Many elderly patients in hospitals have dementia, yet in all but a few cases, this is rarely taken into consideration. In an ideal world, the following would alleviate some of the issues experienced by such patients, and their families.
1 Admission avoidance should be a priority
Wherever possible, admission to hospital should be avoided. A dementia patient will feel safer and happier in the familiar surroundings of their own home. They will also be attended to by people they already know, rather than unfamiliar hospital staff.
2 Dedicated dementia reception
If admission to hospital cannot be avoided, then the dementia patient should be admitted via a dedicated dementia reception area, and not Accident and Emergency. Accident and Emergency units are too busy, too noisy, and can cause additional, and unnecessary distress. The dementia reception unit should be furnished with beds, not trolleys, the patient's comfort should be a priority.
3 Fully dementia trained staff
Staff, both within the dementia reception unit, and subsequent wards, should be fully dementia trained. Dementia patients have special needs, needs which are not well understood by general hospital staff.
4 Dedicated dementia wards
There should be wards in hospitals specifically for dementia patients. The layout, decor, equipment and facilities on these wards, should be designed with the dementia patient in mind. The atmosphere should be calm and friendly.
5 Special needs should be catered for
Staff need to be on hand, to cater for the special needs of dementia patients. Assistance with eating and drinking is essential where required. Continence issues need to be dealt with promptly. Visiting times in such wards should be flexible, in order to suit the requirements of both the patient, and their carers and family. Carers should also be involved in the caring process, and be consulted, by hospital staff, regarding such care
6 Planning for discharge and rehabilitation
Planning for discharge and rehabilitation, along with continuing care, should begin as soon as the patient is admitted. Regardless of the diagnosed outcome, where possible, patients should be returned to their home as soon as it is viable to do so.
My own, and my Mother's experience in this matter, was an unnecessary extended stay of 7 extra days, after she had effectively been discharged, on paper, whilst care and equipment was arranged.
7 Discharge should be rapid
Once discharge has been confirmed, the patient should be returned home, quickly and without complications. All care and equipment should be in place. Discharge should also take place during the day, and not at night.
8 Continuing care and follow ups
Social Services, District Nurses and GPs, should ensure that any follow up visits are carried out, and that a programme of visits is in place, to ensure that the patient's health and care needs are being catered for, and continue to be so.