Dementia care in acute settings

24 October 2013

Article by Philippa Watkins, National Assembly for Wales Research Service

‘At any one time, a quarter of acute hospital beds are in use by people with dementia’.

The Older People’s Commissioner for Wales’ March 2011 report Dignified Care? highlighted concerns about a lack of knowledge of the needs of people with dementia, the levels of training and support available, communications, and standards of care in hospital settings.

The latest report (July 2013) of the national audit of dementia care in general hospitals has identified continuing problems in the quality of care received by people with dementia in hospitals in England and Wales. Key findings (for England and Wales) include that 41 per cent of hospitals do not include dementia awareness training in their staff induction programmes. In the 12 months prior to the audit:

  • 21 per cent of hospitals did not provide dementia awareness training to doctors or other allied healthcare professionals;
  • 11 per cent of hospitals did not provide dementia awareness training to nurses, and 10 per cent did not provide this training to healthcare assistants;
  • 40 per cent did not provide dementia awareness training to support staff in the hospital.

The Welsh Government has previously identified improved training for those delivering care as a key priority in developing and improving services for dementia sufferers in Wales. A 2011 Cabinet Statement highlighted additional funding made available to improve dementia training, and the actions taken to ensure that people with dementia are cared for with dignity and respect in all settings, and especially on hospital wards.

Commenting on the audit report, the Alzheimer’s Society said:

Hospitals are under immense public and political pressure to improve their standards, but given that people with dementia occupy a quarter of hospital beds, it is scandalous that improving dementia care is not a top priority for a number of hospital managers.

The Royal College of Nursing (RCN) agreed that more needs to be done to improve training and dementia awareness, but also emphasised the need for dementia specialist nurses. A 2013 report prepared for the RCN by the University of Southampton stated that if dementia specialist nurses were able to reduce hospital stays for older people by one day on average, an annual return on investment of 37 per cent could be achieved with a net saving of nearly £11 million nationally.

The Older People’s Commissioner’s progress report, Dignified Care: Two Years On, describes the pace of change and improvement in dementia services as too slow, and that hospital staff need to be better equipped to understand and manage dementia.