Supporting people with Dementia in the General Hospital

Colin MacDonald Alzheimer Scotland Nurse Consultant NHS Lothian [email_address]

Some scary stats... ,[object Object],[object Object],[object Object],[object Object],[object Object]

Dementia in Scotland ,[object Object],[object Object],[object Object],[object Object],[object Object]

The disabling impact of Dementia..? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dementia in the general hospital ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cost of getting it wrong..... Case Scenario Mr X is an 87 year old man with mild / moderate Dementia. He stays at home with his wife, who is his main carer. Mr X is fully mobile and continent, but needs some assistance to wash, dress, and with his meals. He goes to a local lunch club twice a week to give his wife a break. No other support services are required. On 1st April he develops severe chest pain and is taken to A&E. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Scenario 1 (Sub-optimum pathway) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Scenario 2 (Optimum pathway)

So what can we do? ,[object Object],[object Object]

Dementia audit project (One year cycle from Nov 2009 – Nov 2010) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Examples of actions and support (by Alzheimer Scotland Nurse Consultant) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Examples of actions and support ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Examples of actions and support ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Good practice statement 5: Dementia friendly environment: ,[object Object],[object Object],Examples of actions and support

Audit results - Phase 1 (TRAK info) ,[object Object],Nov 2009 Nov 2010 Total number of patients with dementia 95 108 Average age 84 83 Average length of stay 30 days 17 Average ward moves per patient 2.7 1.9

Audit results - Phase 1 (discharge destination) ,[object Object],[object Object],Nov 2009 Nov 2010 Home 36% 42% Care home 10% 20% Other NHS or LTC 42% 27% % discharged to (any) LTC 52% 47%

Audit results - Phase 2 (case notes) ,[object Object],[object Object],[object Object],[object Object],[object Object],Nov 2009 Nov 2010 Psychotropic meds prescribed in hospital 24% 7% Catheter 30% 3%

Audit results - carer survey ,[object Object],[object Object],[object Object],[object Object],[object Object]

Audit results - staff survey ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Final point ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Supporting people with Dementia in the General Hospital

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Supporting people with Dementia in the General Hospital