A place of safety

BMJ 2006; 333 doi: (Published 14 December 2006) Cite this as: BMJ 2006;333:1260
  1. Andrew Ludman, cardiology registrar, Queen Elizabeth Hospital, London ( (ludman{at},
  2. Sian Ludman, paediatric senior house officer, King's College Hospital, London

    Throughout our medical training, my wife and I have often bemoaned the confused elderly person who appears in the casualty department for no apparent medical reason in the middle of the night. A recent event has helped change our opinion.

    We were returning from a wedding late at night and came across a confused elderly woman wandering outside our house. She was wearing only a dressing gown and a small towel. We recognised her and knew she lived near by, and that the confusion was not new. Escorting her to her house, we discovered she was locked out and, despite our elementary burglary attempts, we could not gain entry. Furthermore, we could not coax her to tell us the contact details of her relatives so that we could get home to bed.

    Apart from being gently confused, she did not seem unwell, and, remembering the difficulty we have in discharging elderly patients, my wife and I were determined not to take the easy option and call an ambulance. What followed was a three hour saga in which we first sought help from the police (“Sorry all our cars are at emergencies; we will be with you shortly”). We then rang my hospital to gain the number for the on-call social services team. I left a message to be contacted urgently for help in obtaining a warm bed overnight until the woman's relatives could be contacted (I am still waiting for the call back).

    Eventually, the police arrived but were unable to offer an alternative to calling an ambulance; so, having exhausted our meagre possibilities, we acquiesced. That night, the casualty department was the only place of safety available while we clarified the situation.

    We still bump into our confused neighbour; she doesn't remember us, but seems to be managing to live independently. We try not to moan now about elderly people who just need a place of safety for a short while—even if that is a hospital.

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