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Dementia care in hospitals

My personal experience of dementia care in hospitals

I am passionate about the quality of care for people with dementia in acute hospitals.

From the moment I stepped into an older persons medical ward I could tell it was not the right environment for somebody with dementia. As an Occupational Therapist my previous posts included a Community Care Team and inpatient older person’s mental health wards; I also had experience as a care assistant in two dementia care homes.

The move to this setting opened my eyes and made me increasingly aware of how much change is needed in the care of people with dementia in acute hospital wards. From this role I moved to an Occupational Therapy position in an acute inpatient dementia ward. This increased my passion for working with people with dementia, but the desire to make change in the acute physical care setting was never forgotten, if anything it grew with my knowledge, skills and understanding of the complexities of care for older people with dementia.

My observations of dementia care in hospitals

Some observations of dementia care in hospitals during my time in acute medical wards:

– the noise, lighting and lack of meaningful activity leads to increased agitation and therefore labelling of “challenging behaviour”

– the lack of activity and opportunity to maintain basic skills of daily living results in de-skilling, increased dependence and therefore increased need for care during admission and on discharge.

– staff’s education and experience having been primarily focused on physical needs leaves a gaping hole in knowledge and skills for working with people with dementia. This appeared to result in negative attitudes, misunderstanding and poor management of agitation, anxiety and distress.

– the social care system is not prepared for the growth in number of people with dementia needing care following a hospital admission meaning people are left for weeks, and sometimes months, for an appropriate care home to meet their complex needs.

– lack of staffing contributed to limited provision of the assistance really required, especially at meal times, in turn contributing to the massive problem of malnutrition and dehydration.

Evidence suggests that inadequate food and fluid intake can lead to prolonged hospital stays, increased mortality rates, and many other poor clinical outcomes associated with malnutrition and dehydration. In my experience there is a continual need for, but limited access to, Speech and Language Therapy assessments and continual requests to explain why someone isn’t eating. In reality I believe there is more to somebody not eating than physiological problem of dysphagia in the pharyngeal and oesophageal stages of swallow, which leads to me to the research I currently undertaking to attain my PhD.

My research and what I am going to do to try and help

My research will initially comprise of an observational study, exploring the well-being and ill-being of patient’s with dementia during meal times in an acute hospital ward. The aim is to begin to develop a model conceptualising the limitations of food intake during episodes of eating. Following this, the aim is to begin to understand what interventions may be beneficial to improve quality of dementia care in hospitals.

You can read more about dementia care by visiting our page – https://ukcareguide.co.uk/help-advice/dementia-care – Here we provide information and guidance on people looking for support and guidance with providing dementia care.

By Naomi Gallant – @naomi_gallant

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