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Dementia care in hospitals still poor

National audit finds further work needed to improve care for people with dementia in hospital
By
WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
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12th July 2013 - People with dementia are still experiencing poor quality care in hospitals in England and Wales, according to the second National Audit of Dementia, which has been published today. Although some improvements have been made since the first audit in 2011, there is a gap between written policies and actual practice and several areas have shown little progress.

Professor Peter Crome, chair of the National Audit of Dementia Steering Group, says in a news release: "It is pleasing that the second National Audit has shown improvements in the care of people with dementia including a reduction in psychotropic medication prescribing. However much still needs to be done and there remains a large gap between what hospitals say should happen and what actually does happen."

The audit looked at data collected from 210 hospitals across England and Wales, almost all of those eligible, and looked at the case notes of 7,987 patients with a diagnosis or current history of dementia.

Continued failings

The audit shows that many patients are not receiving key health assessments. While many elderly patients with dementia develop acute confusion during a stay in hospital, fewer than half of the patients in the audit sample had been assessed for delirium, and only half had received an assessment of their mental state. The audit report describes these assessment rates as “alarmingly low”.

A third of hospitals do not have guidance in place on involving the person’s carer and sharing information with them.

The audit also reveals that fewer than half of hospital executive boards are routinely involved in reviewing the quality of care received by people with dementia (although this is an improvement on previous figures) and 2 in 5 hospitals do not provide dementia awareness training to new staff.

Problems with the quality of information and communication are also an issue. The audit shows patients’ case notes often do not include information that could aid communication with them, and information important to future care is not routinely summarised at the point of discharge.

Positive improvements

The second report is not all bad news though and several aspects of care that have improved since 2011.

There has been a 10% drop in the overall number of prescriptions for antipsychotic drugs, and patients are now more likely to receive as assessment of their nutrition.

36% of hospitals now have a care pathway in place for people with dementia - up from 6% - and a further 51% have one in development.

Must try harder

Overall results show that hospitals are working to improve the quality of care that people with dementia receive but that further improvements are still required.

Norman Lamb, care and support minister says in a statement: "Whilst there are some excellent examples of dementia care in hospitals, this report highlights too many areas where care for patients has failed.

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