Two years ago in early December, my 80 year old dad, who by the way believes he is not yet 80 and flies around the place like a much younger version of himself, fell ill.
He has a chronic respiratory condition (he worked in a coal mine in his younger days and of course smoked), which he has not really come to terms with but he is fit, he walks up hill and down dale faster than I am able, and spends his days either fixing the house up, building walls or gardening. My dad is not one for sitting around and contemplating his demise.
But he became slower, less perky, and gradually he was so ill he ended up in accident and emergency on Christmas Day. This was not his doing. I called the ambulance much to his annoyance but when they arrived, it was obvious from his vital signs that my dad was not in a good way. I accompanied him and observed every stage of the next few hours.
My dad was diagnosed with probable pneumonia and placed on oxygen. Bloods were taken and the hospital PJs adorned. Intravenous antibiotics and fluids were started and analgesia administered. All good. My dad perked up in a few days and eventually he was discharged.
On discharge, I asked about two things, prevention of future episodes of pneumonia in the form of relevant vaccinations and the results of the blood test. I.e. Was the infection picked up and if so was it a bacterial infection? If so, what antibiotics was the infection sensitive to and more importantly what antibiotics was this nasty infection resistant to? The Dr needed a little more information from me. It went something like this;
Didn't my dad have the seasonal flu vaccine?
Yes.
So what else does he need?
Pneumococcal vaccine? He is a little bit over the age of 65!
Oh, hasn't he had this already?
I don't know, is it in his notes? Have you checked with his GP? Couldn't you just give him one whilst he's here?
Mmmmmm.
Right, so I'll check with his GP. Which I did. Nothing on the computer so I arranged for him to have it once discharged.
Second point;
Do you have the lab report?
Yes we do.
Does it tell you what antibiotics to give?
Yes it does.
Is my dad on the right ones?
Mmmmmmm, no.
So we changed the antibiotics to right ones and he went home.
We discussed this with our GP and a plan of action was agreed with my dad. I was identified as his advocate and all was well.
We made contact with the Chief Nurse of our local hospital and when my dad felt better, he was invited in to talk to a cohort of student nurses about his experience. This was filmed and it is a very powerful hour and a half which we hope will be shared with cohorts of students for years to come. It's called Patient Activation!
If we are going to live well for longer and with the prospect of multiple long term conditions, we as citizens will need to become much more activated. If we aren't able, our carers and families are going to need to do that. Asking questions of health and care professionals and being aware of what is required in terms of primary, secondary and tertiary prevention will need to be known. But in order for this to be effective, we have some work to do!
My dad have permission for this to be written!
Joanne Bosanquet, Deputy Chief Nurse, Public Health England
