Dementia patients in hospital
02-September-2010
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Dementia patients in hospital

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I have been truly sickened today by the total lack of understanding from trained medical staff towards dementiapatients 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.

Hospital ambulance

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


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Goodbye Pete.

Next time try to submit some reasoned arguments of your own rather than disjointed quotes from articles you've dug up. And if you're going to quote me, please do so correctly.

Full marks for trying, less for content, but I expect teacher would be proud of you.

I don't need your agreement, or anyone else's.
*MikeP  04-Aug-2010 07:05

 
Keeping mentally active does help a little to stave off dementia but not a lot.

Research now seems to indicate that keeping physically active is more important as lack of exercise results in poor circulation to the brain.

No doubt , being lucky enough to have the right genes will also prove to be a big factor.
*Sally  04-Aug-2010 02:38

 
My view on this is... being a heavy smoker doesn't mean that you will definatly get lung cancer, but it will increase your chances, being a non smoker doesn't mean that you will not get lung cancer, but the chances of getting it will be minimalised,

Also eating mountains of food daily, doesn't mean you will get fat, but it will be more likely that you will, (i'm sure we all know someone who seems to eat loads and loads and stay skinny) and there will be those who hardly eat at all, struggling like hell to keep their weight in check,

With dementia I think similar rules may apply, if you are a complete thicko, I think your chances of getting dementia are greatly increased, and if you are a clever intellectual, then your chances are lessened, just my views folks, and not scientific fact.
*Gainsborough lad.  03-Aug-2010 23:00

 
Far be it from me to jump into the middle of an established argument but in my experience (and that's just mine) dementia is totally random, it affects EVERYONE and ANYONE without any rhyme or reason. I am a dementia nurse in an elderly care unit and I support patients through diagnosis, treatment and ongoing care. There are certain factors that can increase a risk but on the whole it's random. This month I have seen a chemistry professor, a trained nurse, a teacher, a manual worker, a housewife and a disabled person who hasn't been able to work since an accident in his early 20s, all have been diagnosed with dementia and are undergoing treatment.
*AS  03-Aug-2010 21:13

 
MikeP, let's review:

Contributor states that dementia is "directly related to education".

MikeP in an attempt to reason says, "That's drivel. Lot's of educated people get dementia." Cites copious (non-theoretical?) unspecified research to support this.

Pete cites credible news agencies (BBC and Reuters) reporting on the results of a very large scale study of the condition by a team of UK and Finnish scientists which link it directly by onset and effect to education.

MikeP is still satisfied with his, "Drivel" comment. Why? Because MikeP said it.

Goodbye, MikeP.
*pete  03-Aug-2010 18:27

 
Pete : The flow goes spectacularly against my position when you choose to support yours with isolated quotes from articles. Do some serious research and then come back to me with support for your argument. I'm confident in mine.
*MikeP  03-Aug-2010 17:19

 
Of course you say they are "only theories" when the flow goes so spectacularly against your position. But is your, "Utter drivel. In fact some of the most highly intelligent and educated people suffer from dementia and a lot of studies have shown this to be the case." (wholly without any supporting literature) ennobled by its author's (MikeP's) credibility? Is it thus permissible and valid? You reread the article. I put it to you that the drivel is yours, and as usual, it is yours alone.

Like I said, no educated readers are taken in by you.
*pete  03-Aug-2010 16:53

 
Pete : May I suggest that you read the articles properly and fully rather than picking out and quoting only the parts which support your argument. I could also find parts which satisfactorily support my argument. The reality is that nobody knows, and these are only theories.
*MikeP  03-Aug-2010 16:29

 
MikeP said, "The primary contention of the article is that better educated people are better able to cope with the effects of dementia, not that they are necessarily less likely to develop it."

The article said:
"It also found that for every extra year of education there was an 11 percent decrease in the risk of developing dementia."

But if anyone is interested in MikeP's credibility, read the "drivel" article for yourself.

and this one:

http://www.bbc.co.uk/news/health-10741274

Of course, it's all just rubbish made up for the press according to MikeP. But it sounds like he wasn't in school long enough to gain the positive effects.
*pete  03-Aug-2010 15:38

 
"I daresay that I could find an article 'proving' that the earth is flat if I tried hard enough."

You wouldn't find anything because you never look or read. You just write whatever comes into your mind and you try to authenticate it with vague claims about "studies" which support your nonsense of the day.

You aren't fooling any of the educated readers here.
*pete  03-Aug-2010 15:26

 
Not at all. The primary contention of the article is that better educated people are better able to cope with the effects of dementia, not that they are necessarily less likely to develop it. Education and continued mental acitvity may delay the onset of dementia but this is no more than a theory and studies are incomplete.

It may not be education per se which reduces the effects of dementia, but the fact that better edcuated people they are more likely to have the resources to cope and to have better treatment.

Early onset dementia is often caused, or exacerbated, by poor nutrition, insufficent exercise, and lower living standards, factors which are less likely to affect the better educated. Uneducated people are likely to vegetate in front of moronic daytime TV programmes, which is enough to send anyone over the edge, whereas better educated people will indulge in pastimes which require some brain cell activity.

This may be a little hard for you to understand, Pete, but rather than interpreting the article that you found in order to suit your own belief, try reading it and understanding it.

You might also wish to bear in mind that on the internet you can find something to prove, or disprove, just about any theory. I daresay that I could find an article 'proving' that the earth is flat if I tried hard enough.
*MikeP  03-Aug-2010 15:11

 
Well, just one simple Google and MikeP is driveled spectacularly:


http://www.reuters.com/article/idUSTRE66P2EJ20100726
*pete  03-Aug-2010 14:58


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