Its the job, stupid

Does dementia matter?

I am increasingly annoyed about why the majority of clinical staff do not see that caring for dementia is part of the job.

It’s as if… no, it really is that they are trained and developed during their working lives to do the traditional physical clinical work. To deal with the diseases and trauma they see every day.

So, pneumonia, cancer, prostatitis, back pain, arthritis, and everything else…these are what nurses, therapists and doctors do. They diagnose, treat, discharge.

And they’re really good at this. They’re professionals.

And they know and recognise that many patients have more than one condition. Multiple co-morbidities.

So for example, they’ll check blood pressure, diabetes, heart disease, and make sure the interdependencies and drug effects don’t conflict.

They’ll check that my eGFR is high enough to allow me to have an angina drug which might damage my kidney.

But it seems that the brain disease that causes dementia symptoms is not recognised as something they should know about and be able to react to and treat appropriately?

25% of inpatients live with dementia. But (I guess that) no more than 5% of staff really know how to provide appropriate care and conditions for them.

Oh I know that induction programmes for new staff will include half an hour on dementia, perhaps a short guide to the Butterfly Scheme.

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And there’ll be an e-learning module somewhere…which is a complete waste of time. No, it is counter productive, because it will certify that the staff member has done dementia training that year.

My acute trust says that over half their 5,000+ staff have had dementia training. Hmm.

Inpatients living with dementia stay in hospital for some 30% longer than others. They more often are discharged into a care home, because they have been disabled and infantilised by their stay in a ward, and because their capacity to adapt to living in a hospital is severely reduced, which impacts their recovery. And then discharge teams won’t take the “risk” of returning them to their homes.

The cost is staggering. The insult to those patients is appalling.

If all clinical staff were really properly trained, and if they all addressed patients’ needs related to brain disease, as well as their other conditions, there would be shorter stays, better health outcomes, and reduced social care costs. Not to mention improved quality of life for the patients.

But no, dementia is not what we do. We do diseases. We do traumas. Injuries.

Well… get real.

Dementia results from brain disease. Physical brain disease.

And it’s your job!

It’s not an add-on.

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It’s not an option, which can be ignored when times are difficult.

You can’t pick and choose.

Caring for someone, healing someone, is about the person.

You can’t cure the brain disease that causes dementia symptoms. Bu you can make sure you provide care in the right way for that person, and not in a single standardised way, the same for everyone, and good for no one.

If you ignored co-morbidities when treating a condition and your treatment killed a patient you’d be struck off.

So don’t ignore the brain disease.

It’s the job, stupid.