The story in the link below is a sad reminder of the responsibility we have, as healthcare professionals, to always provide our services with respect for the patient and to convey hope for comfort, if recovery is unlikely, and never to imply that age or frailty equates to “no care”. https://www.bbc.com/news/uk-england-devon-48798285

This former Professor sustained a fractured hip and during recovery developed a pressure ulcer. He died at some point later from multiple systems failure. His wife and family raised issues of inadequate staffing, lack of respect, ageism, and “listing frailty as the reason for death”, equating frailty with “lack of care.”

From decades of research and evidence-based medicine, without knowing much about this patient, it is fair to assume that after his fall and hospitalization he had a degree of frailty and increased vulnerability to adverse outcomes, including skin breakdown. Families do not realize this often and unless healthcare professionals communicate this, along with a proactive plan of care to prevent the outcome, when it occurs they are surprised and need someone to blame for this unexpected outcome.

The care might not have been appropriate and the other family observations true also. However, their final perceptions of frailty and old age framing a less than adequate plan of care is tragic. Frailty, when understood and communicated as a framework for determining the best plan of care, aligned with patient and family wishes, should support the best of care and although the outcome might remain unchanged the patient will have received appropriate and desired care and any negative outcomes would not come as a surprise.

Losing a husband and parent is very hard and made harder when unexpected and when there is a lingering thought that perhaps it could have been prevented.