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Dementia care needs 'significant improvement'

The National Audit of Dementia has found that a "significant improvement" is needed in the way hospitals deliver care to people with dementia.

16 December 2011

The National Audit of Dementia, which covers England and Wales, has found that a "significant improvement" is needed in the way hospitals deliver care to people with dementia stating that interaction between care givers and patients "is mainly task-related and delivered in a largely impersonal manner" while the hospital environment is "often impersonal".

The report will put further pressure on the Government who recently announced that that parts of the planned reform of the care system for elderly and disabled people may not come into effect until 2025.

The report, the first of its kind, was conducted by the Royal College of Psychiatrists' who audited 210 hospitals. It found that hospital policies are often in place but these are not always followed and simple steps such as greeting or talking to patients during care, explaining what they were doing or offering choice, are not taken despite them being able to lessen the distress to patients, most of whom are elderly.

NHS guidance says the use of antipsychotics to control symptoms such as agitation, distress or aggression should be a last resort, however, many hospitals still use them.

The audit found 28% of people with dementia received antipsychotic medication in the hospital, of which 12% were newly-prescribed the drugs while in there.

The reasons for these prescriptions were not recorded in 18% of these cases, while less than half of staff felt properly trained in dealing with challenging behaviour.

59% of wards said personal items such as family photographs or cards were not put where dementia patients could see them for reassurance. Only 26% of casenotes showed an assessment of functioning such as basic activities of daily living, activity/exercise status, gait and balance, despite it being included in 84% of hospital procedures.

The report recommends basic dementia training for all staff, with some ward staff receiving higher-level training. A senior clinical lead for dementia should also be in place in each hospital, with dementia champions in each department and at ward level.

Royal College of Nursing (RCN) chief executive, Dr Peter Carter said: "It is extremely worrying that two thirds of staff found that their training and development was not sufficient.

"It is essential that all staff are supported through training, education and leadership so that they are able to provide skilled, knowledgeable care to people with dementia.

Emma Jones from the Human Rights team at Leigh Day & Co said: “I wish I could say that this report comes as a shock but anyone who works regularly with victims of elder abuse knows that the treatment of the elderly has become much more automated and routine and less to do with care and personal attention.”

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