District nurse 'put 90-year-old father on Liverpool Care Pathway in his own HOME without consulting his family'
- Thomas James died at home after he was given sedatives by the nurse
- She allegedly claimed that the drug was just to calm him, and reassured his family that it would not make him sleepy
By JOHN STEVENS
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A district nurse put an elderly man on the controversial Liverpool Care Pathway at his home without any consultation with his family, it was claimed last night.
Thomas James, 90, had cancer but insisted he was not ready to die until after his granddaughter's wedding.
But he passed away at home after he was given sedatives by the nurse who allegedly claimed that the drug was just to calm him, and reassured his family that it would not make him sleepy.
Debbie Croston from Braintree, Essex, with her father Thomas James, who died on the Liverpool Care Pathway at his home
The next day they were unable to wake him to give him food or drink and he fell into a diabetic coma.
His daughter demanded that he was taken off the drug, but he died ten days later, on October 8, from pneumonia.
Last night Mr James's family told how he was determined to go to the wedding and had picked out a red tie to match the bridesmaids' dresses just days before he died.
The former trombone maker and soldier in the Royal Engineers, who lived near Braintree in Essex, had stomach cancer and diabetes, but was still active and going to the shops on his mobility scooter in the week before he was put on the Pathway.
His family have made a formal complaint to their NHS Trust. They believe that he was put on the Pathway and given an end-of-life drug without proper informed consultation and that as a result his death was hastened.
Ironically, the family had chosen to have him treated at home as they believed doctors had tried to put him on the Pathway in hospital two years earlier after he had a leg amputated.
(File picture) Controversial: The LCP is intended to ease the final hours of patients who are close to death and to spare them the suffering associated with invasive treatment
The Liverpool Care Pathway, which can involve the sedation of patients and the withdrawal of foods and fluids, is designed to ease the suffering of dying patients in their final hours.
But the Mail has highlighted several cases where relatives have not been consulted about the use of the procedure or where patients have turned out not be terminally ill and have gone on to live for up to two years after being taken off the Pathway.
Mr Thomas's daughter Debbie Croston, 50, said: 'He had a reason to live as my daughter is getting married at Christmas and that was why all he wanted was to survive until December 29.
'It's all he mentioned. We went out and bought his tie just before he died. He felt rough but he said, “I'm going to be here whatever happens”. He was determined to be there for her and it was snatched away.'
Mr James was receiving care from district nurses at his home and was being treated with antibiotics for a chest infection.
'They need to start actually caring for people. Everybody makes out we're such a caring society, but we're not.'
Mrs Croston
During one visit a nurse asked to speak to him alone and got him to sign a DNR (do not resuscitate) form. She then suggested that she give him an extra drug.
Mrs Croston said: 'She said, “I've thought of something else that will make him more comfortable”. I told her that he's not uncomfortable, he's just sitting in the kitchen sleeping, he is 90. But she said, “No, I think I'm going to put this drug Midazolam in”.
'I asked what it was and she gave us a thing to read and we saw it was a sedative and told her we didn't want him to be more tired. But she said, “No, I can absolutely assure you it's not a sedative, all it's going to do is keep him calm at the dose we use”.
'Not once did they say to me about the Liverpool Care Pathway, that this was it.
'That night he had his dinner and ate some sausages and went to bed.
'Next morning I rang his carer to see how he was and she said that they were struggling to wake him up. He was almost gone, you could not wake him up, he was just slipping into a coma.'
Mrs Croston ordered the nurses to take him off the Midazolam and he roused so they could give him tablets and dextrose mixed with fromage frais.
But after nurses found out that the family were feeding him, they told them to stop and one wrote in his notes: 'Up against the wall with this family'. When the family refused to let nurses administer the drug again, they say one told them: 'To be honest, it's my decision, not yours'.
Mr James was no longer given any sedatives, but his family say it was too late. Mrs Croston said: 'He never recovered properly, his lungs filled up with fluid as he could no longer get out of bed and he died of pneumonia.'
Mrs Croston, who owns a hotels business with her husband, said: 'Midazolam is an end-of-life drug. Once people have it they don't come back from it, and they were so insistent on giving it.
'They just wanted to finish him off as he was a drain on resources, I suppose.
'I'm convinced he would have made the wedding. I'm not saying he would have been well afterwards, he could have gone the next week, but there's no way he was ready to go on that Friday when they put that stuff in his arm.'
Mr James's family had wanted him to be treated at home after they claim doctors tried to put him on the Liverpool Care Pathway two years earlier after he had his leg amputated when he was put on morphine and had his drip taken away.
Mrs Croston said: 'You think we're safe at home. We'd fought tooth and nail not for him to go to hospital because you don't know if he'd come out. Yet they got rid of him at home.
'People say he was incredibly old, and he was, but that does not give them the right to decide when their life is finished.
'Once their last breath has gone out of their body that's it, you can't bring them back. If I'd known it was a natural end, it was his time to go, it would have been easier to accept.
'They need to start actually caring for people. Everybody makes out we're such a caring society, but we're not.'
Jane Hentley, director of nursing at Central Essex Community Services, said: 'We would like to offer our condolences to the family at this sad time.
'Central Essex Community Services is taking this case very seriously and we are conducting a thorough investigation. We are unable to comment further.'
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