'My wife screamed for help all night but it never came'

Mary Arbuckle, 86, died after failing to receive appropriate treatment when she was admitted to Liberton Hospital with pneumonia.

Her husband Tom, 71, is convinced that a failure to cope with her dementia was the main reason for the flaws in her treatment.

The former US newspaper war correspondent, who lives in Newington, is angry about the "dreadful" treatment he says she received at the specialist care for the elderly hospital.

"It was absolutely dreadful in there, one doctor to deal with 36 patients, and not enough nurses," he said.

"My wife had vascular dementia but was in a ward with those who did not have dementia.

"But the hardest thing to swallow is that she screamed throughout the whole night, begging for help, and didn't receive that help. She died the next day.

"All night she cried out 'hurry, hurry, hurry' and 'come quick, help me'. A nurse told me about it the next day.

"I believe it was because of her dementia that she didn't receive the treatment she should have done. They would have just dismissed her.

"She was not the type to do that without good reason.

"There are good nurses there, but I felt there was also an attitude that she was going to die anyway, so why bother about her."

The Scottish Public Services Ombudsman has already ordered NHS Lothian to apologise over the care she received and made a series of recommendations for improvements at the hospital.

Mrs Arbuckle died in August 2008 after staff allowed her to refuse to take antibiotics for her pneumonia, even though she had been judged incapable of deciding on her own treatment.

She was also given the sedative haloperidol, instead of having her treatment reviewed, when her condition worsened and she became distressed. Her husband raised his concerns with medical staff the night before she died.

The ombudsman acknowledged that ensuring Mrs Arbuckle had taken the prescribed antibiotics was unlikely to have improved her chances of survival.

But her husband – who reported from war zones in south-east Asia for papers including the Washington Post and New York Times in the 1960s – is convinced that with the appropriate care she may have lived for a few months more.

"Her pneumonia was not bad, it should not have killed her," he said.

"They said she refused to take medication, but she was evaluated as having a mental cognition of 10 per cent, so she clearly was not able to take that decision. I was never told about this and it wasn't in her records."

The ombudsman ruled that doctors did not give her appropriate medication during her stay and gave the wrong course of antibiotics.

Mrs Arbuckle, who worked as a travel agent and was also a well-known corset maker for Blair's in Edinburgh, had been admitted to the Edinburgh Royal Infirmary on 18 August, 2008 suffering from pneumonia.

"She was then moved to Liberton and that should never have happened, she should have been kept at the Royal," said Mr Arbuckle.

"When I found this out I dashed straight there to try and stop it."

Mr Arbuckle said his subsequent complaint about how his wife's dementia had affected her treatment was not properly addressed at first.

"I don't feel like NHS Lothian took it seriously at all, and it is only because I've pressed them and know my wife's case and spent a lot of time at the hospital that I was able to challenge them and take it to the ombudsman.

"I like the NHS and think the ERI is a centre of excellence, a wonderful hospital, but the satellite hospitals in the Lothians are not up to scratch, and Liberton as a geriatric ward is not safe for confused, elderly people."

The widower said he had concerns about the hygiene and privacy in the ageing hospital building.

He said: "It's not very clean, although better than it was several years ago, but, for example, my wife was given mince and tatties for dinner one night and dropped a bit of it, which was still there on the floor the next day.

"The place is too crowded and the beds are too close together. Really my wife should have been in isolation."

Alzheimer Scotland joined the relatives of patients this week in criticising dementia care in hospitals across the Lothians and the rest of Scotland.

Libby Campbell, associate director of nursing, NHS Lothian, said: "Mrs Arbuckle was admitted into Liberton Hospital because she was acutely unwell. She did not come into hospital for long-term treatment of her dementia which would have meant admission to a dedicated ward.

"Mr Arbuckle's complaint has been investigated fully by the ombudsman and we have fully accepted the recommendations made. Comprehensive steps have also been taken to ensure a repeat of those circumstances should not happen again.

"In particular, we are also reinforcing with staff the importance of communicating with the relatives of patients, who have dementia, to involve them in care.

"NHS Lothian is working with the National Dementia Centre in Stirling to ensure all clinical staff are trained to provide the best care possible for patients with dementia, meaning that all wards have trained and experienced staff.

"NHS Lothian has also appointed a nurse consultant for dementia and work is being carried out across the board to further improve standards of care."

'WE ARE COMMITTED TO PROVIDING THE BEST STANDARDS OF CARE'

AS WELL as a huge response from Evening News readers, our report on the care of dementia patients in Lothian hospitals brought the following letter from Dr Paul Morrison, consultant psychiatrist at NHS Lothian and lead clinician for old age psychiatry in Edinburgh:

I write in response to your article of 13 April ("News uncovers families' heartbreaking tales of dementia patients 'left to rot' in Lothian hospital wards").

Far from leaving "patients to rot", the services provided by our multi-disciplinary care teams are tailored to the needs of individual patients to improve their health and quality of life.

We recognise that patients with dementia are among the most vulnerable in our care and we are committed to providing them with the best standards of care possible, working to nationally approved guidelines and standards.

We have developed and are implementing a dementia action plan, supported by the Dementia Services Development Centre and the Mental Health Collaborative, funded by the Scottish Government. NHS Lothian has also appointed a nurse consultant for dementia.

On admission, all patients have a 72-hour assessment, which includes a section for carers to give relevant information about the patient. Patients' care plans are updated on an ongoing basis, dependent on need, and are reviewed regularly.

Patients admitted to Ward One at the Royal Victoria Hospital are usually those who have the most severe and distressing symptoms of dementia. Some patients can be irritable and aggressive, either with staff or other patients. We try to minimise this aggression using our assessments to determine the best treatments and care for each individual.

Patients on Ward One have access to a wide range of services and activities, including occupational therapy and physiotherapy and activities such as the "music in hospitals" band and dance and movement therapy. There is a safe, accessible garden next to the ward and patients are supervised by staff at all times when in the garden.

To correct a statement in your article, I would like to reassure the public that patients have and sleep in their own individual beds. Appropriate levels of trained nursing staff are on duty and provide excellent care to our patients. Staff are given time to attend courses to maintain and improve their skills, which is a further demonstration of our commitment to providing high standards of care.

However, we recognise that there is always room for improvement in the service we provide, which is why we are constantly seeking ways to further improve standards of care. We acknowledge Mr Moss's concerns about his mother's care and we would encourage him to make a formal complaint to us so that we can carry out a full investigation and work with him to address these concerns.