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Care of dementia patients in hospital

(10 Posts)
Nana3 Thu 29-Oct-15 22:20:56

My Dad is 89, he has advanced dementia and is in a specialist hospital. Twice now he has been transferred to the main hospital after midnight because of infections. I know they are thinking of his health but such an old, confused and frightened man being woken up and making such a traumatic journey in the middle of the night, it's unkind and even cruel. Is it because resources are less stressed at night, why do they do it? When he gets to hospital they don't have the skills to treat his mental condition and he is in a terrible distressed state when I visit him.

jogginggirl Thu 29-Oct-15 22:27:13

Nana3 - that sounds awful for your dear dad and for you sad

Can the hospital not call you and advise that this is going to happen - then at least you would have the option of being with him (if this is possible) or at the very least have someone at the hospital who can re-assure and deal with his needs.
So sorry ...

Luckygirl Thu 29-Oct-15 22:30:29

It would seem to make sense to treat his infection on the ward that he is familiar with, unless there is a danger of infection to others. Is he put in isolation when he is moved to a general hospital, or is he put on a ward? The only other justification would be if he needed intensive care not available in his specialist dementia unit.

People with dementia do get very distressed when they are moved like that. Could you discuss it with the doctor there and ask why the transfers are necessary and why he could not be treated where he is?

Do you have a Power of Attorney over his care? - that would allow you to make the decision that he should not be moved if similar circumstances arise again. You cannot organise a P of A now that he does not have mental capacity, but you may already have one.

Nana3 Fri 30-Oct-15 06:52:14

Thank you for your kind and useful replies replies.
The specialist hospital did call me at 1.30 am to tell me he had gone to the main hospital, they don't ask me if I want him to go. I'm afraid I didn't feel up to going to be with him right away. I am so tired.
I also thought the same about him being treated in the specialist mental hospital, there are staff nurses and sisters there and once I saw a doctor but they say they don't have the facilities. Maybe they don't at night.
Somehow when you get that phone call you need to trust that they know what they're doing. Questioning their decisions doesn't come easy to me but I'm going to have to try. I will certainly ask them officially if it's possible not to send him again if and when he returns there and I will have to deal with any consequences of that won't I.
I do have financial power of attorney, there are different levels, things changed in this area since my parents first organised this.
We have a meeting on Tuesday to discuss his transfer to a care home, I will have a whole different system to deal with then, if he makes it.
My mum has very recently moved into a residential care home, I could begin more issues around her and their separation, but not now.

hildajenniJ Fri 30-Oct-15 08:17:55

I trained in a mental health hospital with specialist dementia wards. As all the doctors were psychiatrists, they didn't have the training to treat physical illnesses therefore the patients had to go to the general hospital when the became physically sick. An escort usually went with them, but couldn't stay after the patient was handed over and settled, as they were needed on their own ward. It was policy to inform the next of kin straight away unless they had specified that they did not want called during the night.
It isn't any help I'm afraid, but that is the situation with mental hospitals.

hildajenniJ Fri 30-Oct-15 08:20:54

PS. The nurses and sisters are in a similar position, they do specialist mental health training, and know very little about physical illness.

M0nica Fri 30-Oct-15 08:34:20

This system is also very unfair on other patients in the ward the older person with dementia is taken to.

DD was in hospital and seriously ill and for nearly two days couldn't get any sleep because a lady had been moved to the bed opposite her in similar circumstances and in her distress and confusion was moaning and talking and calling night and day. After a few days she settled and all went well but with three other ill people in the same bay as her it did their recoveries from a range of health problems and operations no good at all.

Humbertbear Fri 30-Oct-15 09:17:37

My father had dementia and was in a nursing home. He had a minor heart attack and was sent to the local General Hospital where he suffered neglect and they failed to notice that he had a stroke while in their 'care'. On his return to the home the matron took me on one side and suggested that in future he should 'be kept comfortable' in the nursing home. I whole heartedly agreed.

M0nica Fri 30-Oct-15 09:25:09

When my DU was in care, three patients sent to the local hospital and who all stayed there for prolonged periods were sent back to the care home with scabies.

Luckygirl Fri 30-Oct-15 10:21:49

There is no difference between a sick eldery man at home being given antibiotics to the same man in a dementia ward being given his treatment. In the one case it is family around, and in the other it is mental health nurses. It really should not be necessary to transfer him unless there are particular specialist facilities needed. I used to work on a dementia unit and we always cared for people in situ when this situation arose. The doctors have a general medical training before specialising in mental health and are quite capable of supervising the administration of antibiotics either orally or intravenously.

Are you sure that your P of A does not also include decisions about his care?

It is reasonable for you to discuss your concerns about this with the doctor, and if it were me I would do so. My mother and father both received some poor quality care and all 3 of us offspring had no hesitation in talking to the staff about this.

I wish you lots of luck with your quest for a home for him. Might he go to the same one as you mother? - or does he not recognise her? At the very least it would make visiting easier form you. When finding a place for my Mum we were so appalled by some of the "specialist" dementia nursing homes that we went against the advice of the hospital and sent her to a residential home where she lived contentedly until she died.

Do not forget to ask for a "continuing care assessment" before he leaves - if he has dementia and physical problems he could qualify for continued NHS funding. We got this for my father. It was a bit of a battle but we got there. If you want to pm me about this, please feel free. There are hundreds of people who qualify for this funding but do not get it because they either do not know about it, or because the assessments are carried out wrongly.