Dementia patients in hospital
15-March-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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Better to die demented than to be aware of one's condition like a condemned criminal.
*The NHS Mortuary  21-Jun-2009 08:58

 
I'm a Support Worker. I've watched 2 of my workfriends dismissed by a complaints board after cases like this.

Unfortunately, relatives blame the ward staff directly for the care (or lack of), ignore the ward staffs reasoning that for 12 all care patients that all want something near enough at the same time, there are 2 staff. One nurse sorting out medication and the paperwork side of things and the general support worker (HCA), running backwards and forwards all day being moaned at, threatened and treated like a monster by relatives that refuse to listen to them or their reasoning about how complaints about low staffing levels are more usefull than complaining about the staff.

I work on essentially, a High Dependancy step down Unit for Gastroenterology, bowel surgery and alike. Encountering patients with mental illnesses that are just dumped on an inappropriate ward like ours and already extremely understaffed. Patients with dementia and other illnesses really need one to one or one to 2 care plans, not 1 to 12.

With all these budget cuts and ward funding cut down, I usually end up dreading my 3x12hrs shifts per week, when only a few years ago, I loved it. Now I end up with relatives nagging, creating a tense atmosphere, complaining and making snide comments about how "useless" we are.

Piss off and go to a private sodding hospital. Also, if you think you could do a better job after years of being ground down, accused of doing nothing, being put on the spot by management because of narrowminded relatives and taking on the workload we HAVE to, then ****** well do it!

Otherwise, leave hard working people like me, alone!

Please understand this the next time you try to accuse a staff member as opposed to the hospital management.
*Unsung hero  21-Jun-2009 00:31

 
Sad Son, unfortunately most care homes are run as a bussiness to make money, how do you make more profit? Cut costs, how do you cut costs? Less trained staff or just less staff all together, and pay them a pittance, poor facillities to provide care etc. I bet your mum pays a fortune for her 'care' too, it's an all too common story, the owners cut costs to the nth degree, the staff run around like headless chickens or are so poorly trained they don't actually know what to do and the people who are paying for all this, the elderly and vulnerable members of society, suffer. Not on, it's so not on.
*KT  08-Jun-2009 22:08

 
My mother suffers from dementia and I am sickened by the care she received both from the carehome, who though really nice to her basically just leave her and others to rot. Personally
I would rather just die than go through what she has to go through
*SAD SON  08-Jun-2009 21:09

 
http://www.number10.gov.uk/Page19506 read this statement from Alan Johnson, Secretary for health regarding an e petition that has been submitted requesting specialist dementia nurses.
*Anon  05-Jun-2009 16:03

 
My father passed away in March this year at the age of 88 having suffered vascular dementia, heart failure, hypothyroidism and low temperature. He was admitted to hospital on 2nd January where he spent 2 weeks on a general ward in a confused and neglected state. Because he didn't understand where he was and why, he became delusional thinking that the nurses were trying to poison him and began refusing all medication that he needed. He was not helped to wash, toilet, feed or drink and was often left sitting or lying in his own urine. I feel very angry that an intelligent man who, through no fault of his own was suffering with this terrible condition, should be treated in this abominable way. I am currently in the middle of a complaint procedure with the hospital concerned, trying to fight the cause of these poor elderly people, our mums, dads, aunts, uncles, brothers and sisters, and make the nursing staff realise that it is not acceptable to treat anyone in this way. I urge people to speak out if they have experienced anything similar because one day it could be you in that hospital bed.
*J9  03-Jun-2009 19:58

 
It's true that all this is happening (I did a lot of research for a book published last year on dementia) but I think it's very important that people speak out about it. Don't just accept it as inevitable. Who said, 'evil flourishes when good men say nothing?'
*Louise Morse  03-Jun-2009 10:14

 
Once again, the care of people is put second best to money. I can really understand that nurses/doctors have absolutely impossible targets to meet with practically no budget. It's very sad that everything boils down to money, or more specifically, the people who hold the purses have no idea how a real A and E or ward works, and expect the impossible. Most dementia patients or those with a mental illness are too confused and distressed by the actual event to think of complaining. The people on the front line, nurses, doctors, HCA's, porters etc actually do the job (for a pittance most of the time) and the people in the ivory towers squeeze more and more out of them to cut costs, which in turn makes them look good and recieve a bigger bonus. How fair is that?
*KT  02-Jun-2009 21:05

 
I agree also, working in the NHS myself you need to give people a little more time to overcome fears and anxities. You can not treat anyone without a good medical history/understanding.

However TIME is the biggest factor effecting this type of patient and the NHS does NOT have the time to be as lots of professionals say "faffing".
With the money situation as it is and the lack of understanding by the fat cats sat doing nothing, worried that their massive annual salary for doing sweet FA is going to stop. They put more pressure upon the workers like myself. I have to see 12 patients in a morning and afternoon session and also I over book my clinics 3 or 4 times just to keep up the service.

I do get frustrated with MHC patients but I just take a big breathe and say to myself its not their fault.....so why cant others do that also?

My parents always said "there is always time for manors!"
*NHS worker  02-Jun-2009 11:11

 
Agree wholeheartedly with everything you've written. Mental health care in this country is generally disgraceful. My partner was diagnosed schizophrenic some years ago (although I believe he actually has schizo-affective disorder). We recently moved and had to change GP. I have tried explaining until I am blue in the fact that he needs to be able to see the same person each time he goes, but they just tell me they don't assign GP's to individuals. So each time he goes he sees someone new, who has no idea of his background and no knowledge of his condition. Once he fell asleep and missed an appointment (meds are strong and this can happen) and they told me if he misses one more appointment he'll be taken off the books!!! There is absolutely NO consideration for his condition. If he is nervous or anxious he is treated as "awkward". Even the mental health centre treats patients as an inconvenience and don't even get me started on the attitude of the receptionist!!

I am seriously considering looking for training myself so I can work in this area. A little empathy goes a long way in this area and I honestly think I could do a better job untrained than half these so-called professionals.
*HelzBellz  02-Jun-2009 08:30


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