Dementia patients in hospital

I have been truly sickened today by the total lack of understanding from trained medical staff towards dementia patients and other age associated mental illness such as Alzheimer's disease.

I work within the field and have an understanding of how dementia can affect someones behaviour, especially when in pain or in a distressing situation.  As dementiais well publicised to be on the increase, I for one, would expect healthcare professionals to have some understanding of this illness and to have had some training in dealing with dementia patients, especially in an Accident and Emergency Department.

Today I accompanied a patient to the local Accident and Emergency department with a suspected hip fracture after a fall.  Firstly, the ambulance crew were bordering on 'taking the mickey' out of the patient as their type of dementia causes incorrect and sometimes inappropriate (sexual, swearing etc) words to be used when the person tries to vocalise their thoughts.  Seeing as the crew were well briefed about the patients illnesses and likely behaviour I found this disgusting.  They shouted their questions louder, and gave big sighs when the answers the patient gave did not make sense - to them - it made perfect sense to the patient and if you listened closely, was quite easy to work out.

Once at the hospital, the staff at A&E weren't really any better.  Whilst trying to set up a canula, for a drip should it be needed, the patient became distressed and resisted.  I tried to explain to the patient that although it would hurt, it would also help.  Unfortunately, the patient could not understand due to the dementia, why they were in so much pain to start with, and couldn't understand why a strange person was trying to stick a needle in the back of their hand.  The nurse then proceeded to tell me that if the patient did not cooperate then they were refusing treatment and would be discharged at their own risk!  I explained (again, as I had already on admission) that the patient suffers from dementia and would need some more time and reassurance to allow treatment, through no fault of their own.  The nurse said she didn't have time to 'mess about like that' and left.

The x-ray tech was a little better, and actually allowed me to spend as much time as I needed to settle the patient, so they could be x-rayed.  They were impatient and did it with bad grace, but at least it was done.  The doctor who then did the relevant examinations was rude and impatient with the patient, they said and I quote "Well there's nothing I can do if you behave like that!".  Again, my explanations and pleas for time and understanding fell on deaf ears.

This is not the first time I have experienced this and it concerns me that dementia patients are sidelined and do not receive the treatment they need for lack of understanding.  I realise that Accident and Emergency staff are very busy, and appreciate that a 'difficult' patient is time consuming and inconvenient.  But they are people, people who deserve to be treated with respect and not taken the mickey out of or shoved to one side.

One answer that springs to mind is a team of emergency practitioners that are trained in dealing with mental illness and the sometimes challenging behaviour of dementia (and other illnesses) patients.  This way at least they will get fair treatment.

I have just one more thing to say on this matter, that may enlighten you to how a dementia patient feels:

You're lying on a bed, you don't know where you are, your leg and hip really hurts, but you have no idea why.  You feel scared because you know something is wrong, yet you don't know what.  Every time you try to get up and find someone you know to help you, someone tells you to lie down, or you will make it worse.  Make what worse you wonder?  Someone you don't know is pulling and pushing at you, making your leg hurt more, they tell you to stop fighting when you try and pull away and they hold on tighter.  They keep telling you that you are in hospital.  What does that word mean?  And that you have broken your hip.  How?  They are poking and pulling at your leg, maybe they hurt you?  Where are you really?  Why are these people trying to hurt you?  They are being impatient and short with you and you don't understand why, why do they want to hurt you?  What have you done?  You look around you....

You're lying on a bed, you don't know where you are, your leg and hip really hurts, but you have no idea why.  You feel scared because you know something is wrong, yet you don't know what.  Every time you try to get up and find someone you know to help you, someone tells you to lie down, or you will make it worse.  Make what worse you wonder?  Someone you don't know is pulling and pushing at you, making your leg hurt more, they tell you to stop fighting when you try and pull away and they hold on tighter.  They keep telling you that you are in hospital.  What does that word mean? And that you have broken your hip.  How?  They are poking and pulling at your leg, maybe they hurt you?  Where are you really?  Why are these people trying to hurt you?  They are being impatient and short with you and you don't understand why, why do they want to hurt you?  What have you done?  You look around you....

By: Worried for the future