Why I joined the FRAMES project
My background
My name is Jamil Abdulkader and I’m a lay researcher on the FRAMES project. I joined the project because I want to do everything I can to help prevent falls in older people in hospital, having seen the effects of falling for my mum.
My family are East African Asians, originally from Tanzania. Having moved here as a young man, I worked in the UK banking industry for many years, and my mum joined me and my wife in the 1980s after my father died. When mum came over, she was quite active.
She spoke a little English – enough to get by – and because me and my wife were then both working she would do all sorts of things for us. She would cook and if we went away, she would look after the house: everything. She liked reading and going to the local library, sewing and watching the TV. She loved late night snooker and the Australian soap opera ‘Neighbours’! Every afternoon we’d hear the theme tune coming from her room, regular as clockwork.
The beginning of a bad experience
As she got older, though, she started to slow down. She developed arthritis in her knees, and because she wasn’t moving as much her muscles got weak and she had problems with balance. She also became profoundly deaf – though she didn’t like her hearing aid and would take it out - and her eyesight was poor.
It was okay when she was in the house – we’d raise our voices so she could hear us, and she knew where everything was so she could get around. Her zimmer frame was right there, ready, so she had something to hold onto. But outside it was difficult. People thought she didn’t understand English but it wasn’t that; it was just that she couldn’t hear them. It’s a very lonely world, you know, if you can’t talk to people and can’t communicate what’s happening for you.
As time went by she developed kidney problems and also dementia. She had some falls in the house, but still it was okay because her room was carpeted, and she didn’t have far to fall. Then she was admitted to hospital with her kidneys. That was the beginning of her bad experience and it was bad for me and my wife too. We were worried all the time. Mum was always on my mind.
A difficult period
The hospital was such a confusing place for her: she didn’t know where anything was and she was moved to different beds so she couldn’t settle. Everyone around her was a stranger. She couldn’t hear properly and with her dementia she forgot a lot of English, so she couldn’t communicate with the staff.
As well as this, she was really private about personal things and didn’t like asking for help, such as help going to the toilet. My mum was a Muslim lady and she wanted to cover her head in front of strangers and needed her prayer books with her. She would edge herself across the bed to try and reach them from her bedside cabinet and lean right over.
Perhaps that’s how she fell the first time. We weren’t there at that moment so we’re not sure, but one evening we noticed a bruise on her ankle and when we asked the nurses about it they said she must have had a fall when she was getting out of bed. She was quite tiny and it would have been easy for her to slip down between the bed and the cabinet if she was reaching for her things, and it was a long way for her to fall. The nurses were very good and willing to help but they didn’t know how.
That period was bad. When we brought mum home afterwards, that was it. She’d been the Queen of our house, but after that she stopped getting out of bed. The fall hurt and she was frightened to put her foot down from the bed to the floor. Eventually she was readmitted to hospital, and she fell again, I don’t know how many times. It was very difficult and took a lot out of us all, we were like zombies.
Helping others
After mum died at the age of 83, my wife and I said we would do what we could to help others in the same situation. I don’t blame the hospital or the staff – they were so kind – but I think there are things that can be done to prevent experiences like my mum’s, especially by improving communication between staff, patients and their carers.
As soon as a patient is admitted, the communication should start and we should share as much information as possible. Hospitals are such strange environments for patients, especially older people who are ill and confused, and it would help a lot if things are done to make it less strange and more comforting such as not moving patients at risk of falling to different beds too much and making sure they are observed constantly if possible.
I’m not interested in blame, but I am interested in learning, and I hope this research project will help hospitals learn more to prevent falls in older people.