A NURSING expert has warned going into hospital is dangerous for dementia patients

nae sporran

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Oct 29, 2014
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Professor June Andrews, director of the Dementia Services Development Centre at Stirling University, accuses staff of dosing confused patients with sedatives to keep them quiet and advises relatives to spend as much time as possible with their loved one on the wards rather than leave them at the "mercy of the system".

The internationally renowned expert, who is a nurse and former NHS manager, refers to receiving the wrong medicine as "a common hazard of being in hospital."

Professor Andrews' startling comments are contained in a guide, published this week, designed to help families cope with the illness.

Tips include "guerilla" visiting tactics to get around strict visiting hours and ensuring the patient receives lots of cards so staff know the person is cared about.

"Patients who appear to have a large and interested family seem to get more attention," said Professor Andrews.

"I feel sure that some people will be offended by this book, but the people who work in hospitals and manage hospitals who really understand dementia will see that in fact it is asking families to do more. The book actually has quite a sophisticated understanding as to why hospitals fail people with dementia. It is because hospitals were not designed for dementia. They were designed for strokes and heart attacks and fractures. As time goes by, hospitals are becoming under more pressure and the extent to which they can manage dementia becomes less and less."

The book has been endorsed by the radio and television presenter John Humphrys - whose father suffered dementia - and Professor Andrews says that rather than painting a bleak picture of what it is like on the wards, it gives a realistic one.

According to Professor Andrews, in the wake of the financial crisis "this is as much as we can expect from hospitals."

In fact she describes now as "the good old days" for the NHS, as the size of the frail elderly population is increasing. It has been predicted that the number of people living with dementia in Scotland will increase 75 per cent by 2031 to more than 100,000.

Called Dementia: The One Stop Guide, the book says some hospitals have clever schemes for helping dementia patients avoid unnecessary hospital admissions and some use discrete symbols, such as butterflies, to identify people with the condition to NHS workers so they can treat them appropriately.

However, Professor Andrews also notes not all staff know how to deal with dementia properly.

She describes how someone who was coping well in the community can go downhill because of the hospital environment.

She says: "This same person who managed to be happy and live quietly at home, sleeping at night and entertaining themselves by day, will be kept awake by noise and light at night, and bored to death in the daytime, never even seeing daylight. After a few days of that they 'll become noisy and irritable and may be given medication to quieten them down.

"It is not unusual after this to have a fall or a fracture, leading to more surgery, and a long period in hospital during which all their skills leave them as they get undiagnosed depression and delirium, which at times is ignored by hospital staff and goes untreated, leading to an early death."

A spokesman for the Scottish Government said it was committed to improving hospital care for people with dementia.

He said: "We have a three year strategy to improve dementia care in hospitals, including a 10 point action plan to drive up standards. In partnership with Alzheimer Scotland we are funding an Alzheimer Scotland Dementia Nurse Consultant in all territorial NHS boards, and more than 500 dementia champions across Scotland to support healthcare staff who work with people with dementia.

"Healthcare Improvement Scotland's inspections of care for older people in acute hospitals include a specific focus on nutritional care and hydration. They focus on identifying areas of strength as well as areas for improvement, and we expect NHS Boards to use their recommendations to drive forward improvement and ensure a better quality of care for people with dementia in acute hospitals."


Copied from the Herald.

I think funding for more Carer support and liaison staff to help communication with senior medical staff is needed more than guerrilla visits.
 

nitram

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Apr 6, 2011
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Extract from >>>A CASE STUDY LINKED IN THE MAIN ARTICLE<<<

A DEMENTIA patient who kept saying that he was hungry was dismissed as confused.

Then his wife, who had been told she could not visit him in hospital at meal times, asked why there was a sign saying "nil by mouth" above his bed.

She discovered the notice had been left there from the previous patient and her husband had not eaten for days.
 

nae sporran

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I did not read that bit nitram, just shows the need for vigilance and being assertive.
 
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Padraig

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Dec 10, 2009
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I'm surprised to learn that it takes an expert to state that fact! Each time my wife had to visit a hospital I had a fight with staff to get my concerns about her welfare listened to.
To this day I'm angry with their attitude of talking down to the people they are meant to serve. When it comes to dementia, the question should be, is who knows the patient best? They should co-opt the assistance of close relatives and work in unison. In the final analysis, they are there to provide a service paid for by us, the tax payers.

These so called nurses doped my wife on drugs without informing me. She was a quiet gentle person.
 

love.dad.but..

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Jan 16, 2014
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I have posted recently - 10 days hospital - and I totally agree with everything said. I stayed the whole 10 days and nights with dad - the lack of dementia awareness amongst most staff is shocking and therefore their care and lack of monitoring is very worrying. I wouldn't hesitate to stay again with dad if he is admitted, the hospital were fine with me doing it but most probably as much as anything it meant one less patient to think about, just me badgering them instead. I have poa for health and welfare and didn't have any problems with the staff at all but I did wonder whether as poa - do hospitals have a duty to recognise that a poa has a legal right to stay with the patient to speak for them as they don't have mental capacity and can a poa insist that the hospital allow them to stay. Anyone know the answer?
 

BR_ANA

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A relative must stay on hospital with 70yrs or older (Brazilian law). I have explained dementia to many staff. Last stay I was checking if staff was really changing my mom position every 2 hrs (avoid pressure wound) because on previous stay they didn't.
 

BR_ANA

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do hospitals have a duty to recognise that a poa has a legal right to stay with the patient to speak for them as they don't have mental capacity and can a poa insist that the hospital allow them to stay. Anyone know the answer?

I don't know the answer. Someone may know.
 

Izzy

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I heard the lady interviewed on Radio Scotland and Reporting Scotland yesterday. It seems to be a 'one stop shop for carers'. I felt she said nothing that we do don't already know. I did wonder about the part about delaying symptoms. She talked about keeping active etc to avoid/delay the symptoms.

It covers everything from delaying the symptoms, getting a diagnosis, to making a home dementia-friendly (make sure there's lots of decent light). The chapter, however, which is arguably most controversial is called "The dangers of a hospital admission and how to avoid them."

I've not listened to it but here is an interview with June Andrews on a programme called Brainwaves -

http://www.bbc.co.uk/programmes/b051241w
 
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tss502

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Oct 20, 2014
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Very interesting interview with her this morning on the Today Programme (Radio 4).
 

Soobee

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Aug 22, 2009
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Extract from >>>A CASE STUDY LINKED IN THE MAIN ARTICLE<<<

A DEMENTIA patient who kept saying that he was hungry was dismissed as confused.

Then his wife, who had been told she could not visit him in hospital at meal times, asked why there was a sign saying "nil by mouth" above his bed.

She discovered the notice had been left there from the previous patient and her husband had not eaten for days.

that sort of thing makes me cry.
If there are systems for double-checking medication etc why aren't there checks on the signs round the beds?
 

Spiro

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Mar 11, 2012
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Very interesting interview with her this morning on the Today Programme (Radio 4).

She said on the Today Programme that people with dementia "have bad things happen to them in acute hospitals."

You can say that again. Mum had an accident while in hospital and required surgery. She is having difficulty mobilising and may never walk again. She was admitted with another problem and made a full recovery; the situation is completely different now.

I fully appreciate that she has dementia and currently, there isn't a cure. But before her admission she was mobile and was still involved in activities outside the home.

Right now I never want her to go anywhere near a hospital again.
 

Sue J

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Dec 9, 2009
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that sort of thing makes me cry.
If there are systems for double-checking medication etc why aren't there checks on the signs round the beds?

It is terrible, but even if the sign was there a nurse should still have been responsible for ensuring the patient was fed, then they may have noticed the sign, they still have report times and handovers I presume?

I lost a friend 8 years ago, when she was in an acute ward I insisted on going in to feed her, despite 'protected meal times' the staff were not encouraging. A patient opposite once said I keep telling them she needs help to eat but the tray was often taken away untouched when I was unable to go, she lost so much weight:( This was ten years ago,still affects me greatly, and things are getting better?
 

Acco

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Oct 3, 2011
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I was determined from the start to be with my wife for as much time as I could manage, initially because I was concerned she would be frightened not knowing those around her in unfamiliar surroundings. It was the best thing I could have done for her; providing much needed drinks, ensuring she was helped eating her food at mealtimes, upon arrival each day ensuring she was not laying in bed in saturated pants and bedding, getting her up and walking the ward, monitoring the provided medication (and blood pressure, temperature, etc., readings from the nurses records at end of bed). All absolutely essential as I came to realise over her two weeks in hospital. There is more that can be said but suffice to say time spent with my loved one during that stay was necessary in her best interests. Having said what I have, I do understand the difficulties faced by the nurses and despite my concerns about my wifes treatment, found the nurses and support staff very caring, friendly, and kindly but with far too much to do for far too many patients who could not help themselves.
 

Spiro

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Mar 11, 2012
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Since the incident that I posted about earlier on this thread, Mum's care has significantly improved!! I wonder why.:rolleyes:
 
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nae sporran

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Oct 29, 2014
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Since the incident that I posted about earlier on this thread, Mum's care has significantly improved!! I wonder why.:rolleyes:

Excellent result Spiro. I learned the last couple of times you have to keep asking every visit. Hope your mum makes a full recovery.
nasporran