A 91-YEAR-OLD who was in charge of taking her own medication while living at a nursing home in Amesbury may have taken an overdose, an inquest has heard.

Joy Spaght was found unconscious in her room at Amesbury Abbey on 29 December 2013 and although rushed to hospital by emergency services, she died two days later on New Year's Eve.

Salisbury Coroner's Court heard on Tuesday that when Mrs Spaght had moved from London to the nursing home in 2011, she had wanted to maintain independence over some of her medication rather than being given each dosage by nurses. In discussions with doctors, it was agreed that Mrs Spaght was capable of administering her own prescription drugs and they were kept in a locked cabinet in her room.

However, the court heard that contrary to the nursing home's guidelines, Mrs Spaght's self-medication was not formally reviewed as often as it should have been with only one review involving relevant parties signing papers having taken place since the initial assessment.

The last formal review to have taken place was 18 months before she died and the matron at the time, Deborah Lee, told the court "frequent" absences and shortages of nurses at the home had affected her management duties.

She said the home undertook monthly reviews of care plans for each resident where concerns could be raised and that while Mrs Spaght was self-administering much of her own drugs, she had "a lot of contact" with nurses who administered the rest.

Doctors who regularly saw Mrs Spaght told the court that while they were not aware she continued to self-administer her own medication, they had no concerns of her doing so and that it was normal for patients who self-medicated to be given a month's supply at a time.

Dr Neil Meardon, a GP at Amesbury’s Barcroft Medical Practice, who saw Mrs Spaght regularly during visits to the home, said it was the safest thing for her to be in charge of her medication due to receiving private prescriptions from her psychiatrist that changed in both dosages and drugs.

Dr Philip Milln, a consultant psychiatrist at New Hall Hospital in Salisbury, told the inquest he had seen Mrs Spaght on 29 occasions during the two years she was his patient. He described her as a "fastidious woman" who was "extremely careful" with her medication.

He told the court she suffered from generalised anxiety disorder which had led to secondary depression and that a "long episode" of depression had been sparked by the news a newly-fitted pacemaker was no longer going to help her with her palpitations.

The court heard that Mrs Spaght found the Christmas period "quite difficult" and a suicide note had been found in her room.

A post-mortem showed she had bronchial pneumonia and also had high levels of the anti-depressant Dosulepin in her blood.

But Dr Milln told the coroner he was unable to understand the post-morten recordings of Dosulepin saying such a high dosage would have killed Mrs Spaght immediately rather than 57 hours later.

Adjourning the inquest to March 24 Wiltshire and Swindon assistant coroner Claire Balysz said to Mrs Spaght's daughter Amanda Turner: "This has quite understandably been an upsetting process for you to go through.

"Although this isn't a court of blame, the atmosphere has been, at times, certainly confrontational and I am sorry you have had to go through this.

"I am going to adjourn again today so I can have enough time to go through the evidence and come back with a conclusion."