The truth about bed blocking

It seems that many such patients are staying in hospital beds ‘unnecessarily’.

My problem is about this label – ‘unnecessarily.’ Whose necessity are we talking about? The hospital authorities, the professionals, the families or the patients? If an 18-year-old boy is admitted with an attack of asthma and then develops a chest infection and needs to stay a bit longer until fully fit no one labels him as a ‘bedblocker’ if however a 81-year-old is admitted with a fall and a chest infection and stays longer, he becomes a ‘bed-blocker.’

The true medical scenario is whilst the 18-year-old takes five days to recover fully, the 81-year-old takes 25 days. It is NOT a social issue at all, but a very well established medical fact.

I accept not all such convalescent patients need not stay in the so-called very acute and expensive facility but they still need treatment perhaps of a different kind – in which the Smart Alec doctors are no longer interested.

The professionals in general, want an immediate cure and a stimulating exciting environment, most of them want to 'cure’ their patients quickly and then move on to the next one. A fast express train approach — a rather slow movement, stopping at each station, tends to bore many of them.

Older people because of their general loss of adaptability tend to recover slowly but that does not mean they won’t recover.

And failure to achieve this means a longer term dependency and disability which is enormously expensive to everyone. It may not affect the hospital budget but it does affect the country as a whole in the long run. In old days most general hospitals used to have rehabilitation facilities, Day Hospitals etc for their recovering older patients. These no longer exist as such —- Day Hospitals providing an excellent ambulatory service have now been shut down without anything similar and specialist-led in its place. Lots of beds have been closed to save money and the support services in the community provided by the local authorities have also been reduced.

True, the acute health care budget has been protected but the community care has not without the understanding that these two work in tandem complimenting each other. There was a time when relatives and carers used to be offered some relief — for holidays once a year by statutory agencies, by admitting their frail dependent relations so that they can continue to support them all through the year and do not refuse to take them home. Sadly today's commercial health service, sometimes run by people without any medical insight or experience, behave differently.

Well the so called ‘blockage’ in hospitals is only a part of the whole picture of inadequate planning, thinking and technical and social knowledge. At the same time unless these issues are properly understood and tackled, this somewhat ‘incorrect’ and ‘inappropriate’ label of bed-blockers will continue

There is never any bed ‘blocking’, but attempted ‘early’ discharge prior to the patient becoming fully fit and a lack of appropriate support facility in the community. One needs to look at the scenario in a more comprehensive way and plan more carefully. Sadly many forget that our hospitals are not supermarkets.

Furthermore a sensible thoughtful and humane approach will ultimately save money plus add benefit to many older people. Tomorrow's older people will be totally different to those of yesterday's. More knowledgeable and independent seeking more support and supervision and advice rather than bricks and mortar institutional facilities. Our attempt should be to keep people as independent as possible for as long as possible. To ensure that people in later life remain more healthy and independent taking care of their own health for a longer period. Care of the frail elderly is complex and most of the health care personnel fail to grasp it properly often make careless decisions for short-term commercial gains but with far reaching consequences. We are, sadly, observing some of these now.

Arup Banerjee