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.

6 thoughts on “Its the job, stupid

  1. But it is your job, you are the place where we go when we are unwell, traumatised, need surgery and whatever other reason we turn up at A&E, outpatients or inpatients. You need to know and understand our other conditions that may make it more difficult to treat why we are there today. At that moment.

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  2. I’m sorry to hear your experiences have been less than satisfactory, and agree it is important that as healthcare professionals we treat and care for the whole person.
    I’m disappointed you’ve chosen to reflect on only negative experiences – your comment that ‘the majority of clinical staff do not see that caring for dementia as part of the job’ suggests you may have encountered some who do care, even if your perception is that they are in the minority. It would be good to know what you found good about the interactions you’ve had with these healthcare workers, that way others might learn from what you say.
    I can only speak from personal experience of many years in healthcare. On-line training is not ‘a waste of time’, as any learning is useful, but should be used to supplement other forms of training. All healthcare staff have a professional duty to ensure they are competent and current in all clinical matters pertaining to their field of practice, and there are few fields where dementia care is not pertinent.
    As a nurse of many years experience, I assure you I take dementia care very seriously. When presented with a patient with care needs, however complex, I assess those needs and endeavour to offer that individual all the support they require to achieve their best potential. Patients on my ward are encouraged to get up and dressed, to sit at a table for their meals and take part in activities that stimulate their minds as well as being as physically active as they are able. We treat people as individuals and encourage social interaction. I work with many healthcare professionals who also support this way of working – and in my experience this equates to far more than 5% of the workforce.
    I appreciate there is still a long way to go, but it would be helpful if a balanced view were offered. I’m sorry you’ve had negative experiences, but if you were to share your positive ones as well this would help in driving good practice forward. Also, an entirely negative review is quite demoralising for those of us who work incredibly hard to ensure all patients receive the highest standard of care possible.

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    • Thanks for your feedback. My experience during my work and my patient experience years is that online training can pass in facts, though with fairly short term retention. Face to face Training in dementia Care is powerful, esp when you hear stories from those affected.
      While man Health staff will try to provide personalised care, many of these do not understand dementia. And medical staff make little attempt to learn about dementia and its effects.
      So, sorry, I stand by what I wrote.

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      • The term dementia ‘awareness sessions’ was put forward to me some time ago, to be used, rather than ‘dementia training’ and at the time it seemed to make little difference to me, almost splitting hairs.. However it is now very clear that while dementia awareness sesions can give many people what they believe is a fair understanding of dementia, In fact it is usually just a general outline of some aspects of the condition and this is far removed from an understanding of the day to day situation experienced by individuals affected. I don’t know what level of ‘dementia training’ is undertaken at NHS or any other level or if it is in fact more akin to dementia awareness sessions, so I’m unable to comment either in the positive or the negative. What I do now know is that there are few people more qualified to comment (or perhaps give insight and training sessions) on this, than someone who has been diagnosed and lives with any level of the disease or their family carer. These individuals are often suddenly exposed to real life changing difficulties, which they are ill equipped or ill informed to deal with. It’s a massive physical, mental and emotional challenge and can be hugely testing at many levels. The little hope that most have is dredged up from the core of their being and they take up this enormous challenge just to try to live a near normal life. We know that dementia has many aspects and it affects individuals in different ways, so I’m not sure how dementia training could adequately cover the many bases. Given the current and forecast scale of the situation, it needs some pretty high level research, funding and serious training now. Behind the diagnosis every individual has a mind and a life and deserve a better hand than is often currently dealt. The outlook for sufferers and their families seems pretty bleak and talk of care must be broardened to improvement of life qualities and expectations. Personally I take my hat off to anyone who is either a sufferer or a carer, for I know they’re trying to make the best of perhaps the most testing situation there’ll be in life. I also understand that there are professionals out there trying hard to make much needed headway ~ God speed in this!

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