Dementia Guidelines

2

Mental Capacity

Capacity should be judged in relation to a specific decision; some decisions are easier to make than others.
4

Delerium Screening

Delirium is characterised by altered consciousness and cognitive decline, and has a rapid onset and any acute illness can precipitate delirium...
5

Use of Purple Folder

If on admission to the ward, the patient has a diagnosis of dementia, the purple folder (dementia toolkit) should be used to house the...
6

Johns Campaign

Relatives may have precious information on what actions/responses are likely to make a person feel more distressed...
8

One to One Nursing

First and foremost, it should be recognised that all behaviour has a meaning and often the behaviour can be interpreted ...
9

Nutrition

People with dementia can experience particular problems in maintaining adequate hydration and nutrition...
10

Elimination

The Traffic Light section of the Purple Toolkit should be completed in relation to elimination to advise staff of the patient's toileting requirements...
11

The Role of OPALS

The Older Person's Assessment and Liaison Service (OPALS) includes 2 nurses, 1 Occupational Therapist, 1 Physiotherapist, 1 Social Worker...
13

Physiotheraphy

Physiotherapists can undertake individually tailored assessments of the impairments, activity restrictions...
17

Medications

Within 24 hours of admission or sooner if clinically necessary, patients should have their medicines reconciled in accordance with the Trust policy...

About these Guidelines

Introduction

The term 'dementia' is used to describe a syndrome which may be caused by a number of illnesses in which there is progressive decline in multiple areas of function, including memory, reasoning, communication skills and the ability to carry out daily activities (Wilson et al, 2011). Alongside this decline, individuals may develop behavioural and psychological symptoms such as depression, psychosis or aggression which can complicate care and which can occur at any stage of the illness (Department of Health, 2009).

Background

Up to 70% of acute hospital beds are occupied by older people, approximately 40% of whom have dementia (Alzheimer's Society, 2009). Dementia may not be the primary reason for admission, however, patients who do have dementia experience more complications such as pressure sores, falls and incontinence (RCN, 2013). Studies also show that the average length of stay of a person with dementia in an acute hospital is longer for someone without the condition (Johnston et al, 2011). Overall, people with dementia stay on average 25% longer, and in some cases 85% longer than those without dementia (CHKS, 2012).

In acute wards, the main emphasis of care is generally focused on the presenting condition, for example, a fracture following a fall. Staff treating these patients have the knowledge, skills and expertise to treat the patient in their respective speciality but the underlying diagnosis of dementia is often overlooked. Issues relating to communication, nutrition and management of pain have been identified as priority areas for improvement on hospital wards when caring for a patient in the acute setting (Alzheimer's Society, 2009).

The Purpose

The purpose of these guidelines is to ensure that the Trust meets strategic and clinical best practise standards in delivering dementia care within the acute hospital settings.

Objectives

  • Ensure that all practices associated with the management of patients with a diagnosis of dementia within the acute hospital setting are based on the current evidence.
  • Standardised practice management of patients with a diagnosis of dementia within the acute hospitals across the trust to ensure a consistent approach for staff and families.
  • Standardised practice management of patients with a diagnosis of dementia within the acute hospitals across the trust to ensure a consistent approach for staff and families.