Getting it right for dementia patients

 

Bridget Fordham, dementia nurse specialist

Much has been made of the poor care the elderly can sometimes experience at the hands of hospitals in the NHS.

Some of the most depressing cases involve dementia patients - as shown in the dossier of "appalling" cases highlighted by the Patients Association a few weeks ago.

Last week a report by monitoring body Dr Foster gave an insight into the difficulties hospitals are facing with overcrowding which makes providing the right care for the frail and elderly more difficult.

But that doesn't mean there aren't places getting it right - as I found out when I visited the world-renowned Guy's and St Thomas's Trust in the heart of London.

The trust has been giving special consideration to the care it provides to dementia patients for some time.

Part of this involves providing specialist dementia training to staff, which has been happening since 2009.

At first it was given to nurses and other key staff such as speech therapists and dieticians, but it has now been rolled out to the entire workforce from doctors to porters.

'Big difference'

Bridget Fordham, the trust's clinical nurse specialist for dementia, told me: "Our staff said that of all the patients they dealt with they were the most unsure about those with dementia.

"They just did not have the confidence or skills to deal with them. Dementia patients can get very agitated. Delirium is a big problem.

"So we started doing some training to help. Staff say it has made a big difference and helped them in the way they care for patients."

But the trust has also sought to make changes to the physical environment to help dementia patients.

In the three elderly care wards at St Thomas's Hospital doors to toilets and washrooms have been colour-coded with bays to give patients visual prompts in finding their way round.

Bathroom door Doors to bathrooms are colour-coded with bays so dementia patients can find their way round more easily

Padded flooring has also been laid to help soften falls, which are more likely among dementia patients.

A number of other measures have been introduced trust-wide.

These include a print of a forget-me-not which is placed above the bed of all dementia patients to alert staff to their condition. Dementia patients are also given blue wristbands to wear.

This has proved particularly useful if patients have wandered away from their wards, as Ms Fordham explains.

"We obviously don't want to lock patients in and people with dementia can go wandering so what this does is tell staff that this patient has dementia and should not be out on their own.

"We have had security staff finding patients and because they have had the dementia training they understand the situation and know how to approach them."

Red trays and beakers are also used to signify which patients need help with nutrition.

Nurses on the elderly care wards believe the aids have been a big help.

Deputy charge nurse Jim Domingo says: "They are really useful. If you are coming back from some time off or when there is agency staff working it just makes sure we know straight away who needs what."

Patients and their carers appreciate these measures too. Christine Nethercott, 64, from nearby Bermondsey, has been a regular visitor to St Thomas's over the past five weeks as her mother, Eleanor, has been recuperating from an infection.

While she has been in, Eleanor has had dementia diagnosed.

"It's really reassuring to know staff will be aware of my mother's condition and looking our for her when I am not here," says Christine.

"I must say the care she has received has been wonderful."

 
Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this
    +3

    Comment number 22.

    I must admit that I am left a bit startled reading a report that is positive about the NHS at last.

    I mean, the reports that have been attacking it, (Dr.Fosters and PA have privatised arms) were playing pychops games to make us doubt in the NHS.

    What is positive besides the training and help for Dementia pts. in the report, is that help has been done WITHOUT privatisation.

  • rate this
    +9

    Comment number 21.

    When my late father was in the early stages of dementia - and knew what was likely to happen to him - he regularly asked me to help him end his life. I refused because I am a coward who does not want to go to prison. I cared for him through four more years of increasing mental and physical suffering. Until dementia is preventable or curable we should be able to die with digity. I plan to do so.

  • rate this
    0

    Comment number 20.

    Little_Old_Me
    If not stop moaning & care for them yourself.....

    That is fine until medical/surgical intervention is needed, while medical notes inform staff that the patient has mild dementia this does not seem to be taken on board. With staff on wards constantly changing (12 hours x 3 shifts per week) there is little continuity for a confused patient.

  • rate this
    +4

    Comment number 19.

    I agree that an NHS hospital is not the place for demetia sufferers, but these patients are likely to suffer from other ailments which do require them to be hospitalised. With this in mind, the specialist training and other measures that have been put in place must be a help for the staff and mean that the patients will get better care whilst they are in there.

  • rate this
    +6

    Comment number 18.

    I think it is very positive the measures the above hospital have done to help Dementia patients. Of all patient types, I feel understanding is lacking in Dementia sufferers, followed by people with Learning Disabilities.
    Other trusts should consider training as above for all hospital workers. I feel it would make the different enviroment for the patient much safer.

  • rate this
    +5

    Comment number 17.

    While this is great, the use of colour and other visual aids has been going on for years. We used colour coded doors, natural barriers (end of a carpet etc), pictures and loads of other aids, with great success, in the Dementia nursing homes I commissioned many years ago. However, at the end of the day it always comes down to having the right number (as well as trained) of staff

  • rate this
    0

    Comment number 16.

    The focus MUST be on prevention, and that should be applied to all forms of illness.
    .
    Much of what ails mankind comes from diseases & the multitude of problems they cause us once the infecting organisms have breached our defense systems, can be both massive and, very long-term.
    .
    In many vases there is no quick fix, no full return to 'normal', or to the good health we enjoyed previously.

  • rate this
    +4

    Comment number 15.

    Dementia care is a specialist area requireing knowledge and understanding, yet it is deemed as social care by the local authority. We are an aging population and cases of dementia can only increase so this needs urgent attention now and not when we reach crisis point.

  • rate this
    0

    Comment number 14.

    Dementia - a very big problem for mankind. Vast sums of money have been spent on 'research', and not just in this country. Indeed most 1st world countries have had teams of scientists trying to make headway for years. Public donations keep many of them in jobs.
    .
    But now ....the answers are to be found in Genes & DNA!
    On the latest bandwagon & down that misleading road again, raising false hopes?

  • rate this
    0

    Comment number 13.

    Hospitals are not the place for dementia patients. Specialist care homes for those with no family or independent living capability, supported living for those still able to manage on their own to a degree. Support for family carers who usually would be happy to care for rather than hospitalise their relatives to enable them to cope with providing that care.

  • rate this
    +12

    Comment number 12.

    If I could sign a pice of paper that said: "Please euthanise when I can't feed myself and can't remember my own name," I would. I could then grow old knowing that I will never be a drain on my family or society at large.

  • rate this
    +1

    Comment number 11.

    Caroline

    Would you agree that it is inappropriate for most elderly patients in hospital to be in hospital?

    Hospitals are full to bursting, with staffing levels absolutely at a minimum. We cannot at the same time as cut staffing, expect staff to care when they feel that they are doing the best in the circumstance but being given a bad press for it.

  • rate this
    +3

    Comment number 10.

    Remember Gerry Robinson highlighted best of dementia care in his 2009 TV programme.
    Love, care, providing variety of suitable activities in a non-threatening environment. Should be so easy, need not cost much.
    Why do we still hear cases of abuse neglect and excuses about insufficient funding?
    Let's value, appreciate and care for lovely folk who are struggling with their memory and confusion.

  • rate this
    +6

    Comment number 9.

    @josy - Many people do still provide care for as long as they can - often to the detriment of their own health. As people live longer the numbers with dementia increase and there is often a limit to the care relatives can provide, especially if they have to work and still have children at home.

  • rate this
    +8

    Comment number 8.

    Good positive action from caring people. I'm sure they represent the vast majority of the nursing staff across the country.

    Having been in hospital and seeing it for myself, I'm sure most of the bad reports are caused by poor management, ill thought out cuts, under staffing, over administration and worst of all targets

    Let those who do the caring progress the ideas and you get brilliant results

  • rate this
    +5

    Comment number 7.

    Yes, care undoubtedly costs and, in an equal society, I would have no problem paying a few more pounds to ensure elderly people are not abused or neglected in so called 'care homes'. However, I admit to finding that prospect sickening when MPs are claiming vastly inflated salaries and expenses,

  • rate this
    +6

    Comment number 6.

    Thanks for this ray of sunshine in what is usually bad news about more bad news.
    Christine Nethercott has said it best (from her own experience): "It's really reassuring to know staff will be aware of my mother's condition and looking our for her when I am not here."

  • rate this
    +12

    Comment number 5.

    So glad to see that the lack of care for the elderly and their most common issue - dementia - is finally being highlighted in the media. There's another article today about the isolation and loneliness of the elderly. There's so many children's charities and programs to help children in need - shouldn't we care just as much about the elderly, who are often completely alone in the world?

  • rate this
    +1

    Comment number 4.

    Welfare programmes only work to an extent, families have always provided the basic care, only this generation seems to believe they are entitled to assistance with everything from cradle to grave!

    In order to provide good quality care, you need to fund the care adequately, not pay minimum wage & expect quality treatment at the hands of the unqualified, most managers care about profit!!

  • rate this
    +10

    Comment number 3.

    Personally I was pleased to see a positive story for a change. My gran has alzheimer's and we all do what we can to help and support her. However, it is hard work and it's easy to understand how not all families would be able to cope with this on their own. So the more hospitals and care homes that can get it right the better. Not sure why the other comments are so negative!

 

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