
28/1/12 I informed the nurse my mum was in severe pain and was tired and that she appeared to be deteriorating. I asked if her oxygen levels had been tested and I was informed they were OK, however Mum was visibly weaker.
29/1/12 I spoke to the deputy ward manager and told her mum was still not eating and her breathing seemed laboured I told her Mum was tired and weak. The Deputy Ward Manager told me Mum was not too weak and that she had walked to the toilet alone using her delta frame.
30/1/12 At approximately 7pm, we observed that all of Mums tablets had been left on the table in the dispensing cup. Mum had been put on oxygen and had deteriorated further. A Nurse brought a drip and hung it over the bed lamp She informed us that Mum had a chest X-Ray and had pneumonia on her lower left lung. She was surprised that Mum did not have a canula and said that she had asked the Doctor to do it at 9.30pm the canula still had not been done. At 10pm we were informed that this had been done and Mum was on anti-biotics.
31/1/12 10.55am I telephoned the consultant's secretary to request a meeting with him. We were given an appointment on Thursday 2/2/12 at 11.30am I informed the secretary that we wanted to meet with the consultant himself
When we met him we asked about Mums prognosis - given the fact that we were told on the MAU that mum was dying. We were informed that mum was poorly and may require an operation on her kidney.
We informed him that Mum was not eating or drinking properly and asked what was being done to ensure she was kept hydrated and had enough nutrients
We informed him about tablets constantly being left on Mums table for these points he said he would speak to the ward manager
I asked why I was ignored when i had told the nurse I suspected Mums oxygen levels had dropped and was subsequently proven right there was no reply
I asked how they would monitor Mums oxygen levels I was told this would be done through blood tests.
We informed him that Mum had deteriorated that her speech was not right and the fact she struggled to get to the toilet with a frame and assistance was a long long way from how she was in October. He did not comment
We also informed him that Mums legs were swollen but despite this she was not being provided with a footstool. he said he would ensure that a footstool was provided.
31/1/12 Mum informed us she had not eaten all of her food but her food chart said that she had. Tea was being counted as fluid (despite the dehydrating effect of caffine) and Mum was only having small sips of tea. Mums chart said that her canula was fitted at 20.20 but it was not fitted until 22.00
While we were there a nurse had asked Mum what she had eaten - Mum could not remember, it was at this point we realised mum's food intake was not being monitored rather than someone simply asking mum what she had to eat.
31/1/12 3pm it was noticed that her antibiotic drip had finished and was tugging on mums arm. we asked for it to be removed . At 7.15pm I had to ask staff again to remove the same drip. The footstool mum had been provided with was on the opposite side of the bed.
1/2/12 Tablets left in dispensing cup on the table
1/2/12 Nurse said Mum was lively - this was a lie Mums speech was slurred and she was very grey in colour and was lathargic. again tablets had been left in the dispensing cup on her table.
2/2/12 We met with the consultant
We informed him about Mum not having the canula fitted until 10pm
Drs kept referring to Mums TB - Our mum had NEVER had TB
We highlighted that up to 29.11.11 Mum was able to walk, she was independent despite her disabilities. We highlighted that mums speech was slurred and she could not stand unaided the movement in her left arm had deteriorated Mum was drooling from one side of her mouth. Since the admission to ward 15 Mums short term memory had deteriorated.
2/2/12 My sister asked for Mums oxygen to be put back on a Nurse did this. Later the doctor pulled me to one side and told me that ONLY nurses should put the oxygen back on Mum. He was implying that my sister had done this and it was against the agreed plan of care. I informed him that a Nurse had put the oxygen back on. He said nothing in reply.
2/2/12 tablets left in the dispensing cup on the table but the Nurse informed us they had watched mum take her medication
2/2/12 Mum had not had any of her ensure drink. Mum was clearly upset and had been crying. She informed me that the urologist had told her he was going to put a drain in her kidney "early next week" . I spoke to nursing staff about this - they were gathered around the table having a chat. They informed me the Urologist had NOT seen Mum and she was confused . I spoke to The doctor who informed me nothing would happen until the pneumonia had cleared. Once the pneumonia had cleared, they would move mum to the rehab unit and she would be treated as an outpatient for her kidneys. I went to explain this to my mum, telling her she had been confused but the patient in the next bed to Mum "Dot" said that she had heard the doctor telling Mum and what my Mum had told me was right. I went back to tell the Nursing staff and they laughed and said "we have more than one confused patient on the ward' I found this comment particularly offensive and left the ward sobbing as the pressure and stress was becoming too much to bare.
3/2/12 tablets left in the dispensing cup on the table
3/2/12/ Mum had a very sore mouth, it was dry and had open wounds and it was too painful for her to eat. i asked the Nurse if Mum could have porridge she said porridge was not on the menu but used a low salt menu to get Mum her porridge.
4/12/12 Mum did not have the footstool
7/2/12 mum still had difficulty eating her mouth was still very sore I asked another nurse about porridge, she brought Mum a soft food Menu - mum had never been offered this before despite needing it.
7/2/12 I arrived on the ward Mum was sobbing. She had had a canula put in and was told she was having a nephostromy tomorrow . A Nurse confirmed this. Again despite numerous requests to be present whenever mum was seeing a consultant our requests were ignored. We had even put the request in writing and Mum had signed this.
8/2/12 Mum had been put back on oxygen The doctor informed us that Mum had pus in her kidney and the kidney wont clear while the pus is there so a nephrostomy was essential. Mum also had an abscess in her stomach and we were told this may clear after the nephrostomy - if not it may need to be drained. we were also informed that the swelling in mums legs could be an indication that everything was "backed up from the Chest infection " and this could affect her heart and she was to have a heart scan. I informed the doctor that at 9am Mum walked to the toilet but was very breathless and needed 2 nurses to help walk her back to bed
8/2/12 Mum was taken down for her Nephrostomy. The surgeon informed me that mum had TWO pressure sores, one on each heel and told me that she was completing an incident form as one wound had gone close to the bone. She asked me to ensure that the staff on the ward dressed the wounds.
8/2/12 3pm had to remind The nurse to dress Mums pressure sores 7.30pm two nurses came to dress the sores.
On ward 15 on 2 occasions mum contracted the Norovirus, yet doctors and wrd staff were frequently observed not following the correct hand hygiene procedures when they were walking on and off the ward and between rooms.
My sister and I complained about the standard of care in writing to the Matron.
9/2/12 Mum was moved to ward 2 Much better standard of care! Mum was given a chair with a leg rest and was offered a soft food menu, without us having to ask. Mum was also given a red tray for assisted feeding.
10/2/12 Mum moved to another room her legs were dressed to help with the swelling
12/2/12 The abscess in mums stomach Burst.
On ward 2 we didn't keep detailed notes as the standard of care was good.
On 9.3.12 Mum was informed she would be home in a few days
11.3.12 Mum got another infection. Doctors tried to insert a drip into her arms but couldn't find a vein.
A senior doctor told us Mum was close to death and they thought it best not to take her to intensive care and scare her by putting "lines in her neck" He said all of this in fornt of my mum who was terrified so she said she didn't want to go to intensive care.
11.3.12 Mum was moved into a side room. The doctor told us Mum would die in a day or 2. On the first day we tried to give mum sips of water but when she swallowed it wrong the nurse said we were best not giving her anything to drink and just to swab her mouth, we did try this but Mums mouth was still far too sore and putting gauze in her mouth was causing her pain. After 5 days of no food and drink, Mum was still alive but was in a great deal of pain. My sister and I queried the withdrawal of treatment and we were asked to speak to a pallative nurse. The pallative nurse informed us that mum was on a care pathway and this slow death was normal and could take up to 2 weeks . When I said I felt like we were murdering our Mum we were told "it wasn't your choice to make, the doctors make the decision" We were told that Mum would not be feeling hungry or thirsty as her body was preparing to die. We were given a leaflet about the Liverpool Care pathway.
Mum was in agonising pain for 10 days this was caused by the Liverpool Care Pathway. It got to the stage when we were unable to hug our mum, or comb her hair or hold her had . We were told by a nurse just to rest Mum's hand on ours - even this became too painful for Mum to bare. Mums body began swelling - we were not warned of this we had to remove her rings from her fingers as they were turning blue, this had not been picked up by nursing staff. Fluids were leaking through mums hands (we were not told about this either) after 10 grueling days Mum died. This was not a painless and peaceful and kind death this was torture for our Mum and for us. We had wrongly put all of our trust in the people who were meant to be doing what was best for Mum.
I have since looked at survival rates for people with no fluid or food intake and what I have seen states 8 - 14 days. The fact that Mum was almost 80 and lived 10 days without any food or water surely proves she was not dying and may still be here without the Liverpool care Pathway.
The treatment of my Mum was wrong it was abuse Emotional/psychological, physical, neglect/acts of omission.
This has made my sister and I suffer with haunting memories - we have since learnt of people surviving because families removed relatives from the Liverpool Care Pathway - we trusted doctors and nursing staff we wanted what was best for mum but we feel we helped the hospital murder her.
The Liverpool Care Pathway it is far far worse than any euthanasia , if an animal is ill and a vet diagnoses a terminal illness you are expected to do the kindest thing and have the animal put to sleep. You do not have the right to withdraw treatment and starve the animal to death - if you did this you would rightly be prosecuted.