"Care of Patients with Dementia"

About: Royal Alexandra Hospital / Trauma & orthopaedics

(as a relative),

I would like to add my support to the campaign to give the carers of those living with dementia the right to stay with them in hospital. I would also like to raise the point that the education of medical staff must include a good grounding into caring for patients with dementia.

My mum was admitted to the Royal Alexandria Hospital, Paisley, in early September 2014 after falling and having a suspected fracture. She had quite severe dementia at this point. I was in the US when it happened, but was reassured by the discussions my family had with the medical staff that she was physically well enough to undergo surgery.

She remained in the hospital for 5-6 days, so when I got back I called to enquire when it would be possible to see her and how she had been doing. At this point, I felt alarm bells go off. The nurse I spoke to hadn't been on duty for some of Mum's period as a patient, so couldn't be expected to know lots. However, I got the impression that Mum wasn't being consulted about anything, because of her dementia condition. A person with dementia has lost their memory, not their mind. I feel that it is very important for medical staff to understand that point. I appreciate that it is difficult to implement in practice, when someone with dementia may not appear to be making much sense, but those who know them can decipher their words and statements and in Mum's case, she could quite often make a point or an observation, or say something which let you understand her feelings.

For that reason, and based on my experience with Mum, I feel very strongly that the reassurance of a familiar person, asking questions and listening/interpreting to the answers, makes such a difference to a person who has dementia when they are admitted to hospital and are suddenly faced with strange surroundings and people. A family member should be able to stay with them, exactly as John's Campaign advocates.

I would further add my own view that education about caring for and communicating with such patients now has to be a fundamental part of the educational curriculum, for nurses, doctors, paramedics and anyone else who has direct contact with patients.

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Responses

Response from Lorna Gray, Patient Experience, Public Involvement Project Manager, NHS Greater Glasgow and Clyde

Dear NOD83,

Your story highlights so many important issues and I understand how your Mum’s experience has really brought this home to you. You are absolutely right when you say that there needs to be a focus on how frontline staff care for and communicate with their patients who have dementia, and also that carers have an extremely important role in the care of their loved one while in hospital.

NHSGGC is doing a lot of work around both of these areas, and I’d like to tell you a little bit about some of these initiatives. What might also be helpful is for me to work with my colleagues Sandra and Elaina who have given me the information below to write in more depth about what we as a Board are doing in our next blog on Patient Opinion.

We have a rolling programme of training to support staff in identifying carers and increasing their awareness of the support services available which they can signpost carers to. We also encourage staff to look at how carers can be involved in the care of their loved one while they are in hospital if that is what the carer wishes. This may include for example, a relative staying with the patient during meals to help them with their food if they feel that this would be beneficial to the patient. This would be the case for any patient who needed this extra support from a family member, not only those patients with dementia.

In terms of work around dementia specifically, we have a national dementia strategy in Scotland which states that hospitals will “work as equal partners with families, friends and carers.” We are currently looking at how this can be incorporated into the day to day working of wards in a purposeful, planned way, and have already started this process in one of our hospitals, Lightburn. There’s more information about what we are doing in Lightburn in the latest edition of Health News – you can follow the link here: http://www.nhsggc.org.uk/media/233891/nhsggc_health_news_2015-08.pdf

This is close to what you are suggesting, and while at the moment this doesn’t include family members or carers staying with patients in the hospital, it does encourage them to be much more involved in the day to day care of their loved one.

Specifically at the RAH, we have put a therapeutic garden in one ward; have introduced dementia champions to wards; and have a dementia Clinical Nurse Specialist working in the hospital. Board wide, we have an Allied Health Professional dementia consultant, and Sandra Shields (who I mentioned above) is the Alzheimer Scotland Nurse Consultant for Dementia for the Board and is overseeing all this work.

I know that this only provides you with a flavour of what we are doing, but hope that it shows our commitment to ensuring carers are treated as valued partners in their loved one’s care in hospital, as well as the work we are putting specifically into supporting our staff in working with people with dementia in the most person centred way. As I said, I will work at putting together a post on our blog which covers this in more detail, showing some more specific examples and will post on here when I’ve done that.

If you have any other questions, please do not hesitate to get in touch with me again, either via Patient Opinion or directly on lorna.gray@ggc.scot.nhs.uk.

Best Wishes,

Lorna

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