Alarm at levels of dementia awareness in Irish hospitals
Specialists call for dementia programmes for hospital staff, training for GPs and for increased public awareness
Dementia patients require extra care and may have hearing and other complications. Photograph: Thinkstock
One of the most striking findings from the National Audit of Dementia Care in Acute Hospitals 2014 report was that only 6 per cent of hospitals include dementia-awareness on their staff induction programmes, and none of the 35 Irish hospitals in the study has compulsory dementia-awareness education for staff.
“It has to become mandatory training,” says Dr Sean Kennelly, a geriatrician at Tallaght hospital in Dublin. “If you don’t get the first step – identifying a very vulnerable person who is likely to run into problems during their hospital stay at the front door of the hospital – then it’s likely nothing else is going to happen to assist their care.
“Let’s say you take two older people who come into hospital with a chest infection; one with dementia, one without dementia. If you take all the other factors out of it, the fact that you have dementia probably means you’re going to be a minimum of four more days in hospital.
“When you consider that chest infections – along with chest pains – are our most common causes of medical admission, that is a huge number of extra bed days. The reason is that it is often not identified that a person has dementia until they are discharged.”
Screening standardsKennelly advocates training across the hospital environment, including doctors, nurses, healthcare assistants, X-ray staff, and the porters who ferry patients between departments.
He also notes that two or three hospitals in the State have implemented standard screening of all older patients with memory tests when they’re coming into emergency departments. This can be particularly disorientating for people with dementia, as often the patients will have no family present, they might have poor hearing, and staff might not have their medical history to hand.
“A lot of the time, the patient might [experience] paranoia. For older people who would get acutely confused – who might have been removed from their home, who could be sick with an infection – they may perceive they’re not in a hospital, they’ve been brought to a police station or that somebody is conspiring against them. They may feel their son or daughter, or whoever, is trying to harm them. They misinterpret a huge amount of action.
“By our nature in hospitals, we’re very comfortable dealing with the biology, with heart rates, with a person who has an infection. We delve straight into that. Often, we forget to talk to somebody who is confused and who doesn’t understand why somebody is coming out of leftfield and sticking them with a needle.”
There are about 48,000 people living with dementia in Ireland, according to the Alzheimer Society of Ireland. The majority of them – about 63 per cent – live at home, which means they’re being cared for by family members, many of whom might have given up their jobs.