Hospitals and dementia; Change is needed!

[Mixture]

Early Nov my 87 year young partner fell in the street and by ambulance, taken to A&E. Initial diagnosis nothing broken but pain said otherwise and CT scan a week later said pelvic damage so 6 week bed rest prescribed. The hospital was full so for the first she was put into a day ward with no windows and no bathroom and volunteer staff to look after the patients. The day ward was so busy with staff struggling to see to their patients and the hospital had restricted visiting to 1 hour and excluded meal times. I bucked the system and nurses were grateful and turned a blind eye. She wasn't communicating, eating or drinking much and was getting very dehydrated.
She was transferred to a room in surgical ward with physiotherapy and facilities, and doctors, and I continued to buck the system and attended one mealtime and helped to encourage feeding and drinking with more success than nurses. Because I gave time! -------- One hour to eat lunch was typical.
She wasn't talking, or drinking and she hated things being stuck in her and stuck on her so when they fitted a drip, she pulled it out, which I prevented while there. After 4+ weeks the system had given up, with a doctor saying that she wouldn't last long.
I will do a separate post in praise of Jelly Drops as they turned her round, but this post is about some changes that I think are needed in hospitals for dementia patients.
Most hospitals have children's wards where a parent can stay and I believe that many dementia patients are more dependant on their carer than some children.
Had facilities been available for me to stay I could have prevented drips being pulled out and I feel that she would have eaten and drunk more. This would have saved the nurses time, led to an earlier discharge, and I believe saved the NHS costs.
In my mind "Change is Needed in how Hospitals deal with Dementia Patients " by providing carer stay facilities.

 

[Cat27]

Welcome to TP @Mixture
Some hospitals are excellent at including carers. Sadly we need many more to do the same.

 

[nae sporran]

Welcome from me too. @Mixture. Hospitals are not the best places to be when you have dementia at eh best of times. Of course, Covid has made that all so much harder. I found the carer support centre to be helpful and supportive when my partner was in hospital in the autumn, and would recommend getting advice there or from the Alzheimer's Society Dementia Connect helpline if your partner is in hospital again.

 

[Violet Jane]

Isn't there something called John's Law which is supposed to make provision for the carers of dementia sufferers to stay with them. I agree that many dementia sufferers are more dependent than many children.

I think that hospital care - by which I mean non-medical care - needs to be reviewed as it is based on an outdated model of relatively fit people coming into hospital to have operations or treatment. There need to be more staff to support frail and demented patients who make up an increasing percentage of people in hospital. Too many people end up malnourished because they do not get the help they need to eat. Meals are just taken away untouched or barely touched and nobody thinks that this is a problem. I feel that good medical care is undermined by poor non-medical care on the ward. Yes, there are staffing shortages but I think that a change of culture is needed as well. I'm sorry to say that my experience of nursing staff on elderly care wards has not been very positive.

I do wonder why more patients are not sent to nursing homes to recover.

 

[CAL Y]

@vi

Isn't there something called John's Law which is supposed to make provision for the carers of dementia sufferers to stay with them. I agree that many dementia sufferers are more dependent than many children.

I think that hospital care - by which I mean non-medical care - needs to be reviewed as it is based on an outdated model of relatively fit people coming into hospital to have operations or treatment. There need to be more staff to support frail and demented patients who make up an increasing percentage of people in hospital. Too many people end up malnourished because they do not get the help they need to eat. Meals are just taken away untouched or barely touched and nobody thinks that this is a problem. I feel that good medical care is undermined by poor non-medical care on the ward. Yes, there are staffing shortages but I think that a change of culture is needed as well. I'm sorry to say that my experience of nursing staff on elderly care wards has not been very positive.

I do wonder why more patients are not sent to nursing homes to recover.

@Violet Jane . As most older people know, the problem lies with the closing down of convalescent homes and cottage hospitals which means PWD are accused of being bed blockers and either discharged to their homes with inadequate care in place or have to pay exhorbitant fees for care homes.
And they call it progress.?

 

[RosettaT]

My experience when OH was in hospital was poor too. I did go in twice a day pre covid especially to help feed him as on a few occasions his food and drink were untouched for hours. Time and time again I explained they couldn't just place something on the table and expect him to eat or drink it. There was no appropriate ward for him either and was in 5 wards in 7 days at one point, with no information being passed by mouth and no-one had the time to read his notes.

 

[HelpInOut]

Isn't there something called John's Law which is supposed to make provision for the carers of dementia sufferers to stay with them. I agree that many dementia sufferers are more dependent than many children.

I think that hospital care - by which I mean non-medical care - needs to be reviewed as it is based on an outdated model of relatively fit people coming into hospital to have operations or treatment. There need to be more staff to support frail and demented patients who make up an increasing percentage of people in hospital. Too many people end up malnourished because they do not get the help they need to eat. Meals are just taken away untouched or barely touched and nobody thinks that this is a problem. I feel that good medical care is undermined by poor non-medical care on the ward. Yes, there are staffing shortages but I think that a change of culture is needed as well. I'm sorry to say that my experience of nursing staff on elderly care wards has not been very positive.

I do wonder why more patients are not sent to nursing homes to recover.

I think by non medical care you mean nursing care.
My experience is that neither medical not nursing care are particularly good even for the elderly, let alone those with dementia. The framework used to assess and plan nursing care is patient centred, using something called the Nursing process, and typically a model based on the 12 activities of daily living. There are other models , but this is the most commonly used one,

• maintaining a safe environment
• communication
• breathing
• eating and drinking
• elimination
• washing and dressing
• controlling temperature
• mobilization
• working and playing
• sleeping

It doesn't matter whether someone's come in for their big toe nail removed or as an emergency due to a heart attack. The principles are the same. Assess the patient, identify an actual or potential problem, plan and implement care and evaluate the care to see if you've resolved or prevented the problem.
It's not rocket science, but it does involve being interested enough in your patients to find out about their needs, and also takes a fair amount of time, which for one reason or another, nurses don't seem to have these day.
My parents (Dad with dementia and Mum with short term memory problems but refusing to be assessed) were both in hospital recently with non dementia related problems, and I have to say I wasn't impressed with either the medical or nursing care. Dad they just sat on for 24 hrs and did nothing .Mum they were going to send home walking with a zimmer frame when she's the one who cooks all the meals /makes all the hot drinks and carries them through to where they eat with no care package in place. The decision to discharge someone and to ensure that the discharge is safe lies with the whole team, not just doctors OR nurses.

 

[Chaplin]

Early Nov my 87 year young partner fell in the street and by ambulance, taken to A&E. Initial diagnosis nothing broken but pain said otherwise and CT scan a week later said pelvic damage so 6 week bed rest prescribed. The hospital was full so for the first she was put into a day ward with no windows and no bathroom and volunteer staff to look after the patients. The day ward was so busy with staff struggling to see to their patients and the hospital had restricted visiting to 1 hour and excluded meal times. I bucked the system and nurses were grateful and turned a blind eye. She wasn't communicating, eating or drinking much and was getting very dehydrated.
She was transferred to a room in surgical ward with physiotherapy and facilities, and doctors, and I continued to buck the system and attended one mealtime and helped to encourage feeding and drinking with more success than nurses. Because I gave time! -------- One hour to eat lunch was typical.
She wasn't talking, or drinking and she hated things being stuck in her and stuck on her so when they fitted a drip, she pulled it out, which I prevented while there. After 4+ weeks the system had given up, with a doctor saying that she wouldn't last long.
I will do a separate post in praise of Jelly Drops as they turned her round, but this post is about some changes that I think are needed in hospitals for dementia patients.
Most hospitals have children's wards where a parent can stay and I believe that many dementia patients are more dependant on their carer than some children.
Had facilities been available for me to stay I could have prevented drips being pulled out and I feel that she would have eaten and drunk more. This would have saved the nurses time, led to an earlier discharge, and I believe saved the NHS costs.
In my mind "Change is Needed in how Hospitals deal with Dementia Patients " by providing carer stay facilities.

Sadly I think there are many similar examples of this type of ‘care’ in our hospitals and what you described above was happening in hospital pre covid times! I suggest you send your comments to the Department of Health & Social Care. Unless you spell it out in simple terms to the Ministers they just don’t get it! We’ve had awful experiences with mum in hospital & thankfully Nurses could see we made their job easier by being their morning to night so also turned a blind eye.

 

[Feb]

My mum died in August after 1 month in hospital. I was persistently told I could only visit for pre booked 1 hour per day. I spent the majority of this trying to get food and fluids into my mum and updates from staff. They have since replied to my formal complaint after 5 months and said staff should have informed me due to her dementia there was more flexibility in visiting. They have also apologised by not taking any notice of my brother and I both who held power of attorney for health and wellbeing being able to advocate for her. As they didn’t give us an opportunity. They ended up giving her invasive treatments she would not wanted nor us.
I was heart broken to hear I was unjustly stopped from visiting my mum for more than 1 hour a day for 30 days. That is time I will not get back and it would have been so helpful for her to have some one she loved and trusted there who can tell people about her.
I arrived to find them feeding her a banana, she hated banana all her life and certainly even with her dementia would not eat one!

 

[nellbelles]

Hello @Feb and welcome to DTP please accept my condolences on the loss of your Mum in such tragic circumstances people here will totally understand your feelings at the way you and your Mum were treated.

 

[Origano]

Isn't there something called John's Law which is supposed to make provision for the carers of dementia sufferers to stay with them. I agree that many dementia sufferers are more dependent than many children.

I think that hospital care - by which I mean non-medical care - needs to be reviewed as it is based on an outdated model of relatively fit people coming into hospital to have operations or treatment. There need to be more staff to support frail and demented patients who make up an increasing percentage of people in hospital. Too many people end up malnourished because they do not get the help they need to eat. Meals are just taken away untouched or barely touched and nobody thinks that this is a problem. I feel that good medical care is undermined by poor non-medical care on the ward. Yes, there are staffing shortages but I think that a change of culture is needed as well. I'm sorry to say that my experience of nursing staff on elderly care wards has not been very positive.

I do wonder why more patients are not sent to nursing homes to recover.