Dementia patients will be at the heart of this year’s drive to improve the quality of care by Northern Devon Healthcare NHS Trust, which serves communities from Ilfracombe to Sidmouth and from Holsworthy to Axminster.
Two out of the nine priorities for 2013/14, as set out in the Trust’s Quality Account, are designed to strengthen services for people with Alzheimer’s and similar conditions.
They reflect the fact that around two out of every five hospital inpatients have some form of dementia, which can lead to distress, disorientation and confusion. That proportion is likely to rise as the population ages over coming years.
The first two priorities adopted by the Trust this year are to:
- Improve screening and assessment for dementia patients as they come into hospital
- Improve the care environments for patients with dementia
Initial assessment is vital, as only around half of patients with dementia have already been diagnosed before they arrive at hospital – perhaps for a waiting list operation, after a fall or if they have fallen seriously ill.
Once diagnosed, it is much easier to ensure that each individual gets the right care, taking into account their mental condition, as well as the best treatment for their physical condition.
The Quality Account adds: “Part of process for the person diagnosed with dementia
and for their family will be acknowledgement of their condition and the adjustment that follows. Early diagnosis helps give more time for that adjustment and for the making of plans, allowing us to work as key partners with the person at this time.”
The physical environment is also important. That’s why the Trust will work with user groups to make a series of small changes to improve ward environments for patients with dementia and other sensory or cognitive impairments. This might include improving the visibility of handrails and crockery or simplifying signage.
The Quality Account priorities fit within the Trust’s updated dementia strategy, which identifies four ‘golden keys’ to good care:
- ‘Nothing about me, without me’. Increasing involvement for people with dementia their carers and families
- ‘Dementia friends’. Volunteer staff, clinical and non-clinical, with additional levels of understanding about dementia, so they can help patients and their families
- ‘Think about my length of stay, from the first day’. Active management to reduce the length of stay of those with a dementia diagnosis, admitted for general healthcare reasons. On average their length of stay is two thirds longer than those without dementia.
- Flexible food and drink. Nutrition and hydration outside normal mealtimes and in different ways – finger food, for example
The Trust’s other priorities in the Quality Account this year are to:
- Reduce pressure ulcers acquired whilst in our care in hospital or at home
- Reduce the number of patients who develop blood clots in our care
- Reduce the number of missed doses of high-risk medication
- Improve hydration in patients to help reduce urinary-tract infections associated with catheters
- Improve information on discharge to ensure that patients understand what to expect when they go home and how to take their medicines
- Use patient feedback to make sure that patients are safe at home following discharge
- Improve end-of-life care by using feedback from patients and carers
The nine priorities were chosen after staff, Trust members and the wider public had been asked for their views. Next year’s Quality Account will report on progress against each priority.
Carolyn Mills, the Trust’s Director of Nursing, said: “It’s clear that dementia care is becoming more and more important for the public as well as for our own staff. Everyone knows somebody who’s been affected, and wants to be reassured that they’ll get the best treatment when they do into hospital.
“We’ve already made a lot of progress in the past few years, but the rising number of patients who show signs of dementia when they come into hospital means we have to do more. We’re committed to make sure that everyone gets the care they need in hospital, and
that they and their families are better prepared for life after they go home again.
“But our priorities for this year go much wider than dementia. I’d encourage anyone to look at the whole Quality Account to see what else we’re trying to do, and to give their views when we come around to setting new priorities next year.”
The full Quality Account is available on the ‘Reports’ section of this website: https://www.northdevonhealth.nhs.uk/about/reports/
The Trust is responsible for North Devon District Hospital in Barnstaple and for community services in East Devon, Mid Devon, Exeter, North Devon, Torridge, and parts of Teignbridge and West Devon. These include 17 community hospitals, at:
- Budleigh Salterton
- Exeter (Whipton)
- Ilfracombe Community Hospital (Tyrrell)
- Ottery St Mary
- South Molton