Dementia patients 'failed by hospitals'

16th December 2011 - Hospitals in England and Wales need to make improvements in care for patients with dementia, according to an audit.

The review by the Royal College of Psychiatrists highlights a series of failings and makes a number of recommendations for how the situation could be improved.

Patients with dementia who are admitted to hospital tend to fare worse than other patients, which is reflected in a prolonged length of stay, higher death rates and deterioration in health.

Dementia and geriatric campaigners say the report underlines the need for change.

Distress

The audit, commissioned by the Healthcare Quality Improvement Partnership, examined the standard of care in 210 hospitals. It found that while patients' safety was adequate on the majority of wards, there was scope for "significant" improvements that could lessen the distress caused to dementia patients faced by an unfamiliar and confusing hospital environment.

A major failing was a lack of staff training, the report concludes. Less than a third said they had been taught sufficient skills for dealing with patients with dementia. It says this often leads to healthcare being delivered in an impersonal manner by staff who did not fully understand the needs of patients.

Hospital environments

The environment of hospital wards was also highlighted. Very few wards were 'person-centred', and most had signs that would be confusing to a person with dementia, while personal items like photographs and cards were frequently out of sight or out of reach.

The audit drew on more than 2,200 questionnaires completed by hospital staff and 105 observations of how dementia patients were being cared for.

Among the report's key findings are:

• Only 6% of hospitals had a care strategy in place designed around the needs of dementia patients, although 44% had one in development at the time of the audit
• Only 32% of staff said they thought that their training in dementia care was sufficient
• Half of staff felt they had not received sufficient training in communication skills specific to people with dementia, and 54% felt they had not received sufficient training in dealing with challenging or aggressive behaviour
• Very few wards demonstrated a culture which was 'person-centred', defined as one which treats the person with dementia as an individual and takes their perspective into account in a supportive environment
• In most wards (59%), personal items, such as family photos or cards, were not situated where the patient could see them for reassurance
• Only 15% of wards used colour schemes to help patients with dementia find their way around the ward, while only 38% of wards had signs that were large, bold and distinctive

One of the report's authors, Professor Peter Crome, Chair of the National Audit of Dementia Steering Group, said in a statement: "This report provides further concrete evidence that the care of patients with dementia in hospital is in need of a radical shake-up."