[This abstract first appeared in: Dementia Newsletter RWHT Volume 1 Issue 6 January 2011].
Many of the guiding principles at the heart of the New Cross Hospital Dementia Project may be found in this article on the challenges posed by patients with dementia in acute hospitals.
Acute sector care for dementia patients is a high priority, requiring a comprehensive and holistic solution.
The duration of hospital stay for all physical illnesses tends to be prolonged by dementia. Dementia complicates the treatment of physical illnesses and increases the probability of morbidity and mortality. Poor and / or uncoordinated hospital care contributes to increased nursing home admissions.
These issues and many related problems tend to be confirmed by the recent audit of Dementia Care in General Hospitals performed by the Royal College of Psychiatrists released on December 16th 2010 (refer to Page 3 of this newsletter).
Specific recommendations proposed in this article include:
- Enhanced communication with patients and carers.
- Greater attention to hydration and nutrition.
- Improved hospital design with dementia-friendly environments within the hospital.
- Better training for all staff and Departments about the nature of physical illness complicated by dementia.
A comprehensive package of education and training for all acute staff caring for dementia patients should include the management of confused-aggressive patients, training in person-centred care, dementia care mapping and the use of personal photographs, picture albums and life histories.
There is a need for increased dementia awareness and proper assessment of patients presenting to all departments.
There should be liaison with psychogeriatric teams, and an active role for one or more dementia coordinators.
The entire patient pathway needs to be considered, involving close liaison with Primary Care, General Practitioners and Social Services, thereby permitting appropriate follow-up arrangements within the community.
These and many other aspects of caring for patients with dementia in the acute sector are touched upon.
These considerations are being actively integrated into the New Cross Hospital Dementia Project. Future issues of this Newsletter will provide regular updates on progress.
Leung, D. [and] Todd, J. (2010). Dementia care in the acute district general hospital. Clinical Medicine, Vol.10(3), pp. 220-222.
- Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006;367:1747-57.
- Alzheimer’s Society. Dementia UK: a report from the Alzheimer’s Society on the prevalence and economic cost of dementia in the UK. London: Alzheimer’s Society, 2007.
- Royal College of Psychiatrists. Who cares wins. London: Royal College of Psychiatrists, 2005.
- Department of Health. Living well with dementia: a national dementia strategy. London: DH, 2009.
- McClean W, Cunningham C. Pain in older people and people with dementia. Stirling: Dementia Services Development Centre, 2007.
- Age Concern. Hungry to be heard; the scandal of malnourished older people in hospital. London: Age Concern, 2006.
- NHS Scotland. Living and dying well: a national action plan for palliative and end-of-life care in Scotland. Edinburgh: Scottish Government, 2008.
- Royal College of Physicians. The prevention, diagnosis and management of delirium in older people. London: RCP, 2006.
- Dementia Services Development Centre. Education and training, consultancy and research to improve care for people with dementia. Stirling: Dementia Services Development Centre, 2008.
- Bellchambers H, Penning C. Person-centered approach to care (PCA): a philosophy of care and management for carers. Contemporary Nurse 2007;26:196-197.
- Booker D. Dementia care mapping: a review of the research literature. Gerontologist 2005;45:11-18.
- Nichols JN. Heller KS.Windows to the heart: creating an acute care dementia unit. J Pall Med 2002;5:181-92.
- Fleming R, Forbes I, Bennett K. Adapting the ward for people with dementia. New South Wales: Hammond Care Group Australia, 2003.
- Department of Health. Mental Capacity Act 2005 training materials.
- Parker SG, Fadayevatan R, Lee SD, Acute hospital care for frail older people. Age Ageing 2006;35:551-2.
- Greening L, Greaves I, Graves N, Jolley D. Positive thinking on dementia in primary care: Gnosall Memory Clinic. Community Practitioner 2009;82;20-3.
- All Party Parliamentary Group on Dementia. Prepared to care. Challenging the dementia skills gap. London: APPG, 2009.