"Was the advice regarding my grandmother ignored prior to her discharge from Royal North Shore Hospital."

I recently witnessed my grandmother be forcibly restrained and dragged kicking and screaming into an ambulance. It was distressing for me and it seemed, extremely distressing for her. How she came to be in this situation is a story that I can only believe is one, of woeful incompetence or wilful arrogance.

My grandmother was admitted to Royal North Shore suffering from seizures brought about by hypernatraemia. Having suffered this brain injury she was incoherent and exhibiting markedly different behaviours than she ever had previously. Prior to her admission she was cognitively very highly functioning.

Over the time my grandmother was in hospital the family (one of whom is a neuropsychologist) observed that she was frequently confabulating, had memory problems and changes in personality. We brought this to the attention of staff attending my grandmother and requested on numerous occasions that she be given a thorough cognitive assessment.

As a hospital, I believe one of their roles is to assess patients and provide appropriate care, it completely confounds me that someone with a brain injury can spend 16 days and apparently, not be seen by even one mental health specialist. How on earth can proper care be provided if no one bothers to assess the patient?

I have no mental health training but when someone is talking about non-existent flies and conversing with the Queen, it would seem fairly obvious that they may require some form of intervention from a mental health professional.

My grandmother had a fierce determination to go home to her independent living apartment. She would do her best to convince people she was capable of this. That a highly confused elderly person, seemed to managed to outwit a highly trained doctor is however of concern.

As well as being mentally incapable of looking after herself in an independent environment, my grandmother was physically incapable. Following a relatively recent motor vehicle accident she was in a neck brace. While in recovery at Greenwich Hospital she had also fallen and fractured her leg. Being incontinent she would have to travel to and from the bathroom several times a night, which was obviously not safe when there was apparently, no one to monitor her.

Such was my grandmother’s lack of reasoning abilities, that when told she would be going home from the hospital she refused all forms of in-home nursing and assistance services that were offered to her. Both the social worker and occupational therapist who assessed my grandmother seemingly concluded that my grandmother would not be able to look after herself in an independent living situation.

Somehow the doctor who assessed my grandmother, I believe, totally ignored this advice, leading my grandmother to be discharged. To me this action shows frightening contempt for the hospital’s duty of care.

The very next day after discharge the inevitable happened. My grandmother left her apartment, leaving the door wide open behind her and was found wandering nearby in an extreme state of agitation and confusion, clearly, I believe, in need of professional care.

I would like to know how this can happen.

I would appreciate it if the hospital could review this case and providing answers to the following questions.

1. Why was someone with a brain injury apparently never properly assessed or seen by any mental health professional?

2. Why was the advice of the family seemingly completely ignored?

3. How was my grandmother, apparently, found to be competent enough to make her own decisions relating to her care?

4. How was it possible that she was discharged to an independent living environment seemingly against the advice of a social worker and occupational therapist?

5. What steps are you taking to make sure a similar situation does not occur again?