Specialized Care Is Required of Hospitals for Dementia Patients Tormented by Fear

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A new report by the Alzheimer’s Society paints a mixed portrait of what hospitalization in the United Kingdom means to an elderly person with dementia. The January 2016 report, “Fix Dementia Care: Hospitals,” says many hospitals in England give high standard care to dementia patients, but at under-performing hospitals there is something akin to a nightmare scenario for elderly people suffering from dementia and their families.

The report used information obtained under the Freedom of Information Act. Some of the report’s more alarming findings are:

  • Only 2% of persons surveyed felt that the specialized needs of dementia patients were understood by the hospital staff.
  • About 5,000 dementia patients per year are discharged after 11 p.m. and before 6 a.m. These “after hours” discharges mean the hospital is short-staffed and that the paperwork, medical records, medicines and other aspects of care are compromised. In addition, it is inconvenient for relatives to pick up a patient during late hours. This increases the vulnerability of dementia patients.
  • In low-performing hospitals, most of the thousands of falls that occurred during a year were by persons with dementia.
  • More than half of the persons surveyed felt that their relative with dementia was not treated in a dignified manner.
  • An extremely high 92% of the respondents said their relative who was suffering from dementia was frightened by being in the hospital and what happened there.
  • Of the persons surveyed, 90% said the dementia patient became more confused in the hospital and that dementia symptoms were worse after the hospital stay.
  • Almost half of the survey respondents said the person with dementia had worse overall health symptoms after the hospitalization but not because the original condition had worsened. They attributed the decline in health to the lack of quality care at the hospital.
  • One fourth of the hospital beds were occupied by dementia patients.

Dementia patients rarely enter the hospital because of dementia itself. Rather, they enter because of falls, fractures, and other health reasons that are indirectly related. Unfortunately, they are also unable to effectively communicate their needs—especially levels of pain— and the hospital screening techniques for dementia are not always adequate. This leaves the dementia patient to be treated like everyone else, even though he or she clearly has special needs.

The Alzheimer’s Society recommends several methods to improve the hospital experience and care of dementia patients, including requiring all hospitals in England to provide an annual statement on their dementia care. The Society recommends that hospitals report on patient satisfaction, the number of falls, the number of inappropriate or late night/inconvenient discharges; the number of emergency readmissions within one month; and the number of people who receive an appropriate assessment upon entrance to the hospital. There are financial incentives for hospitals to do this, but many fall short of it. Staff levels and training and the number of people being given antipsychotic drugs should also be accounted for.

…the Care Quality Commission (CQC) should also appoint dementia specialists for monitoring.

The Society also recommended a monitoring system to assess the reports of hospitals and to decide how to address problems in under-performing hospitals. The Alzheimer Society recommended that the Care Quality Commission (CQC) should also appoint dementia specialists for monitoring.

Entering the hospital is not a pleasant experience for most people. For a dementia patient, it can be terrifying. If hospitals do not screen for dementia or understand the special needs of dementia patients, their care suffers to the point where the person may leave the hospital in a worse condition than before entrance. Humane health care dictates that this should never be the case, especially for vulnerable, elderly patients with dementia. The Alzheimer’s Society’s recommendations provide a template for caring, sane, humane treatment.

 

Sources

Boaden, Andrew. (January 2016). Fix Dementia Care: Hospitals. Alzheimer’s Society. Available at https://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=2907.

Retrieved 1/28/2016.