Hospitals' dementia care criticised

 

A "significant improvement" is needed in the way hospitals deliver care to people with dementia, according to a report.

While hospitals say they have policies in place, these are not always followed and simple steps are not taken that could lessen the distress to patients, most of whom are elderly.

The study said the encounter between staff and patients "is mainly task-related and delivered in a largely impersonal manner" while the hospital environment is "often impersonal".

Staff do not always greet or talk to patients during care, explaining what they were doing or offering choice. Sometimes they do not respond to patient requests for help.

The National Audit of Dementia, which covers England and Wales, found only 6% of people with dementia had their level of cognitive impairment measured on admission and discharge, while only 43% of case notes showed patients had a mental status test despite 75% of hospitals saying they had a procedure for it.

Only 9% of case notes showed patients being screened for delirium, despite 33% of hospitals saying they had policies in place.

People with dementia can become agitated, distressed or aggressive while in hospital due to the hospital environment, aspects of care, illness or injury, or their dementia getting worse.

NHS guidance says the use of antipsychotics to control these symptoms should be a last resort, but many hospitals still use them.

The audit found 28% of people with dementia received antipsychotic medication in the hospital, of which 12% were newly-prescribed the drugs while in there.

The reasons for these prescriptions were not recorded in 18% of these cases, while less than half of staff felt properly trained in dealing with challenging behaviour.

More than half (59%) of wards said personal items (such as family photographs or cards) were not put where dementia patients could see them for reassurance.

And only 26% of casenotes showed an assessment of functioning (such as basic activities of daily living, activity/exercise status, gait and balance), despite it being included in 84% of hospital procedures.

While 96% of hospital policies said they assessed nutritional status, only 70% of casenotes showed this had been done.

Furthermore, 19% of casenotes did not show the patient was asked about any continence needs and 24% did not show that the patient was asked about pain.

Only 74% of wards had a system to ensure enough staff to help dementia patients eat at mealtimes and only 5% of hospitals had mandatory training in awareness of dementia for all staff.

Overall, less than a third (32%) of staff said they had sufficient training or learning in dementia care.

Recommendations in the report include providing basic dementia training for all staff, with some ward staff receiving higher level training.

A senior clinical lead for dementia should also be in place in each hospital, with dementia champions in each department and at ward level.

The report comes after figures yesterday showed emergency hospital admissions for people with dementia have increased by 12% in the last five years.

In 2006/7 there were 17,245 emergency admissions - in 2010/11 there were more than 2,000 more.

Professor Peter Crome, chair of the national audit of dementia steering group, said: "This report provides further concrete evidence that the care of patients with dementia in hospital is in need of a radical shake-up.

"We have a provided a number of recommendations that if implemented will enable patients and their families to have confidence in their hospital treatment.

"It is good to see that several hospitals have responded to the results of the interim findings with programmes of quality improvement."

Royal College of Nursing (RCN) chief executive, Dr Peter Carter said: "It is extremely worrying that two thirds of staff found that their training and development was not sufficient.

"It is essential that all staff are supported through training, education and leadership so that they are able to provide skilled, knowledgeable care to people with dementia.

"Equally, each nurse is personally accountable for their own practice and must act promptly to raise concerns if staffing levels or other pressures are getting in the way of delivering good care."

Jeremy Hughes, chief executive of the Alzheimer's Society, said: "This shocking report proves once again that we urgently need a radical shake-up of hospital care.

"Given that people with dementia occupy a quarter of hospital beds and that many leave in worse health than when they were admitted, it is unacceptable that training in dementia care is not the norm."

Care services minister Paul Burstow said: "We set this audit up to put dementia care in hospital in the spotlight.

"It has found some excellent practice, but it has revealed far too many hospitals failing to put in place dementia friendly care."

He added: "Improving dementia care is a priority for this Government.

"That is why we are putting in place a new financial incentive for hospitals that identify patients at risk so they get the specialised care they need."

PA

News
peopleFrankie Boyle responds to referendum result in characteristically offensive style
News
news
Life and Style
Couples have been having sex less in 2014, according to a new survey
life
New Articles
i100... with this review
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Voices
Holly's review of Peterborough's Pizza Express quickly went viral on social media
Sport
footballTim Sherwood: This might be th match to wake up Manchester City
Arts and Entertainment
musicHow female vocalists are now writing their own hits
New Articles
i100
News
news
Arts and Entertainment
musicBiographer Hunter Davies has collected nearly a hundred original manuscripts
News
Blahnik says: 'I think I understand the English more than they do themselves'
people
Arts and Entertainment
Michelle Dockery as Lady Mary Crawley in Downton Abbey
TVInside Downton Abbey series 5
Life and Style
The term 'normcore' was given the oxygen of publicity by New York magazine during the autumn/winter shows in Paris in February
fashionWhen is a trend a non-trend? When it's Normcore, since you ask
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Marketing Manager - Leicestershire - £35,000

    £30000 - £35000 per annum: Ashdown Group: Marketing Manager (CIM, B2B, MS Offi...

    Marketing Executive (B2B and B2C) - Rugby, Warwickshire

    £22000 - £25000 per annum: Ashdown Group: A highly successful organisation wit...

    SEN Coordinator + Teacher (SENCO)

    £1 per day: Randstad Education Leeds: Job Purpose To work closely with the he...

    Research Manager - Quantitative/Qualitative

    £32000 - £42000 Per Annum: Clearwater People Solutions Ltd: Our client is curr...

    Day In a Page

    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits
    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments
    These Iranian-controlled Shia militias used to specialise in killing American soldiers. Now they are fighting Isis, backed up by US airstrikes

    Widespread fear of Isis is producing strange bedfellows

    Iranian-controlled Shia militias that used to kill American soldiers are now fighting Isis, helped by US airstrikes
    Topshop goes part Athena poster, part last spring Prada

    Topshop goes part Athena poster, part last spring Prada

    Shoppers don't come to Topshop for the unique
    How to make a Lego masterpiece

    How to make a Lego masterpiece

    Toy breaks out of the nursery and heads for the gallery
    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Urbanites are cursed with an acronym pointing to Employed but No Disposable Income or Savings
    Paisley’s decision to make peace with IRA enemies might remind the Arabs of Sadat

    Ian Paisley’s decision to make peace with his IRA enemies

    His Save Ulster from Sodomy campaign would surely have been supported by many a Sunni imam