Catholic Medical Quarterly Volume 75(4) November 2025
Care of the Elderly.
Minutes of CMA ETHICS COMMITTEE MEETING, held at Allen Hall on Saturday 31st May 2025, 14 members attended, plus 3 on-line. Apologies from 6.
Canon John led
the meeting on this important topic, using Church Teaching, his
experiences during his mother’s recent illnesses and death and those of
others, as well as prompts from the current debate on “Assisted Dying”.
In this Jubilee Year of Hope, and on this feast of the Visitation, we Health Care Workers, should be particularly mindful of the compassion we should show to our elderly sick & frail Patients.
Pope Francis frequently alluded to the respect and care due to the sick and elderly (Laudato Si, Fratelli Tuti, Spe Non Confundit). At the Ascension, Jesus promised to be with us in our Church for ever, filling us with Hope. There would follow a Covenant between the Generations to give real help to each other, not “faux good wishes”, but genuine love and help. True Charity means having real compassion for Patients in their last days, not the promise of a quick “assisted” death. A lack of Hope leads to fear of death; true compassion means we suffer with others as we care for them.
The experiences of the elderly, maybe having an initial quite minor problem, like a fall or an infection, show that we don’t always get things right. In some cases, maybe only a few “percent”, (but that will be 1000’s) errors of diagnosis/management compound the initial problem, so that stays in Hospital are prolonged, and death may result. Quite often an elderly patient will arrive at A & E, and be left in a corridor for hours before being medically assessed. This is mainly due to lack of available Hospital beds, consequent upon other patients, ready for discharge, but needing Community Care, getting stuck in Hospital for lack of funding/staffing for that Care. The Patient waiting in the corridor is neglected and deteriorates. Once proper diagnosis and treatment is started, the problems of availability and sufficient Staff come to the fore. Coordinated Care never really has a chance, and even once on a Ward, there is often little coordination between the many teams involved.
While a single acute problem may be dealt with, the elderly Patient’s other, chronic, problems are often neglected. Such Patients may have multiple “background” diagnoses, which nowadays need the attention of different Specialist Teams; these often do not communicate well with each other. Real Care means Spiritual Care too, and this is often lacking in busy Hospital Ward situations. This can all be compounded by older Patients often being less demanding & downplaying their symptoms.
If the Patient survives these problems and is ready for discharge, then we see more trouble coordinating “aftercare”. Is there help ready at home? Are all the tablets etc. ready & understood? Is follow-up needed and a date fixed?
General discussion centered on the feeling that Staff were busy, often seemed distracted by “admin” tasks, had not got the time to communicate with Patients properly. “Defensive” medicine, meant more tests and protocols being applied, rather than individual care & attention. Carers with genuine compassion tried harder to satisfy all the Patients needs. Could Compassion be taught? Not really. Were people coming in to the Care Sector for the right reasons? Should we develop more Faith based Hospitals? Only one Catholic Hospital in the UK now, it was thought. Many Catholic Nursing Homes had gone.
Concerning the present debate on “Assisted Suicide”, people said the Liverpool Care Pathway had been “banned”, but was largely “back” in different forms. While our relief of suffering, including pain, may have the risk of shortening life, it is the primary intention of what we do that counts. We must therefore strive to relieve suffering & really care for our Patient’s general welfare. That is our moral duty.
We are grateful to Dr Steve Brennan for this report.