Discharged in nightwear

Stephanie Chadwick 27/09/17 Dignity Champions forum

I was very shocked today, to see a Frail 94year old lady, sent home after three weeks in hospital, in an ambulance in her nightwear. I appreciate that staff are incredibly busy, but surely someone could have helped her to dress as they knew she was being discharged.(she had clothes with her) . Is it me, have I got this wrong? I was horrified.

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mike stone 28/09/17

The one that usually 'raises a storm' is the discharge of a frail elderly person during the night, with no 'home support' waiting [and, sometimes, no transport home, or obvious way of getting home - which is horrifying!].

As for the question you have asked - we probably need more details, to decide if it 'was wrong'. I suppose we need to know what was expected to happen when the lady arrived home - was it expected that she would be going to bed? If so, it would make some sense I think.

Stephanie Chadwick 28/09/17

It had been arranged for home care to be there to carry out her 'tea' call so she wasn't discharged to an empty house, but it was mid afternoon. She had no coat or cardigan on. She could have declined to get dressed I suppose.

Karen Littleford 28/09/17

Hi Stephanie, it is best probably to start with the lady herself. What were her thoughts at point of discharge? Did she want to go home in her nightwear? Did someone have a conversation with her about this? It is autumn now, if she was not involved in the decision because no one asked or someone made a best interest decision having assessed that she lacked the capacity to make a decision about what she wore at that time was she warm enough, what were the conditions at discharge.

Does she want to send some feedback to the hospital about this from a patients perspective? If not your organisation may feel the need to remind the hospital that in terms of dignity and patient care ensuring the person is protected and warm may be important especially as we are coming up to winter.

mike stone 30/09/17

This one does invite all sorts of 'deeper analysis', as Karen pointed out. Did 'nightwear' include a 'substantial' dressing gown? If the lady was mentally capable, it is pretty-much her decision about whether or not to change into day-clothes: but is she wasn't capacitous, keeping her sufficiently warm is definitely a major best-interests factor (and unless things have changed, hospitals tend to be very warm - especially wards for the elderly: so the difference between inside and outside in terms of temperature, can be 'pretty sharp').

I am pleased that home care were calling in on the lady [does this imply that she lives alone?] and I hope that visit was quite soon after she arrived home, and for long enough to check that she had settled-in okay (neither of which, would I be willing 'to take for granted' - sadly!). Presumably, it had been checked/arranged that she had enough food, etc, at her home?

Neil Purcell 02/10/17

Thought hospital discharge team would have been on this situation usually a 6 week home care team would have been put in place .
This though is not the first time I've come across this surely common sense has to prevail,I wonder if those concerned would like themselves or family members to be treated in this manner I think not .