Amputee upset hospital discharged him

Amputee upset hospital discharged him

SINGAPORE - He was warded at the National University Hospital (NUH) on May 28 last year for the amputation of four toes on his right leg and for cataract surgery.

Retired army officer Ervine Miranda, 59, ended up staying there for eight months.

When NUH discharged him on Jan 6, saying he was fit enough to return home, he was furious. NUH said he was a challenging patient to care for as he had verbally abused medical staff and thrown things at them.

Mr Miranda told The New Paper he had been in and out of hospital since a series of strokes from 2012.

In the latest case after his surgery, doctors said he could be discharged.

But he said he chose to remain hospitalised because he was an amputee.

He said: "Obviously, it is not convenient for me to move around, let alone take care of myself."

Finally, in January, he was deemed medically fit and discharged.

But the divorcé was livid.

Alone

He said: "I live alone and there is no one to help me about. How can the hospital discharge me without looking into who would be providing me care after that?"

Mr Miranda lives alone in a three-room HDB flat in Ghim Moh, after his wife divorced him and left with their two children.

When The New Paper visited him in late January, he was seated on a sofa with his only leg resting on the coffee table, surrounded by 17 bags, which contained his possessions brought back from the hospital.

"I was escorted out like a criminal by the nursing staff and a couple of security guards when they discharged me on Jan 6.

"They bundled me into a taxi with all these bags," he claimed.

"I haven't bathed since and I even have to pay a foreign worker $10 each time to help me change my diaper and clean my place," he told TNP.

For his meals, Mr Miranda also said he depended fully on volunteers to deliver food, "or otherwise I would go without for that day", he said.

But a check with residents and shopkeepers in the area found that Mr Miranda often went down to the food centre in his motorised wheelchair to buy food and cigarettes.

One neighbour, who declined to be named as she was afraid of reprisals from him, said: "He is not a friendly person.

"Often, he would chase people already in the lift out by shouting loudly, so he could go in."

It was tough taking care of Mr Ervine Miranda during his eight-month stay, said the National University Hospital (NUH).

It gave permission for its employees to speak to TNP.

Senior staff nurse Uma Paramatheva, 27, who took care of most of Mr Miranda's needs in the ward, said he had his good days and bad.

"He would be really sweet when he wanted something, but to the younger nurses, whom he thought he would be able to bully, he sometimes hurled vulgarities," she said.

Her colleagues said he often shouted, swore and threw his food tray on the floor when he was not given the meal of his choice.

"How could we when he decided to change his order very close to mealtime?" she said.

Assistant Director for Nursing, Ms Normalis Alwi, 49, said: "He would appear helpless when he was required by the occupational therapist to try to become independent, yet almost half the time when he was warded, he was not found on his bed.

"He would go down on his own to the foodcourt to have his meals."

Beer & cigarettes

Cans of beer and packs of cigarettes were sometimes found hidden under his hospital bed and Mr Miranda would make no apologies for them.

While Ms Normalis felt sorry as he was lonely and there was no family support, she and the other nurses agreed his behaviour was unacceptable.

Nurse clinician Karen Sun, 32, said: "If he thought he could bully you and get away with it, he would.

"To our foreign colleagues, he would sarcastically ask if they left their brains back in their home countries when they came to Singapore to work."

His tantrums and outbursts were so bad that one of the younger foreign nurses was traumatised and declined to be interviewed.

She would not even talk about the experience with her colleagues.

Despite these challenges, the nurses continued to do their best in managing his health and would visit him at home with the medical social worker to ensure that his health and social needs were taken care of, said the hospital spokesman.

She said the bed occupancy is high, averaging more than 90 per cent, with some days exceeding 100 per cent.

"From time to time, we receive requests from patients to stay on despite being fit enough for discharge. In cases where family members could not care for patients after they had been discharged, we provide training for the main caregiver," she said.

Last year, Health Minister Gan Kim Yong said four in 10 "long-stayers" at restructured hospitals are those ready to be discharged.

He didn't proceed with public assistance

Mr Ervine Miranda had applied for Public Assistance (PA) at the Social Service Office @ Woodlands. But when told he could not have a choice of wards and doctors whenever he is hospitalised, he did not proceed with the application, said its general manager Ang Chee Meng.

Mr Miranda had earlier accused the South West Community Development Council and the Social Service Office of not processing his PA application.

Mr Ang said the Social Service Office continued to help him under the ComCare Transitions Scheme (CCT), a help scheme by the Ministry of Social and Family Development for individuals and families in social and financial need.

Depending on a household's situation, CCT helps with rental, utilities and provides cash for basic needs, education and medical costs.

"Our officer has been in constant contact with Mr Miranda, his medical social worker, and the grassroots leader who has been helping him with his needs," Mr Ang said.


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