Non-dementia friendly hospital ward, and safeguarding

[LocalResident]

Safeguarding etc.
I agree it’s essential that, for example, Social Services should be contacted; however I would like to provide brief details of when I ended up as a ‘victim’ accused and being reported to a Local Authority’s Safeguarding team.

Non-dementia friendly hospital ward
It took place over a period of many months in a NHS hospital ward which was not dementia friendly. An elderly patient – a relative living with dementia, was initially admitted for a short period of rehabilitation before being assessed for discharge to return home with extra support provided.

The patient didn’t receive enough physiotherapy, discharge arrangements including the discharge planning meetings were poorly coordinated and were delayed and delayed.

Sadly during the extremely prolonged period in hospital the patient lost a significant amount of weight and was often dehydrated. This was simply because he was not encouraged and helped to eat and drink. He didn’t have enough energy to do the mobility exercises when physiotherapy staff did turned up. And the total lack of suitable mental stimulation in that non-dementia friendly hospital ward every day for three months simply increased his cognitive decline. Previously he had attended an excellent Day Centre six days a week.

It was during hospital visiting hours (afternoons and evenings) I started to get concerned when I saw many drinks left on the patient’s table – lined up not drunk. I was told a patient was free to refuse food and fluids, and ‘busy’ medical and care staff don’t have the time to assist patients to eat and drink.

Initially I was praised when I managed to encourage the patient to drink and by this stage using thickened fluids and later pureed foods. However, soon I became aware of being ‘spied on’ by medical and care staff in the ward every time I visited. I was fully aware of the correct procedure when assisting the patient to eat and drink, these include head upright, and allowing plenty of time to swallow etc. – to prevent choking etc. The pureed meals looked unappealing – these were brightened up when I took in and started adding tomato sauce and mayonnaise!

In the end I was reported by the medical staff – because of the alleged safeguarding issue ‘guilty’ of pushing liquids and force feeding.

Eventually the patient was discharged from hospital in a far worse state physically and mentally than when admitted, now unable to stand or walk even with aids.

Ironically, just prior to discharge, Fast Tracked NHS Continuing Health Care was arranged because of his extremely poor health, (a formal request for NHS CHC which was made about a month earlier had been rejected).

The patient never returned home, despite some mobility modifications had been put in place - when at a time - during one of the earlier discharge meetings there was agreement he was OK. He ended up in a Nursing Home being nursed in bed and where he was well looked after - which of course includes ‘fed and watered’!

My concerns about this non-dementia friendly hospital ward were forwarded onto the Care Quality Commission and also to the county’s HealthWatch team.

 

[Rosettastone57]

What you are describing in a hospital ward regarding food and drink is not unusual. My mother-in-law spent nearly 2 weeks in hospital during the summer and I'm afraid that staff quite rightly as they said simply don't have the time to pay individual attention to each patient to make them eat and drink. My mother-in-law had been used to her carers coming in and cutting up her food for her and of course this was not done in hospital and she simply couldn't understand why not. I had to ask staff to help her with the cutting up of food. I'm afraid that most of the wards that I saw during her time in hospital I would not describe as particularly dementia friendly but then what NHS hospital is? Many of the staff simply do not have the experience of dealing with dementia and have no idea about what is involved as many others have posted on here before unless you see it directly in action people haven't got a clue. My mother-in-law also have some physiotherapy but it was a complete waste of time because she simply can't remember what she's been told and didn't have the initiative to do any exercises anyway . I appreciate it is frustrating to see loved ones in this situation but I'm afraid it is what it is

 

[Louise7]

I agree that there is a lack of dementia awareness in hospitals but saying 'it is what it is' isn't going to change things for the better. The lack of awareness invariably results in longer hospital stays / increased health problems and more strain on an under resourced service. If young children were left in hospital with no one helping them to eat/drink I'm sure that most people would consider this unacceptable and a safe guarding issue. Why does the fact that patients are elderly make a difference? You don't need to be dementia trained to know that it will be detrimental to a patient if they don't eat/drink or mobilise regularly.

We don't know all the circumstances here but the OP has apparently been reported for feeding a patient who needed assistance to eat. From personal experience there seems to be a 'culture' in some hospitals for staff to 'turn against' a patient/relative if concerns are raised. Unless people speak up about what is going on nothing will change.

 

[Juliematch]

Im really sorry that this has been a bad experience for you. My dad has just come out of hospital for the second time,after a failed discharge.The first ward was really not aware of dementia problems.Drinks put in front of him and food ,which were left.At one stage I was there when a member of staff said”your not eating much” and I explained he had dementia.They put a forgetmenot sticker by his name on the ward board but nothing by his bed.When I could, I stayed for meal times to feed him and took in a drink I know he likes ,1 day I stayed 6 hours.I really feel for the poor nursing staff.They are so busy washing changing medicating etc they don’t have the time to sit with one person. When he then went to the stroke unit( no stroke but had a seizure) they were so different.There were more staff that had the time and understanding for dementia. It made such a difference to me knowing that they helped him. In a perfect world everybody would be dementia aware but until that time comes we have to educate and help where we can.

 

[love.dad.but..]

Im really sorry that this has been a bad experience for you. My dad has just come out of hospital for the second time,after a failed discharge.The first ward was really not aware of dementia problems.Drinks put in front of him and food ,which were left.At one stage I was there when a member of staff said”your not eating much” and I explained he had dementia.They put a forgetmenot sticker by his name on the ward board but nothing by his bed.When I could, I stayed for meal times to feed him and took in a drink I know he likes ,1 day I stayed 6 hours.I really feel for the poor nursing staff.They are so busy washing changing medicating etc they don’t have the time to sit with one person. When he then went to the stroke unit( no stroke but had a seizure) they were so different.There were more staff that had the time and understanding for dementia. It made such a difference to me knowing that they helped him. In a perfect world everybody would be dementia aware but until that time comes we have to educate and help where we can.

Also perhaps because there are similarities post stroke and inability to that of patients with dementia so the stroke ward staff are probably more in tune with their needs and anticipate where a patient on their ward will have problems and be more proactive straight from the off. Good to hear that was a fairly positive experience.