New strategy for better care of the dementia patient

Nurse Jeni Bell with staff at the new dementia ward at Southampton General Hospital Nurse Jeni Bell with staff at the new dementia ward at Southampton General Hospital

Southampton doctors and nurses are revolutionising the way patients with dementia are treated in hospital with the launch of a pioneering new project that aims to create a calm and comfortable time when admitted for treatment.

Southampton General Hospital has become the first in the UK to employ a hospital-based specialist nurse and have unveiled their new “dementia-friendly” ward for those suffering from memory loss when admitted with other medical conditions.

The development, led by matron Jill Young and her team in the medicine for older people unit, has been hailed a breakthrough moment for dementia patients and their families.

Everything from door colours and floor patterns, to artwork and the height of the nurses’ station have been analysed by a team of advisers, community nurses and Dementia UK to create the most suitable environment for patients, relatives and carers.

Among the innovations are brightly coloured doors to help patients remember which bay they are staying in and images such as umbrellas, lighthouses and starfish instead of bed numbers as a visual memory aid.

Doors that patients do not need to enter, such as cleaning stores and staff offices, blend in with surrounding walls, while the nurses’ station has been lowered and renamed ‘reception’ to improve accessibility andmake it more approachable for patients.

Paperwork is locked in cupboards to keep the area clutterfree and visiting restrictions have been lifted to give carers and relatives access any time day or night.

Jill said: “We know dementia patients can be extremely confused in a hospital environment, particularly when they require medical treatment, and relatives are often concerned their dementia needs are neglected in the absence of carers or family.

“That’s why we embarked on this project – it gives us a chance to show we are determined not just to improve care for these patients, but to give their families and friends the confidence that we understand the condition and can offer the right support.

“We have worked hard to focus on the small things, like colour recognition, less clutter, better communication between staff and patients, to prevent further confusing patients and to give them and their families a sense of normality.”

Until now, mental health nurses specialising in dementia care, known as admiral nurses, have formed part of community nursing teams.

In the newly-created hospital post, Jeni Bell, a former clinical lead admiral nurse in the community, will shadow clinical staff and oversee a training and development programme to look at understanding patients’ body language and handling those who do not interact verbally.

Barbara Stephens, chief executive of Dementia UK, added: “This project, particularly the introduction of the first admiral nurse specialist to be based in a large acute hospital, is a breakthrough moment in the care of dementia patients in hospital and a model of what we want – and need – to see across the country.”

Comments(7)

Scrutinizer says...
5:49pm Thu 6 Sep 12

I really do not understand why yet again there is no mention of reminiscence therapy as a quality of life-improving treatment in an article concerning dimentia and other memory-loss related illnesses. Firstly, I must state that I am not a health professional of any kind. However and nevertheless, I have seen for myself how it has been proven time and time again, that simple interaction of this nature with, say, someone in the family suffering from the effects of stroke-damage, involving stimuli such as photographs, artefacts relating to a person's family and working life period can significantly improve the quality of said person's life, even if not organically, ie. chemically so. This kind of treatment does not cost a fortune. Indeed it could be entirely voluntary-operated in hospitals and care homes. The medical profession should take reminiscence therapy as a form of treatment, much more seriously than it has been doing. It is without doubt very effective. I am, myself, intending to get seriously more involved in this, where and when possible.

wilson castaway says...
9:33pm Thu 6 Sep 12

My nan has dementia, when I visit her she is ok for the first twenty minutes, then starts to repeat herself, then the confusion as to I am begins.She has a great long term memory, she can often remember things from years ago but her short term memory is barely existant.Shes also very mischevious.Last time I visited nan, herself and her friend were sticking thier fingers up to the owner of her care home.It was so funny.She definately regressed to her teenage years.

BillyTheKid says...
11:56pm Thu 6 Sep 12

Scrutinizer wrote:
I really do not understand why yet again there is no mention of reminiscence therapy as a quality of life-improving treatment in an article concerning dimentia and other memory-loss related illnesses. Firstly, I must state that I am not a health professional of any kind. However and nevertheless, I have seen for myself how it has been proven time and time again, that simple interaction of this nature with, say, someone in the family suffering from the effects of stroke-damage, involving stimuli such as photographs, artefacts relating to a person's family and working life period can significantly improve the quality of said person's life, even if not organically, ie. chemically so. This kind of treatment does not cost a fortune. Indeed it could be entirely voluntary-operated in hospitals and care homes. The medical profession should take reminiscence therapy as a form of treatment, much more seriously than it has been doing. It is without doubt very effective. I am, myself, intending to get seriously more involved in this, where and when possible.
1 There are a large number of elderly people with dementia who are also partially sighted, so reminiscence therapy does not work for them as they cannot see the photos or objects. So how do you help these people ?

2 What do you do when your dementia patient refuses to eat, and tips the food all over their bed ?

3 What do you do when your dementia patient asks a question that is simply a string of unrelated words ?

I know what I do. Just wondered if anyone had any thoughts.

Scrutinizer says...
1:08am Fri 7 Sep 12

1 There are a large number of elderly people with dementia who are also partially sighted, so reminiscence therapy does not work for them as they cannot see the photos or objects. So how do you help these people ?

2 What do you do when your dementia patient refuses to eat, and tips the food all over their bed ?

3 What do you do when your dementia patient asks a question that is simply a string of unrelated words ?

I know what I do. Just wondered if anyone had any thoughts.

Ok, well;

1) Photo's don't need to be seen actually. But this requires some careful consideration. They can be carefully described in detail, concentrating on the context eg. people in the picture (say, family, work-friends, neighbours etc), location and event. Also, people don't neccessarily need to be able to see the objects either. Interaction involving eg. sound, and smell can work. They can be just as powerful. A man who eg. has worked with wood all his working life will never 'forget' the smell of this material. Likewise, a woman who has, say, worked with a certain type of paper in an office or foods in her kitchen. But different types of reminiscent therapies to suit different needs.

2) I'm obviously not suggesting all sufferers of dementia-related illnesses are going to gain improvement of quality of life through reminiscence techniques. The extreme cases, sadly, may well be completely beyond this form of stimulation.

3) Ditto my answer in 3).

But what I am saying, and fervently believe, because I've actually observed the benefits of reminiscence therapy, is that it works and can do so for many people, if only in a limited way, certainly in the early stages of dementia. But like anything it is limited, and no doubt it's use can not hope to match any (successful) drug-related treatment.

heleneb says...
9:35pm Fri 7 Sep 12

I have worked closely with dementia patients on a one to one basis for over 10 years , as an activiy co-ordinator and a dementia therapist... it is about time that hospitals recognize the importance of the clinical environment when treating patients of this nature .....good on ya Southampton...my daughter is one of your invaluable team

BillyTheKid says...
11:59pm Fri 7 Sep 12

heleneb wrote:
I have worked closely with dementia patients on a one to one basis for over 10 years , as an activiy co-ordinator and a dementia therapist... it is about time that hospitals recognize the importance of the clinical environment when treating patients of this nature .....good on ya Southampton...my daughter is one of your invaluable team
Have you lived with someone with dementia ? My father was singing the same tune over and over again for hours each day over several weeks. Now he just repeats the last half dozen or so notes over and over. I can ignore it to some extent, but it does get me down if we're having a bad day. Do you have any advice on that - I'd be really grateful.

Scrutinizer says...
8:21am Sat 8 Sep 12

heleneb wrote:
I have worked closely with dementia patients on a one to one basis for over 10 years , as an activiy co-ordinator and a dementia therapist... it is about time that hospitals recognize the importance of the clinical environment when treating patients of this nature .....good on ya Southampton...my daughter is one of your invaluable team
heleneb,

Hi,

Given your many years of work with dementia patients, I'd be interested to know what your own thoughts are regarding reminiscence therapy. Does your "activity" work include this kind of therapy in any way?

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