What are we going to do about wards filled with people living with dementia?
We’ve all know about the estimate that 25% of inpatients have a diagnosis of dementia.
We know that inpatients with dementia (not primary cause) stay in hospital three times longer than others.
We know that people living with dementia are often confused, disorientated and agitated by the unfamiliar and busy hospital environment.
We know that patients living with dementia need a lot more time, patience, explanation and reassurance about even routine treatments so they are not frightened.
We know that nursing and other staff are working under immense pressure, coping with ever increasing inpatient admissions.
That’s what we know.
I visited a respiratory ward the other day. Well over half the patients had a dementia diagnosis. On at least one bay they all did.
How should we deal with this?
If some wards are going to house more than average numbers of patients with dementia, let’s make those wards really dementia friendly.
Change the lighting. Put in orientation clocks in every bay, with the name of the hospital. Purchase bedside tables that are big enough for personal possessions and photographs.
Use patients’ favourite mugs. Have a nurse stationed in each bay. Write the staff names up large inside the bay.
Have a communal dining table/area and get folks out of bed. Have tea and cakes together.
Provide a homely area with reminiscence and other activities. Sing for the brain on the wards. They’ll love it.
Put up huge posters with local features on walls, to stimulate thoughts and talks.
Paint the walls different warm colours in each bay.
Have large, contrasty pictograms signage in the right places for patients to see. Paint non patient doors the same as walls.
Put in handrails along the whole ward to help mobility and independence.
Don’t move patients with dementia at night, or at all. Unless absolutely medically necessary.
Train all staff, all doctors, all volunteers so they really understand the social aspects of dementia, behaviours, causes of confusion and agitation, and how to provide the right care for these people.
I mean all staff to include housekeepers, porters, beds managers, administrative managers, premises staff, finance director…everyone must understand how they contribute, and how their decisions and actions affect patients living with dementia.
Provide sufficient and appropriate staff on these wards for the patients in them. In other words, flex with the changing needs of patients.
Provide specially trained dementia workers who work with staff and patients as and when and where needed.
Some of this costs money. Yes.
So do hospital stays of ten or more days beyond medical necessity.
So spend to care and spend to save.
Do the sums, the cost benefit analysis.
Remind yourself why you are paid, who by, who you work for.
It’s us. You work for us.
And it really is that simple.
Don’t make it difficult.
Just do it.