Before I begin my tale, I must amuse you all with a joke. A joke at my expense. Many of you know that I visit two hospitals to play piano, one in a hospital foyer and the other on an elderly and dementia ward. Except that, since Covid, the portable piano keyboard has been barred from the ward in order to minimise all risks of infection. But undaunted, I have relied on a Bluetooth speaker and playlists from my phone, using the Spotify Premium App to play patient requests. (I can choose what I like, when I like and no interrupting adverts.) Hence patients can request Chopin, Elvis, Birdsong, Church bells; you name it, I can play it!
And two years ago I was honoured to be voted Volunteer of the Year for bringing music to the wards.
In recent weeks they announced a new Volunteer of the Year. A dog named Bruno. Bruno has been coming in for quite a few years now, going up to bedside and wagging his tail and allowing patients to pat and stroke him. I heard some other guys who were shortlisted for the award were a little bit miffed on hearing they had missed out to a dog! Well actually, Bruno AND his owner were awarded jointly. It was then that someone looked back at my award and said it should have been given to the Bluetooth speaker! Boom boom.
There you go. Hope you had a chuckle. But this post is about assisted feeding at meal times. I visit many elderly and dementia patients and often see an untouched tray of food at mid-day. There is a shortage of nurses to assist in feeding. The Speech and Language therapists are designated with the training responsibilities BUT so far have had not time to give training to hospital volunteers. It’s a Catch 22 situation. Many volunteers are willing to be trained but no training is available. I shook the apple-cart recently by asking “how long do you have to be trained to put a spoon in someone’s mouth.” This, understandably, didn’t go down well with one of the ward sisters on a Steering Committee.
Anyway, I have just put forward a suggestion; divide the training into three levels a) to cover dodgy patients with swallowing or breathing problems, b) elderly patients who are unable physically to feed themselves and c) patients perfectly capable of feeding themselves BUT are disinclined or who need direct encouragement and persuasion.
This Monday, I talked a woman patient from Lebanon into trying to mix her food with the gravy and taste it, even though she said it was not her kind of food and that she had asked for chicken. It WAS chicken but she didn't recognise it! I told her I would happily eat it for her. This made her smile, and she began to mix the food around on her plate. The difficulty with my idea is that each patient would have to be identified as a, b, or c. And a corresponding sign above the bed. Any ideas readers? How about 3 spoons for “a”, two spoons for “b” and one spoon for “c”. Over to you.
On Monday last I witnessed a revolving tabletop when a nurse placed a patient’s dinner on the tray at bedside and the tray spun round to leave the dinner on the floor. I learnt that there is a lever to tighten the tray so that it won’t revolve. Had to laugh. The female patient was beyond noticing. Luckily the food was all in wraps so wasn’t wasted.
I have put my ideas to my manager and asked him if there was any mileage in it - the three levels of mealtime training, not the revolving dinner trays!
😂
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Greenthorn
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Interesting post as ever. I understand what you are saying re feeding patients but as someone who HAS trained people to feed others - I did this with people who were feeding children and young people who had multiple disabilities- I can say that what is common sense to one person isn’t to another! So yes on health and safety grounds people definitely require training in a hospital setting. Also I think people really should be trained in all 3 areas you have identified. I think it would be too complicated and too many opportunities for it to go horribly wrong to have different tiers of training and different identification of patients.
I think it’s a shame the speech therapists don’t have time to do the training and see it as a benefit for patients concerned. Really the senior speech therapist/manager would need to identify this as a urgent need and to allocate staff (or do it themselves) to do the training.
Bevvy, I really appreciate your full and comprehensive reply. Everything you say makes sense. I agree with you last sentence. I believe the voluntary services manager has pressed for this training and that is as far as we can take it. My post was a little bit tongue in cheek but that was my way of venting anger and stirring the pot. I do recognize the chain of command and I cannot escalate this outside my own department. You have brought a lot of common sense here and I am grateful for that. Thanks for taking the time out to reply.
Thank you for your response. You have no idea how much I appreciate your sentiments. I have spent much of the day being “told off” by someone on another group and told how horrible I am 😢. I suggested to said person she contacted medics for what could be an emergency situation rather than posting on site for opinions. She misunderstood my intentions totally. Your words couldn’t have come at a better time.
Bevvy, I would have replied much earlier in the day but had an appointment at 12:30 and have been out, away from my lap top till early evening. I am really glad my reply has given you that feel good factor. I'm on your side!
One of the first thing I was allowed to do, when a student on the wards, was to help people eat. Although Sister told me which beds I could help with. There used to be great spoons, where the bowl had been dipped in a sort of plastic. So over enthusiastic helpers were less likely to crack peoples teeth!! The worst thing that happens these days, is that the food tray is put where the patient cannot reach it, so it just congeals.
Thanks SH. In a nut shell, the NHS is short of qualified nurses. More and more volunteers are commandeered to do jobs which should be paid , e.g. Family Liaison Officers. Too much reliance is being put on volunteers. 😒
Yup, Yup and Yup again, part of it is the ratio of admin. to nurses is not biased towards the nurses. Second, as so many jobs (including mine) have gone from diploma to degree, we learn less of the basics on the wards.
I will tell you exactly why those ward sisters were not happy, because you simply pointed out that the job is not being done and they are just as responsible if not more responsible for the situation. If those patients don't die for the illness they were sent in with, they could easily die from malnutrition. Instead of being unhappy, they should take note that a third party has offered to help and instead of being miffed because of their inflated egos, take it up and see what can be done. I have experience firsthand with dementia. The deterioration is swift and brutal. I hope these patients have advocates (like you) or else it is a bleak situation indeed. It infuriates me. And I am not easily wound up. Thank you for what you do David. We need more people like you. xx
Thanks so much Cas. When I'm on the ward and see patients in bed not making any attempt to eat what is on the dinner plate then I and my colleague get really frustrated. Someone, somewhere is NOT pressing the button to accelerate the training we need. Yes the NHS is short of staff and yes, they are probably short of money. But they could recruit and train scores of Volunteers who would be willing to help. I will let you all know of any progress in this regard, Right now I am getting ready to go to Northampton to pick up Junior who will be with me in London for half term.
Excellent, intelligent and thoughtful post. Thank you so much. If I am ever in hospital please come and visit me. Fantasy of course, but I will magic you there. Xxxx
Congratulations on the work you do. Cheering up patients must be such a rewarding thing to do. Well done. Sorry you lost out to a dog 🐈lol 🤣xxSheila 🎹🎼🎵🎶💕⚘
Good morning, and well done. The efforts you make to help and cheer up patients in hospital are amazing, thank you for being such a caring person. Fortunately it’s many years since I was in hospital. However my mother age 111 was taken to hospital against her and my wishes following a fall, and was put in ward with other elderly on the Liverpool care plan, i.e. they were denied any medical care, food was put out of their reach and no help to eat it. No help with going to toilet and washing etc. My younger daughter went to ward all and every day stayed there helping lot of patients. She said staff didn’t appear to be busy. I couldn’t go as too much risk, was unwell at time and looking after husband following back operation. Tried to get mother discharged, but this was refused until she was too ill to recover then it was up to us to look after her in her own home.
The day she had fall, her GP had been to her house for annual check and do flu jab. She said mother’s heart, lungs, blood pressure all good, could go on indefinitely, mother replied that she had few years yet! She was only 4.5 tall, and sometimes fell getting back into bed, would press alarm button on wrist, I would get phone call and with my husband would go pick her up. The night she fell, he was recovering from op on his spine, so couldn’t help, and I had agreed that after ringing me they could call paramedics to help pick her up. Unfortunately they rang paramedics first and when I got there she was already in ambulance, saying she didn’t want or need to go hospital, but they refused to take her back into her house. I hope this attitude doesn’t persist, old people such as my mother who endured two world wars, left school at 13 and worked long hours polishing bullets etc deserved better care. Jean x
Grrrr stories like this make me SO angry. If someone has mental capacity then paramedics have no right to refuse to take someone back in to their home. My neighbour (96) was nearly returned to hospital by an officious paramedic who decided her home wasn’t safe. She had capacity and I had to really argue for her to stay at home, where she and her daughters wanted her to be. In end I said I would stay with her, knowing full well once he’d left she would ask me to leave. He was SO worried about that, hadn’t noticed he put her into wheelchair at hospital with no skirt on so showing all her undies.
Hi Greenthorn ,firstly thank you for the time you put into bringing so much pleasure to your patients , music is so important to dementia sufferers, apparently rhythm is the last thing they lose which is why even the most poorly will clap and tap their feet to music . It’s also a great tool for reminiscing as you will well know . As to the feeding, personally I feel things are made far more complicated than they actually are , although I do understand why in these days of blame and claim . In my years in a dementia care home the kitchen staff were responsible for providing each individual with the correct dietary requirements ie no dairy etc and they blended meals when necessary They referred to a list pinned on a notice board and I can’t see any reason why the same system wouldn’t work on a hospital ward 🤷🏻♀️ Not every patient would need to be on the list and if there were extremely vulnerable patients ie someone with swallowing issues then they should be clearly marked as “ nurse only to assist with meals “ on the list and at the bedside . At the very least , surely volunteers could be given a list of patients with no feeding issues especially at times when it’s a choice between a person eating or not eating ! Sadly it’s a fact that there are patients leaving hospitals suffering from malnutrition 🥲
This post has generated many interesting replies and you have suggested some great ideas. I think I will compile a list of the best replies and let my managers have sight of it. We did bump into a nurse assigned to Speech and Language (responsible for training) and she was very supportive to our concerns. I will speak about rhythm in a separate post! Lots of great stories there! Thanks so much for your kind comments.
😂Well done you and well done Bruno 🙂. 54 years ago (!) when I was an "auxiliary nurse" in a local care home for ex servicemen, one of my jobs was to help those who were unable to feed themselves. It was such a rewarding task, all that was needed was kindness and patience. No training was given - just did it from day one. Realise we live in a different world now but with some sort of chart (maybe a V meaning volunteers could do it) it should be possible.
The 'V' sign might be misconstrued haha, but I WILL offer this suggestion to my manager. Bevvy's first and comprehensive reply shows that this is a very difficult and sensitive area. We do live in a different world now. If it was just patience and kindness we'd be fine, but it aint. Its more to do with risk management.
What a great guy you are Greenthorn for cheering up the patients with your music and so glad you were given the award. All the money that is thrown at the nhs could be used to teach either staff or volunteers on feeding patients. When my Mum was in hospital the food was left on the side and when visiting they said she wasnt eating, I told them there were days that she couldnt pick up a fork as her arthritis was so bad, they said they didnt have time to feed her. I said I would do it but was told no visitors at meal times, you cant win. I took food in with me and fed her at visiting time x
That makes me so angry. I am categorized as a front line worker and can visit any ward I choose but for the main part I am allocated to two wards for the elderly and dementia. This post has generated really interesting but sorrowful replies. I think it has touched a nerve with many on this forum.
I was trying to think how we got our team assistants trained up at my last job, mostly we trained them up whilst they came with us to patients houses to learn. We had one assistant who wanted to learn more about how the Trusts Speech Therapist did her job and to learn how to be helpful and pick up problems early. Our Trusts Speech Therapist did not take time out to "train". What happened, was that she spent a few days working in the community and one day working on hospital wards with our assistant as a helper for the day. The assistants learnt through watching and discussing things between patients, no special "time" taken.
New volunteers are asked to shadow me for a week or more and usually in just one morning see all 50 shades of grey! I love giving tips, and having light banter with the patients. I only wish I could find more time to write up on my encounters. There are some stories in the pipeline!
Well done for trying to get something done about this inhumane situation. I hope you have made enough waves for it to reach the ears of the powers that be.
Alberta56, i have rocked the boat with my own managers and will persist in being a thorn in their side. I think Caspiana had said that the onus is on the Ward sisters to raise this to a higher level. At the moment it is Speech and Language saying they do not have the staff to do the training.
I think that is very admirable for you to volunteer to play for those in seniors facilities. My mother did the same until she was about 88 and broke her hip and could no longer go. She always enjoyed doing it and the residents also appreciated it.
Thanks Jackdup, I can imagine how much pleasure your mother had entertaining the residents and I'm sorry that a fall ended her visits. She must have had such wonderful memories. I too come away with a buzz after I finish a visiting session, and I try and write notes to remind me of treasured moments, some of which I post on to this site. I have a few stories in the pipeline!
she absolutely did enjoy giving of her time and entertaining and bringing joy through her music. She just passed away this Oct 3, 10 days shy of her 93rd birthday. She played the piano and organ in her church for more than 60 years.
Heartbreaking.Back in the day as a student nurse meal times were sacrosanct.A nurse sat(not stood between two patients shovelling food in Helter skelter) and took time and care to go at the patients pace chatting as she /he did so.
More than one doctor , phlebotomist ,physi was sent scurrying away from the bedside if they dared to interrupt.....
Thanks Cloudancer - I like the expression "to go at the patients pace." Very often that might be minus five miles an hour! We do get training in engaging with patients living with dementia. (We never say suffering with dementia, as so much can be done to give quality of life.) We often count to 8 to allow a patient to respond in conversation. Nothing is rushed and much is gained in "moments between moments." Even doctors now allow me to continue playing a tune to a patient. We all have first name tags and calling each other by first names enables each of us to feel part of a team . This is why the work of volunteers is so important. We DO have time to sit or stand, talking with a patient.
I have just remembered some brilliant musicians who came to play at the Day Hospital I worked at. They were a recorder orchestra, I think from the Dolmetsch company, who came to the UK in 1914. The sound from the large bass instruments was wonderful. Thanks for the reminder.
It saddens me that so much money is spent on administrators that there isn't enough to spend on ward assistants and dietetic assistants to help people like the patients you describe eat their meals. Food is a part of the patient's treatments, as much as a cast for a broken leg and medication to improve a condition. Food provided and not eaten is a waste of everyone's time, money and effort.
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