Re-Examining Dementia Care in the Acute General Hospital

By: Dr Philip Thomas, Senior House Officer,
New Cross Hospital, Wolverhampton.

Elizabeth Ward, Specialist Registrar,
The Department of Elderly Care,
New Cross Hospital, Wolverhampton.

Daryl Leung, Clinical Director for Care of the Elderly 
& Lead Clinician for Dementia,
New Cross Hospital, Wolverhampton.

Marking the fourth anniversary of the New Cross Hospital Dementia Project, the authors wrote an article summarising the main features of the Care Bundle developed for people with dementia at New Cross Hospital in Wolverhampton, and assessing progress and the wider overall impact so far. Starting in 2009, the project aimed to improve acute dementia care in the district general hospital, adopting a holistic and comprehensive design.

Key components in the range of interventions for improving care in the New Cross Hospital Dementia Project comprise:

  1. A specialist dementia acute medical ward (the Dementia and Physical Illness Ward).
  2. Developing a “care bundle” approach; including multiple components, including an “About me” document.
  3. Establishing a volunteer training scheme.
  4. Forming a Dementia Outreach Team.
  5. Running a dementia training programme.

Lead external advisory roles were filled by Professor Dawn Brooker at the University of Worcester, and Dr Roger Resar from the Institute for Healthcare Improvement (IHI) in America, giving specific advice about implementation and design of the Care Bundle.

Brief Case Studies

Six brief case studies are used to exemplify important approaches to care, which have featured:

  1. The reduction of avoidable patient distress.
  2. The identification of underlying causes (of agitation, disturbed behaviour etc.).
  3. Pain assessment and pain management.
  4. Preparation for the end of life.
  5. Checks / scrutiny of medication.
  6. Facilitation of eating and drinking.

Evaluation

The project’s effectiveness was evaluated independently by the University of Worcester. In June 2012 a thorough report was published, attempting to quantify the effectiveness of the Dementia and Physical Illness Ward and the impact of the newly developed interventions.

Full Text Link (a)

Reference

Thomas, P. Ward, E. and Leung, D. (2013). Dementia in the acute general hospital: time for change. The Journal of Dementia Care, September / October 2013, Vol.21(5), pp.20-22.

Full Text Link (b)

Reference

Upton, D. Krishnan, N. [and] Bray, J. [et al] (2012). Report for New Cross Hospital: an evaluation of quality and cost effectiveness of a newly defined suite of care interventions for patients with dementia and their carers in the acute hospital setting developed by The Royal Wolverhampton Hospitals NHS Trust. Report Phase 2. Volume 1. Worcester: University of Worcester; Institute of Health and Society; Association for Dementia Studies, June 2012.

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