Dementia care: Hospitals 'must make improvements'

Woman talking to dementia patient A quarter of hospital beds are occupied by people over the age of 65 with dementia

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Hospitals in England and Wales are falling short in the care given to dementia patients, a review says.

The Royal College of Psychiatrists' audit of 210 hospitals - the first of its kind - says while services are safe, they are lacking in other areas.

The report highlights issues such as poor communication with families and a lack of personal care for patients.

Health minister Paul Burstow said the government was determined to improve standards of care.

Patients with the condition tend to fare worse than other patients when they enter hospital.

But the report says far too little is being done to get them access to specialist services, or to prepare for their discharge from hospital by liaising with community services.

It also criticises the basic planning arrangements in place for what are a vulnerable group of patients.

Basic help with activities such as eating is also insufficient in some places, the report says.

'Shocking'

Staff told the reviewers that they felt they lacked the skills to deal with dementia patients, with fewer than a third saying they had had sufficient training.

But the failings are also related to a lack of quite simple but effective measures, such as placing family photographs or cards where the patient can see them, or displaying larger signs.

Case study

Linda's mother, Evelyn, who had dementia, spent the final months of her life in and out of hospital. It proved to be a difficult period.

Every time she was readmitted, her condition and communication difficulties had to be explained. What is more, Linda felt her mother had very little interaction with staff throughout the day and no assistance with eating and drinking.

Linda says: "Mum's dementia made it virtually impossible for her to realise what was happening, where she was and why she was there.

"Hospitalisation is a distressing time for most people, let alone those with dementia, and the added confusion, agitation and upset for those who cannot articulate their thoughts increases this distress ten-fold.

"It's vital there's an increase in training and knowledge to enable hospital staff to understand the huge complexity of dementia."

Fewer than half of the hospitals had a process in place for sharing information with families.

However, the report acknowledges that many hospitals have started improving their practices in light of the interim findings, which have already been passed on to them.

Professor Peter Crome, who led the review, said he hoped this would lead to improvements in the coming years.

But he added: "This report provides further concrete evidence that the care of patients with dementia is in need of a radical shake-up."

Andrew Chidgey, head of policy at the Alzheimer's Society, told BBC Radio 4's Today programme: "Unless we see a radical change in the way this is happening at the moment, we are going to see not just more people with dementia not getting the care they need, but a health service which is under incredible pressure because of the financial situation.

"What is important to note here is people are not going into hospital for treatment of dementia, they are going in for other things but when they get there they often stay far longer than other patients with the same condition, and many callers to our helpline are saying people are coming out of hospital worse than when they went in.

"Unless we get this new system in place and help people before their needs get worse, we are going to see more people in hospital or care homes far too early."

Peter Carter, general secretary of the Royal College of Nursing, said most hospitals were doing a good job in dementia care, but that some were "not up to the mark".

He said staffing levels and training needed to be addressed.

Care Services Minister Paul Burstow: "Lack of NHS training on dementia is not due to staff cut pressures"

Care Services Minister Paul Burstow said the government was determined to improve standards, and from next year would be introducing a financial incentive to encourage hospitals in England to screen patients for dementia when they were admitted for other conditions, so they could improve care.

He added: "The result of this audit should be a must read for every medical and nursing director. It is time for the NHS to put in place the training and support that improves the care and treatment of people with dementia and saves money too."

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