"Dementia Care in Trauma Wards"

This story is about my father. He has late stage vascular dementia and recently had a bad fall and ended up in Treliske's Trauma Ward with a fractured pelvis.

I was saddened at the lack of attention that was given to Dad's underlying dementia and how traumatic at a stay in hospital can be for those suffering from this terrible disease. I'm not decrying the care given by the nurses and doctors with regards to his trauma but his dementia was always seen as a secondary condition that didn't warrant much attention. Nobody talked to us about Dad's baseline condition before he had the fall - could he communicate much, how mobile was he, what medication was he on and how good was he at taking it etc. Nothing was written on the whiteboard behind his bed stating he had Dementia. One nurse arrived and announced I believe your father is deaf? No, he's not deaf - he has dementia and finds communication very difficult.

My mother had to visit Dad most days for 10 days to make sure Dad took his medication as he's not good at all with taking them and without them he gets very agitated and distressed. The nurses tried but gave up very quickly when he spat them out across the room. Without my mum's care he would have been practically un-medicated for his stay and would have been suffering terribly with anxiety and hallucinations.

When he was recovering the doctors would visit him on their rounds and my Mum would try to ask questions relating to his dementia and was told that he was in a Trauma Ward and that they were only there to deal with the trauma! How can you treat trauma in a dementia patient in isolation? If you ask them to raise their leg and they don't - is it because they physically can't or their dementia means they can't process the request?

Dad was given an opiod patch for his pain but seemed to go downhill in his general condition as the week went on. He became very withdrawn and responsive and we started fearing the worst - that his fall had made him much worse and that he was failing. Then one afternoon he crashed and needed emergency care. It turns out his body wasn't processing the opiod well and he had basically over dosed on it. We were actually asked by a ward sister when discussing his general state - what was he like before he came in? And this is my point - they should have asked and documented his condition beforehand and then they would have known that he was in serious decline rather than assume that his declining condition  was just what Dad was normally like anyway.

There is so much more Treliske can do to recognise the needs of dementia patients in Trauma Wards. And it's not difficult - their stay in hospital can be made so much better by just labelling clearly those geriatric patients who have dementia and what specific issues they may need to address as well as the trauma. Document clearly their baseline condition before the trauma to help identify a decline and to not have unrealistic expectations post trauma.

It would amazing if separate wards could be made available for those suffering from dementia where a calmer environment could be created - this is exactly what Leicester Royal Infirmary have done.