"Excellent staff and facilities"

About: North Devon District Hospital / Ophthalmology

(as a relative),

Firstly I want to thank everyone involved in the eye clinic at North Devon District Hospital for their kindness and support they have given my mum. She has glaucoma, wet macular disease and cataracts. She has to have regular injections in her eyes for her macular disease and yesterday had her first cataract operation. The staff are all excellent and the facilities clean and spotless and everyone has been wonderful.

I have two questions. Firstly, what steps are taken to ensure the hospital knows if the patient lives with dementia - either early stages that have not been diagnosed or is well hidden by the patient? If dementia has been diagnosed, does the hospital know this? The number of eye drops that have to be administered following a cataract operation is enormous and someone who is having memory problems would struggle to remember when to take all of these drops and to remember the instructions given to them when in hospital, especially as they may not be able to read the written ones. They may even end up taking far more than necessary.

Secondly, does the hospital ensure that the patient has someone available to help them open the eye drop bottles and put in the drops when they are at home? Some of the tops are nearly impossible to remove and if your sight is poor following the operation or you have difficulty using your hands, then getting access to the drops is nigh on impossible. If a patient goes home by a taxi or other transport they may not have a spouse or family member on hand in the home to assist with this. Luckily mum lives at home with us so she does have help, but some people don't.

Many thanks.

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Response from Jayne Kruszewski, Customer Relations Manager, Northern Devon Healthcare NHS Trust

Dear Relative

Many thanks for your response - I'm sorry I havent replied yet - I am awaiting a response from the Service Manager and will let you have their comments in response to your questions as soon as I hear back feom them.

In the meantime you can always contact our Patient, Advice and Liaison Service (PALS) on 01271 314090 who will be able to support you further.


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Response from Jayne Kruszewski, Customer Relations Manager, Northern Devon Healthcare NHS Trust

Dear Relative, sorry for the delay in getting back to you, however I now have a response from the Opthalmolgy department which I hope will reassure you:

The nurse manager for the department advises that patients with early stage or undiagnosed dementia usually dont usually have any problems with cataract surgery, and Patients with more serious memory problems usually either have help in place, or the department will explore what help is available to them.

As you advise the drops are frequent, and as such many patients are concerned they may forget, so the department advises them to use a tick chart to monitor the drops throughout the day.. Unfortunately some patients experience problems that the team are unaware of, however the staff do try to identify these patients and offer them help in managing the drops.

Patients who do not have capacity to make decisions about there treatment are seen in a best interest meeting, but these patients will already have full time carers ie family or be in a residential/nursing home, and have help at hand.

Your concerns about loosening the tops of bottles, for patients who are unable to open the bottles, has been passed on to the day surgery manager, who will discuss this useful tip with the department team, to improve services.

Many thanks

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