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Poor treatment of 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 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.

dementia patients are sidelined and do not receive the treatment they need

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.

Hospital ambulance 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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hairyfairy

hairyfairy

when it comes to the treatment of mental health, this country is still in the dark ages. Most mental health nurses don`t care about their patients, they just want their pay packet & a quiet life, so they keep the patients doped up so they don`t have to deal with them. It`s the same across the board, not just dementia patients, but anyone with a mental health issue will be given the liquid cosh to keep them passive & quiet.
hairyfairy
10th Apr 14 21:25

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ladylouise62

ladylouise62

A good gripe. My aunt developed dementia a couple of years ago and was permanently distressed, not even realising that she had just eaten. You could really feel her fear, and that was amongst people she vaguely recognised.
It involved a lot of work and patience to deal with her, and the normal 'conveyor-belt' ways of hospitals are not at all suitable for this type of patient.
To be fair, they are very much judged on speed of throughput, so I can imagine how much of an issue the inherent delays of a dementia patient must be for them. We need a new (or should I say 'the old') way of working.
ladylouise62
6th Jan 11 12:30

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Rock climbing hero

Rock climbing hero

Excellent article and very sympathetic to the understanding of how vulnerable people feel.
Thank you for bringing to our attention.
We need to take more action and help people who ARE treated so badly. I have seen it.
Rock climbing hero
13th Sep 10 23:27

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Rock climbing hero

Rock climbing hero

Agreed that staff are poorly trained and actually very ignorant on understanding people with Dementia. More research needs to be done to find out the causes of Dementia. Unfortunately, patients are treated like idiots and put in archaic mental institute with 'caretakers' ,who have no medical training , put in charge of patients.
They are dosed up to the eyeballs, experimented with different powerful psychotic drugs much to the amusement to staff and bewilderment to the family who visit.
Shame on Britain for treating our citizens so badly. This has gone on for too long.
Rock climbing hero
13th Sep 10 23:23

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MikeP

MikeP

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
4th Aug 10 07:05

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Sally

Sally

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
4th Aug 10 02:38

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AS

AS

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
3rd Aug 10 21:13

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pete

pete

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
3rd Aug 10 18:27

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MikeP

MikeP

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
3rd Aug 10 17:19

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pete

pete

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
3rd Aug 10 16:53

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MikeP

MikeP

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
3rd Aug 10 16:29

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pete

pete

"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
3rd Aug 10 15:26

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MikeP

MikeP

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
3rd Aug 10 15:11

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pete

pete

"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."

Which studies have shown this? Got a journal or paper reference for that...or is that one of your usual "MikeP's World View is the only view" comments.
pete
3rd Aug 10 14:53

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MikeP

MikeP

" Dementia is directly related to education. The more years of formal education you have from childhood, the less likely it will be that you will suffer dementia. So, if you have dementia in your family, be sure your kids go to university and post-graduate study for their own health as well as well-being.
*Moira 03-Aug-2010 06:36"

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.
MikeP
3rd Aug 10 08:34

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