‘Disgraceful’ care leaves dementia patients in worse condition

Patients with dementia are staying too long in hospital and receiving “disgraceful” care that worsens their condition, campaigners said.

Over-65s who suffer from Alzheimer’s Disease or other forms of dementia are estimated to occupy up to a quarter of all NHS hospital beds.

But those admitted to hospital after suffering a fall, infection or stroke stay significantly longer than other patients, and are often discharged in a worse state than when they went in, the Alzheimer’s Society found.

The charity’s Counting the Cost report, just published, found that the specific needs of people with dementia are often overlooked and many end up malnourished, dehydrated or unable to return to their own homes after a hospital stay.

The Society calls on the NHS to cut the average hospital stay for dementia patients by at least a week, which it said could save the health service at least £80million a year.

The report involved surveys of more than 2,400 NHS staff and carers from England, Wales and Northern Ireland, which found that while a patient without dementia can expect to stay in hospital for a week on average, people with dementia stay far longer.

Almost half (47 per cent) of carers questioned said being in hospital had a “significant negative effect on the general physical health of the person with dementia that was not a direct result of the medical condition”.

Complaints included patients being confined to bed and not being allowed to walk, weight loss, dehydration, pressure sores and incontinence.

People with dementia generally became more confused, agitated and less independent after a hospital stay, the report adds.

It found that 60 per cent of people entered hospital from their own home but only 36 per cent were able to return home upon discharge.

“The likelihood of entering a care home after a stay in hospital is very high”, the study said.

Patients with no dementia symptoms stayed in hospital for an average of six to seven days following common operations or treatment.

But out of the number of patients with dementia who were admitted to hospital with a broken or fractured hip, or needing a hip replacement, 57 per cent stayed two weeks or more, and 34 per cent stayed for a month or month.

Meanwhile, 53 per cent of dementia patients admitted with a urinary tract infection stayed two weeks or more. Almost a third (30 per cent) of those with the infection stayed a month or more.

Some 700,000 people in the UK have dementia but the number is growing as people live longer. The report comes after the Government promised to reduce the inappropriate prescribing of strong sedative drugs to dementia patients, which are estimated to cause 1,800 premature deaths a year.

The Alzheimer’s Society said that despite the extra time spent in NHS care, flaws with basic nursing or use of anti-psychotic drugs meant that many dementia patients experienced a decline in their condition, rather than an improvement.

Andrew Chidgey, head of policy and public affairs at the charity, said: “Typically what we see is that people are deteriorating while in hospital because they are becoming more confused, disorientated, distressed and in some cases agitated.

“This means they are becoming dehydrated, malnourished, their dementia is becoming worse and they are taking far longer to recover from whatever they went into hospital for.”

Neil Hunt, chief executive of the Alzheimer’s Society, added: “It really is a disgraceful situation.

“The NHS is not facing up to the scale of this challenge and not equipping its staff properly for the scale of the problem ahead.

“There’s a need to improve the care for patients with dementia. We are not trying to blame anybody or point fingers at individuals in the health service but trying to improve the system and the standard of care people receive.”

Katherine Murphy, director of the Patients’ Association, said the report “confirms our fears that there is a widespread and disturbing failure in the hospital care of elderly patients.”

“The findings in this report are scandalous. Not enough help with eating, drinking, personal hygiene [or] continence… Carers have to watch as their loved one deteriorates on busy wards in hospitals obsessed with waiting times targets.”

Peter Carter, Chief Executive and General Secretary of the Royal College of Nursing (RCN), said: “For the majority of patients with dementia to leave hospital in a worse condition than when they arrived is simply unacceptable. It is vital that the government invests in better dementia training for all healthcare staff to ensure these patients receive good quality care.”

A National Dementia Strategy was published earlier this year, but Phil Hope, the Care Services Minister, said: “This report is a reminder of the scale of work that still needs to be done”.

“We have set priority areas for all hospitals to take urgent action, including appointing a senior member of staff to improve quality of care for people with dementia, proper training for all staff, and specialist older people’s mental health teams working in hospitals.”

“We expect to see urgent improvements continue, so people with dementia and their carers get the best care the NHS has to offer no matter where they are or what treatment they need.”