I think that before I continue with my posts re Anticipatory Care Planning, I should declare that I am not anti-GP/doctor, as it might appear at times that I am.
Care homes receive a bad press and according to the CQC, this is well deserved in an estimated twenty-five percent of all homes. This figure is of course shocking! I would urge any GP who has concerns re the care in care homes to first approach the manager and discuss their fears, and if they feel this has had no effect, to report concerns to the CQC.
The only way we can effect change is to speak out!
Possibly, because all care homes appear to be regarded as profit led hell-holes where the elderly are left to stew in their own body fluids, many GPs take a dim view of us and present with an antagonistic approach to staff.
I also believe that some GPs do not really understand the reality of living with dementia, and how it affects the sufferer and those around them. Twenty-fours hours is a big difference from a practice consultation or a home visit. Care homes have many residents, all with their own idiosyncratic presentations. I am sure at times that even in excellent homes - when conflict occurs between residents (which sometimes happens), visitors may perceive this as lack of care.
The only way to prevent this is to drug the residents up to the eye-balls or somehow restrain them in a chair!
My home is served by several GP practices. Most regard us with disdain and a few of these GPs are so skilled they can diagnose from a doorway! See a patient with 'management problems' - doorway diagnosis! The other GPs are excellent and we work together for the benefit of the resident. If we lack knowledge of a particular condition - we can ask for information without embarrassment, and they will kindly educate us.
The OOH GPs are to be commended for their approach to the the residents and their willingness to listen to staff. No complaints here, but this has not always been the case. This change may be due to the unfortunate incident re Dr. Ubani - but I do not know for certain.
Please GPs, realise that care homes do not have an in-house doctor; nor do we nurses profess to have a doctors knowledge base. We need your help, and more importantly, so do our residents.
It is sadly the case in some instances, that nurses are regarded as non-entities by some GPs. A doctor friend once said to me: "Anyone on a pedestal in medicine shouldn't be in medicine, and I think we need to get back to appreciating one another and enjoying our interaction with patients."
Nothing more need be said!