Elderly patient begged for food

The family of a 91-year-old woman at the centre of a High Court battle to force doctors to put her on a drip were “quite aggressive” in their fight to get her treated, an inquest has heard.

The family of a 91-year-old woman at the centre of a High Court battle to force doctors to put her on a drip were “quite aggressive” in their fight to get her treated, an inquest has heard.

The relatives of Olive Nockels won a High Court order to make the Norfolk and Norwich University Hospital continue giving her fluids while she was being treated for a severe stroke and to stop administering the painkiller diamorphine without their consent.

The action was overturned the next day after consultant Dr David Maisey expressed his concerns over it to the judge.

The Norwich inquest, which was adjourned in July, heard the former school matron had developed oedema, a build-up of excess fluid in the body and was secreting fluid rather than absorbing it properly.

The hospital temporarily withheld saline and dextrose solutions because of this, and after nurses found it difficult to administer it via drips and a nasal tube.

Mrs Nockels, of Hales Court, Holt, died at the hospital on October 10, 2003, four days after her daughter Ivy West and grandson Christopher West won the court action.

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On Monday the inquest heard from Dr Brian Payne, a consultant who tried to assess Mrs Nockels' mental capacity on September 30, 2003, but found her to unresponsive to his questions.

He said he was unaware that the family had heard Mrs Nockels asking for “beetroot sandwiches, macaroni cheese and cups of tea”, and he did not think she was capable of sustained conversation.

“I felt I was looking at a 91-year-old who was exceptionally frail and with multiple disabilities and I thought she was dying,” he said.

“I thought it was entirely reasonable to work the family to an understanding of that position that anything further than that would be futile and burdensome.”

The inquest heard artificial feeding when the body is over-loaded with fluids can put increased pressure on the heart and can lead to other problems, including pneumonia.

Nurse Tracey Shaw said that by October 6, 2003, when the family won the High Court order, Mrs Nockels appeared to be in pain and would say “leave me alone” when they moved her in her bed.

“She was in increasing pain and distress during the final days of her life,” she said.

“This concerned and upset me and my nurses considerably - being unable to prescribe diamorphine compromised our duty of care to Mrs Nockels.”

Nurse Fiona Shaw said she was on the ward on October 2, 2003, when she noticed fluid was escaping from Mrs Nockels' torso, legs and arms, but in a meeting later that day Mrs West and her son were adamant they wanted artificial feeding to commence.

“They weren't listening to what Dr Maisey was saying and were quite aggressive in their manner,” she said.

She later added: “They did not seem to appreciate how poorly she was, as a team of nurses we understood how difficult they were finding the deterioration in their mother's health and we were trying to support them but I don't think we ever reached that understanding with them, unfortunately.”

Giving evidence, Mrs West said she thought her mother had “got a lot better” after her admission because she was talking and was alert, “but other people seemed to have different opinions”.

She said she did not give consent for her mother to have diamorphine when asked by the hospital because her mother was “not in pain when I saw her”.

“All I wanted was my mother to be looked after properly.”

Her son, Mr West, said he did not think anybody was “really interested in her recovery” and only that she “hadn't died yet”, but when asked if the hospital had done everything it could for her welfare and to keep them informed he said “I suppose they did, yes”.

The inquest is expected to end on Tuesday.