'I still want answers' – Portknockie man's anguished plea over late mum's care
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A PORTKNOCKIE man is still seeking answers about his mother's care three years after she died of cancer.
Kathleen Runcie passed away on November 8, 2020 at the age of 91 in Seafield Hospital, Buckie from metastatic bowel cancer.
Having already been diagnosed with sundown dementia – which can cause hallucinations, distress and anxiety in sufferers – two years previously, Kathleen endured rapidly declining health from the start of 2020. This saw her son, Ian (65), having to make dozens of emergency calls to Ardach Health Centre, where she was a patient.
The as yet undetected cancer eventually meant Kathleen had difficulty in keeping food, even water down, vomiting them back up. This sat alongside her worsening dementia.
The cancer was eventually diagnosed when she was admitted to Dr Gray's Hospital on September 3, 2020 and from there she was transferred to Seafield Hospital for the last seven or eight weeks of her life.
Following his mum's death Ian, who gave up work in August 2019 to become her full-time carer, felt that there had been "alarming failures" in her care which ultimately lead to her enduring unnecessary indignity and suffering. Among the many aspects of concern were a lack of follow-up on a cancelled ultrasound scan (US) to help determine if she had cancer and ensuring she was on the most appropriate care pathway.
He went on to claim that concerns were flagged up regarding the perceived lack of investigation into what turned out to be cancer in a letter from a carer to Ardach and also in an email from an NHS24 doctor.
On receipt of Ian's complaints, the health centre undertook a Significant Event Analysis (SEA) to examine the care provided to Kathleen, which saw an admission that certain aspects could have been done better.
In his reply to Ian's complaints, Dr Duncan Green from Ardach wrote: "On reading your mother's file and discussing with colleagues and the length of time you had to seek our help repeatedly appropriately. I realise this must have been disheartening for you seeing your mother go through all of this and in all this time the US had been cancelled and had not been reappointed.
"None of us thought to check up on the status of the request. For that I must apologise on behalf of the practice for the omission of care.
"...However, the overall purpose of the US was to help ensure your mother was on the correct pathway of presumed palliative care, and in reflection I can see that she remained on the frail elderly/early dementia pathway and regret that she had not been put on the palliative care pathway sooner."
Patients on the palliative care pathway are placed on a register and assigned a lead and buddy GP, with the practice care team reviewing their case monthly.
Unhappy with the response, Ian took the matter to the Scottish Public Services Ombudsman (SPSO), again highlighting his concerns as to what he felt was the unnecessary suffering and undignified end to his mum's life.
However, this avenue was to prove a dead end for him, with the SPSO ruling that Ardach's actions had been "reasonable in the circumstances". A further request for a review of this decision was declined last June, thereby closing the last official route of redress.
The verdict has left Ian frustrated and "bitterly disappointed", still seeking answers while battling the personal aftermath of his mum's illness and death.
Looking back on caring for his increasing ill and frail mum, he said: "It was 24 hour, seven days a week care.
“I had very, very little help with care. I was promised care when mum left hospital but it never materialised and I had to go to SDS [Self Directed Support]. In the end I had to give up work myself to look after her because dementia had set in and, obviously unbeknownst to me, the cancer was beginning to spread.
"The vomiting she suffered – faecal vomiting [where the patient vomits faecal matter] was very, very bad, it was just 24/7. Even a drink of water, maybe two seconds it was back up. Eating became quite a struggle and I the end it was just a case of feeding her soup.
"Before she moved to Dr Gray's, the days before that – I think it was about 15 or 19 days – was just continual vomiting.
"Every day was a challenge, changing beds, putting towels under her chin to maybe try and save some of the vomit going onto her bedclothes. It was a losing battle, because she'd try to get up, didn't have the strength and keel over onto one side and start vomiting again onto the bed, the blankets or the floor.
"As the cancer began taking hold she was going more to her bed but with the dementia, although when she was in her bed she wouldn't sleep. At one point there was a three-day spell she never slept"
The stress of caring full-time for Kathleen allied with the quest for answers about her treatment have taken a big toll on Ian's health, one which continues to exact a price to this day.
He continued: "I haven't kept the best of health since, the stress has really brought me down.
"There's days you feel good but there's days you feel awful.
"With the dementia she was seeing things. She'd say 'Why are these people speaking about me on the TV?' and then she would start crying. It didn't matter how much you sat with her and held her hand, it never made any difference; it was just horrible, horrible, horrible.
"I'm not getting answers and it's had a fair affect on me, I'm not getting closure. It preys on my mind, it's a constant burden, it's just too much."
Turning his thoughts to others who may be fighting a similar battle, he added: "My advice to start with is you've got to get the truth.
"That's the most important thing in the world, to get the truth.
"To me, data protection doesn't work. I've been trying to find out who the SPSO spoke to at Ardach as part of their investigations but all they say is that because of data protection I can't be told.
"I certainly don't want anyone else to go through it, all the suffering, it's heartbreaking.
"I know what it's like to be left in the lurch without care and the last thing I want is for anyone else to be in the same position. Don't take care onto your own shoulders unless you're absolutely sure you know what it entails and that you're in a position to cope with all the demands that will ensue."
