By A hospital should have raised the alarm about an elderly widow it sent home with a terminal cancer diagnosis just two days before she killed herself and her disabled son, an inquiry has found.
Shirley Nunn, 67, and her son Steven, 50, were found dead at home in Middlesbrough by a family member in October 2021, two years to the day after Ms Nunn’s husband Paul also died of cancer.
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Ms Nunn, who was a full time carer for Steven, had been diagnosed in July with stage three lung cancer before receiving a terminal diagnosis a month later, after the disease spread to her brain, spine and pelvis.
A Domestic Homicide Review found the tragedy could only have occurred because she felt there was no alternative for her son’s care after her death.
It noted that the ‘loving and caring’ Ms Nunn was more concerned about how her son would cope without her than her own health as matters deteriorated.
‘She was tearful on two occasions reflecting on her deteriorating health conditions,’ it recorded.
‘The panel feels that whilst she was in hospital opportunities were missed to consider her psychological and care needs or to share information concerning this with Adult Social Care.’
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Ms Nunn also killed her son Steven, 50, who she was a full-time carer for following a tragic childhood accident
Steven suffered a life-changing accident at just 11 years old which left him in a coma with a serious brain injury.
During his recovery he went through several operations which permanently affected his walking ability, and was also left with substantial learning difficulties in the aftermath of the incident.
As a result, Steven required full-time care due to balance issues and problems with emotional control, related to his diagnoses of Cerebral Palsy and epilepsy.
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In the years prior to their deaths, Ms Nunn had been his appointed carer with support from adult social care, which had been assisting in his care since 2005.
This continued even in the aftermath of her terminal cancer diagnosis, which saw her being sent home with arrangements made for palliative care – although she continued to attend hospital appointments until days prior to her death.
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The DHC found that Ms Nunn expressed suicidal thoughts on one occasion in September 2021, after her anti-depressant medication was temporarily stopped for medical reasons before being resumed.
In October, Ms Nunn attended hospital again for reasons related to her cancer diagnosis. Staff were informed that palliative care was being set up at home for her and that she ‘preferred to die at home’.
Two days after being discharged, police were called to her home by Ms Nunn’s sister, where she and Steven were found dead.
The DHC found that Ms Nunn expressed suicidal thoughts on one occasion in September 2021, after her anti-depressant medication was temporarily stopped for medical reasons before being resumed.
The multi-agency review has now found there were ‘missed opportunities’ to offer support to Ms Nunn which may have prevented the tragedy.
It found that she was showing ‘increasing signs of emotional instability’ in the weeks before her death.
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The report added: ‘During [Ms Nunn’s] time in hospital and receiving treatment there had been opportunities to consider [Ms Nunn’s] emotional needs and consider whether she remained physically and mentally able to continue as [Steven’s] carer.
‘The panel felt that this was an opportunity missed to empower and encourage [Ms Nunn] to make decisions regarding her son’s future.’
It recommended that adult social care staff should ‘be made aware to look beyond care needs and carer stress, and always apply professional curiosity and consider vulnerabilities such as domestic abuse and / or risk of suicide / homicide when there is a carer dependant relationship’ – especially in cases of a terminal diagnosis.
‘The severity of the cancer should have ensured attention was focused on [Ms Nunn’s] psychological and care situation at the earliest opportunity but urgency of this was not fully understood by professionals,’ it concluded.
‘More emphasis should have been placed on empowering [Ms Nunn] to have difficult conversations about how she was feeling and what support she felt needed to be in place for John.
‘Her mental health should have been focused on as much as her physical health.’
The authors also raised concerns that after Ms Nunn first shared worries about her son’s care after she died, the opportunity to discuss this was delayed by six weeks. They said the meeting should have been regarded as ‘urgent’.
But they concluded that there was ‘nothing to indicate’ Ms Nunn intended to take her own life, or that of her son.
The authors said: ‘This was a very difficult and distressing case and the panel recognise the impact this has had on family members and professionals who worked with both [Steven] and [Ms Nunn] throughout their lives.
‘[Ms Nunn] had cared for and loved her son throughout his life and without question had always prioritised his needs.
‘We can only assume she felt there was no other option or alternative for [Steven’s] ongoing care and support needs and took what must have been the very difficult decision which resulted in their deaths.’
Source: DAILY MAIL
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