The National Audit of Dementia, commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) found hospitals have made important changes to improve dementia care, but staff say more support is needed.
Hospitals in England and Wales have made many positive changes aimed at making hospitals more “dementia-friendly”, the audit shows. Overall nearly 70% of carers rated care as excellent or very good, and 75% said that the person with dementia was definitely treated with respect by staff.
Many more hospitals are providing dementia awareness training to all groups of staff, and 96% have a training framework for dementia care, up from 23% in the first round of audit in 2011. Nearly all hospitals (94%), have created dementia “champions” to lead change and support staff, following former recommendations. Staff however said they could not always access specialist support, especially out of hours.
19% of staff surveyed said that patients with dementia had nutritional needs met only some of the time, and five percent said their needs were not met. Three quarters of staff (73%) said they could obtain food 24/7 for their patients. Food outside of regular mealtimes is necessary for people with dementia as many patients forget to eat or only eat little and often, because dementia has disrupted their sense of routine.
The audit reviewed case notes of 10,047 patients with a diagnosis or current history of dementia and questionnaires from 14,416 staff and 4664 carers from 199 hospitals across England and Wales. The audit is managed by the Royal College of Psychiatrists in partnership with organisations representing healthcare professionals, people with dementia and carers, including Alzheimer’s Society.
At least a quarter of hospital beds are occupied by people with dementia and an estimated £264 million of public money is being wasted on poor dementia care. An Alzheimer’s Society Fix Dementia Care investigation previously uncovered unacceptable national variation in the quality of hospital care across England.
Jeremy Hughes, Chief Executive of Alzheimer’s Society, said “The spread of dementia training frameworks and the introduction of dementia champions in hospitals are encouraging first steps in addressing the challenges of good dementia care for all hospital patients. But this audit also reveals how much still needs to be done, even in such basic areas of nutrition and hydration for the quarter of all patients who have dementia.
“Our Fix Dementia Care campaign revealed the quality of hospital care for people with dementia can be extremely variable. Many end up falling while in hospital, being discharged at night or being marooned in hospital despite their medical treatment having finished. In the worst cases people with dementia are staying in hospital seven times longer than other patients over the age of 65.
“The recommendations suggested in this report absolutely must be taken forward, and all hospitals should continue to be working on the quality of care they offer people with dementia.”