Getting the Best Care in Hospital

Getting the best care in hospital and A&E

Here are the key things you can do to help ensure that you are getting the best care in hospital for your elderly parent or relative.  To make sure you know what is going on you need to be in touch with or at the hospital as often as possible.

1. Inform Staff

The nurse or doctor in charge of your relative’s care needs relevant information about their health and personal circumstances.  If they don’t ask, you need to tell them the following:

  • Contact details: make sure that the hospital has your contact details – mobile, home and work, and those of any other close relatives, in case they need to speak to you urgently. Ensure that you are down as next of kin, otherwise, you may not be given the full information either when you visit or call.
  • Prescribed medicines: if your relative is taking any prescribed medicines, be sure that medical staff know the details. If possible, take medications with you so that they know the prescribed dosage and frequency. GPs often provide patients with a card listing what medicines they have prescribed. Find out if your relative has one.
  • Pre-existing conditions: does your relative have any pre-existing medical conditions that may affect their care? Have they had any surgery previously? If they suffer from dementia you will need to give a lot of detailed information about their capacity to understand and make decisions.
  • Advance Decision and a Do Not Resuscitate (DNR): if your relative has signed a legal order regarding end of life medical care, inform staff now in case this becomes relevant.
  • Power of Attorney: if there is a power of attorney in place to deal with medical decisions (a Personal Welfare Lasting Power of Attorney), let staff know and provide the relevant paperwork.
  • Allergies: make sure that staff are aware of any allergies that your relative might have.
  • Dietary needs: inform staff if your relative has any special dietary requirements.

2. Identify a single point of contact

A large number of hospital staff could be involved in the treatment of your relatives, such as nurses, a family doctor, specialists or a surgeon. Ask the nurse who is the best person to speak to with any concerns or questions. This may be the doctor in charge of your relative’s care; ask for their phone number so that you can get in directly touch if you are unable to visit. Find out when the doctor makes hospital rounds and arrange to be there if possible to ask any questions.

3. Understand your parent’s treatment

This sounds obvious – and/or impossible, but you do need to have an idea of what is going on and why.  Each day the staff looking after your relative will work from a care and treatment plan. In this will be listed dietary restrictions, the tests scheduled, medications and other special orders from the doctor. If you are unsure about anything, ask a nurse to explain the plan of care and medications to you – take notes as necessary. Your relative – or you, if they are unable – may be asked to sign a consent form before certain treatments are carried out.

4. Understand the practicalities of hospital life

  • Visiting: find out when visiting times are, and how many people are allowed to visit. Check if these times are strictly enforced, or whether you can be there at other times too.
  • Personal care: find out what care is planned for your relative and if their needs are being met. If you will be visiting regularly, you should be able to help with personal care if you want to.
  • Eating and drinking: make sure staff know about any specific dietary requirements that your relative has and if they need help with eating and drinking.
  • Toileting: is your relative comfortable with toileting arrangements or do they need any additional help and support? Patients should not be asked to use a commode or left in soiled clothes because staff are too busy to attend to patients.

5. When things go wrong

The Care Quality Commission (CQC) sets national standards called ‘essential standards of care’, which all hospitals in England must meet (links to the equivalent organisations across the UK can be found below). Everyone in hospital has a right to expect:

  • to be treated with dignity and respect, to be involved and told what’s happening at every stage
  • care, treatment and support that meets their needs
  • to be safe
  • to be cared for by staff with the right skills to do their jobs properly
  • the hospital to routinely check the quality of its services.

If you feel that these standards are not being met, you should complain to the hospital staff in the first instance. If the problem is not resolved to your satisfaction, or it is a serious complaint, make an official complaint to the hospital. All hospitals have an official complaints procedure.

Scotland Healthcare Improvement Scotland
Northern Ireland Regulation and Quality Improvement Authority
Wales Health Inspectorate

Our blog has some more tips on helping hospital staff help your relative why I accompany my mother to the doctor. And if you have an experience you would like to share, or you would like to see what others are talking about, join the conversation in Age Space Forum.