‘Shameful’ HSE dead spouse letter

Clare Mental Health Services has apologised to a Sixmilebridge woman over its failure to deal properly with a complaint concerning her dissatisfaction with treatment of her husband, who was admitted as a voluntary patient to the Acute Psychiatric Unit of Ennis Hospital.

Delores Keogh, Castlecrine, Sixmilebridge, has also described her shock and upset at receiving a “shameful” HSE letter as part of the release of medical records under the FOI act, which incorrectly stated her husband, John, who was 59 when he was admitted for treatment, was dead.
Both related issues came to light this week following the release of a report by the Office of the Ombudsman, which stated a local manager couldn’t find any record to indicate whether the complaint made by Mrs Keogh was ever referred to a senior medic and acknowledged that, in all probability, it was not done.
Diagnosed with Parkinson’s disease in 2002, Mr Keogh was treated for suspected Lewy Body Dementia in 2008 and is still receiving treatment for dementia. Mrs Keogh currently receives six hours assistance per week from a carer, even though she insists John needs 24-hour care.
Mrs Keogh has requested the HSE to conduct an independent public inquiry into all aspects of her husband’s care, including his medication and treatment while he was patient in the Clare Mental Health Services over an eight-week period from February 2009 when he was admitted to Ennis Hospital. She believes this inquiry should include all psychiatric patients who were present at the time, covering all the treatments they received from medical staff.
The Mid-West HSE hadn’t responded to a number of Clare Champion queries at the time of going to press.
However, when questioned on Mr Keogh’s case back in April 2009, the HSE stated it was confident this patient “is receiving high-quality care delivered by clinical staff and expert in the management of this type of illness”.
“The cases dealt with by staff can be extremely difficult and often require 24 hour, one-to-one nursing, which is provided at the hospital.
“The Acute Psychiatric Unit in Ennis Hospital, which is managed by the Clare Mental Health Services, is an approved centre under the terms of the Mental Health Act and offers a quality of treatment and care that is informed by best practice. HSE staff responsible for the care of mental health patients are committed to providing caring, professional and competent care to these patients.”
The HSE letter, which caused great upset for Mrs Keogh, was sent on December 21 last and referenced “Mr John Keogh RIP”. It stated, “Please note these are the only medical records we hold on your deceased husband attending the Mid-Western Regional Hospital, Dooradoyle”.
Mrs Keogh was extremely upset to receive this letter and said it took her a number of days to get over it. Her husband was sitting in the next room when she was reading the letter. However, she said if he had been in hospital at the time it would have been even more upsetting, as she would have presumed he was dead, having received official notification of this.
In a recent letter to the Ombudsman, she noted no reference was made to the letter she received under the FOI act stating her husband had died.
“This caused me so much distress and following on from the treatment both me and my husband received, I could not believe that such an insensitive letter could be sent out to me. I am still upset each time I think of this shameful letter,” she stated.
Mrs Keogh has already received an apology from the Clare Mental Health Service for its failure to locate any records of a complaint lodged by her in respect of the treatment of her husband.
In a letter dated October 21, 2011, an official wrote, “I refer in particular to the management of your complaint in respect of the treating consultant psychiatrist by the then clinical director. As advised to the investigator in the office of the Ombudsman, I was unable to locate any records on this matter.
“I would like, on behalf of the service, to offer our sincere apology for the lack of a robust procedure demonstrated in this instance,” the letter stated.
Mrs Keogh said her complaint was sent and signed for by two local HSE managers as well as a local senior medic and was registered for the attention of two national HSE complaint officials.
The Ombudsman stated the fact this matter was not followed up is unsatisfactory from Mrs Keogh’s point of view and in this respect, the HSE management of her complaint was not as thorough as it might have been.
However, the Ombudsman pointed out, given the nature of the complaint, the time lapse and the fact that the senior medic at the time has now retired; it is unlikely anything conclusive would be achieved by pursuing this aspect of her complaint at this point.
He noted Mrs Keogh was informed by the HSE in a letter of April 14, 2009 that she had a right to remove her husband if she wished, although she was advised against this on medical grounds.
In her submission to the Ombudsman, Mrs Keogh claimed her husband was physically restrained about 75 times.
The Ombudsman noted the review of physical restraint concluded restraints have been used appropriately, while recommending any restraint should be ideally in a seated or standing position.
This review also noted not all staff involved had received the appropriate training in the use of restraint and went on to recommend this should be provided. The HSE confirmed recommendations have been followed up with staff in the unit.
Commenting on concerns from Mrs Keogh that nurses, rather than doctors, were prescribing medication for her husband, the investigator stated the HSE had clarified it was not the practice to have “nurse prescribing” and insisted “there is no question of holding stocks of medication for a particular patient or holding stocks of unused medication prescribed for a particular patient”.
The Ombudsman noted many instances in the records confirming Mrs Keogh’s dissatisfaction with the level of care and treatment received by her husband, as well as specific criticisms of the medical staff.
“I note the records show the care for your husband was discussed with the family from time to time and that you were referred to the medical staff when you raised concerns. I understand you were not satisfied with the level of discussion and you would have preferred to see a written plan. However, based on the record, I can’t see any evidence that you were denied reasonable access to information about your husband’s care.
“Based on written record, it appears reasonable efforts were made to enable you to meet with the appropriate staff to discuss your husband’s care.
“It is clear from the evidence of the records that you were concerned by your husband’s condition, you voiced those concerns repeatedly and that you lost faith in the service, especially in regard to your husband’s medication,” the Ombudsman stated.
Mrs Keogh confirmed she has written to the Ombudsman and expressed her disappointment with its conclusions. She stated if the treatment and care her husband received was in a general setting, the outcome of the report would have been different.
“If a person entered into a general ward with a broken arm and came out with two broken legs, it would cause outrage and concern.
She claimed in her letter that the condition of her husband deteriorated after he was admitted voluntarily into the acute psychiatric unit and made a number of claims about the appropriateness of the medication he received.
Expressing her dissatisfaction with “a mere apology for not having my complaint dealt with by the HSE” she asked that this aspect of her complaint be followed up and an inquiry held into the HSE’s inaction into their dealings with her husband.
Retired nurse Bridie Cox, who previously made claims about the care of elderly patients in the Clare Mental Health Services, has supported her call for a public inquiry.