Dementia Care at North Mid

Dementia is a common condition that affects one in three people over the age of 65 in the UK.

The term dementia describes a set of symptoms that usually includes loss of memory, difficulty with communication, reasoning and decision-making, changes in mood and behaviour and difficulty completing day to day activities.

Dementia affects over 1 million people in the UK. It mainly affects people over 65 years of age, but it is also diagnosed in smaller numbers in people under 65 years of age.

Efforts are being made in the UK supported by the NHS to ensure that people with dementia are diagnosed as early as possible and with their families are supported to plan for the future.

If you are worried about your memory, or the memory of someone you care about, speak to your GP, who may do some tests to rule out other causes for memory loss before referring you to our local Memory Service in Enfield, Haringey or in the Borough the patient resides in.

Approximate 25% of all patients on our wards at North Mid have confusion. This is due to them having dementia, unrecognised dementia (i.e. not yet diagnosed) or delirium (acute confusion).

Around 600 patients per day attend our Emergency Department, a small number of these patients will have a known diagnosis of dementia.

Hospital admission is challenging for all patients, especially patients who are confused. Looking after them requires skill and compassion. These patients are prone to staying in hospital for longer, suffering clinical incidents (e.g. falls), and not being able to return to their normal residence when discharged.

At North Mid we are committed to providing outstanding care for our patients. Patients with dementia or confusion will be more reliant on others to support them. Their main carer or family will be vital in ensuring effective care.

This page provides information for service users to help understand more of what we can offer and support the admission.

North Mid Dementia Related Services

Dementia Care Bundle - this is a group of interventions we aim to have for all patients who are known to have dementia whilst they are in hospital. It includes

  • screening for delirium
  • 10 important things about me (patient centred care document)
  • Food passport (what the patient likes and dislikes to eat, allergies, ways to assist with nutrition)
  • Forget Me Not - bedside signage to staff recognise the patient is known to have a diagnosis of dementia
  • Carer’s Passport (see below)

Carer’s Passport - on offer to all main carers for patients who are vulnerable (not specifically just for people with dementia). This entitles the main carer a discount in our Car Park and restaurant, and open visiting on the ward. Please ask ward staff for information and instructions on obtaining discounts including registering your car.

Dementia Nurse Specialist:

The dementia lead nurse at NMUH provides clinical leadership and expertise in dementia service by ensuring information, support, advice, and specialist knowledge are made available to patients, families/carers and multi-disciplinary. The lead oversees patient care and ensure high quality care is provided. To be able to identify patients' needs and create individual care, it is essential to work very close with patients and their families/carers. There is no ‘one size fits all’ in dementia care therefore, each patient needs to be understood and supported as required. Every patient living with dementia in our care should have a Dementia Care Bundle plan completed. Please refer to the NMUH Dementia Care Bundle.

Dementia Lead Nurse can be contacted through the Ward staff.

Dementia Champions :

 NMUH, have dementia champions on each ward/unit including the emergency department. The champions receive dementia training to equip them with knowledge and skills required in supporting people with dementia and their family/carer. They are the source of information and support for people, first point of contact on their individual wards and advocates for people with dementia and their families. 

Staff Training - as per NHS requirements we have a rolling programme of dementia training for all staff based on their roles.

Dementia + Delirium Ward Round - a weekly speciality review for patients on the wards with more complex issues related to their confusion or dementia. The hospital teams will refer for assessment if indicated.

 

Delirium

Delirium is a serious medical emergency, a reversible alteration of a patient’s cognitive status from their baseline. It is common and easily missed. The sooner it is identified the better it can be managed.

If a person is newly confused (e.g. within a few days or weeks) it is most likely to be due to delirium, and seeking medical attention is important to help determine what is causing the issue. The causes can be widespread.

We attempt to screen patients that are at risk of delirium for this when they attend the Emergency Department or require admission

If you notice that someone you are visiting in hospital has become confused, please inform a nurse or doctor looking after them so it can be further assessed.

Main carers and family can help when someone is delirious in the following ways.

  • bring in glasses, hearing aids, dentures
  • bring in any entertainment that they normally might enjoy, preferred home food and snacks that might not be available on the ward.
  • try to visit regularly to help keep the person company, occupied and to reassure them whilst they are in hospital
  • help to encourage the person to engage with their treatment in hospital, e.g. taking medications, working with physiotherapy sessions, sitting out in a chair, eating and drinking

Often people who are confused responded better to people they know and recognise.

 Delirium-leaflet

Preparing for a visit

Ensure the doctors and nurses are made aware that the person is known to have dementia, or if you have any concerns about them being confused and how long this has been going on for.

Also, if there are other health concerns that the person themselves may not be able to explain or recall.

Bring things in- medications, toiletries where possible, glasses, hearing aids, entertainment, own clothes/pyjamas if possible

We will ask that you assist in completing the 10 Important Things About Me document and Food Passport

If there are any other important information we should know, for example that they have an Advanced Care Plan, or have swallowing or communication difficulties which require specific management.

Please ask for a Carers passport - which is on offer to all main carers for patients who are vulnerable (not specifically just for people with dementia). This entitles the main carer a discount in our Car Park and restaurant, and open visiting on the ward. Please ask ward staff for information and instructions on obtaining discounts including registering your car.

Please inform the clinical team if you hold Lasting Power of Attorney and share a copy of this with the team.

It may be required that the ward team completes a mental capacity assessment if specific decision arise, this will be discussed with their main carer/next of Kin / Lasting Power of Attorney.

People experiencing dementia can require significant amounts of care and support from family and friends.

When you're caring for someone experiencing dementia it can be easy to ignore your own needs. A range of services and organisations are available to support people with dementia and their carer.

The following websites offer information on how best to look after yourself and the person you are caring for:

Carers: Looking after yourself Alzheimer's Society

Carers and dementia Carers Trust

Caring for a person with dementia Alzheimer's Society

Communicating with people living with dementia Care UK 

If you are caring for someone with Down's syndrome and dementia you can visit the Down's Syndrome Association website for more information. Please make this link accessible

 

Other useful contacts

Alzheimer’s Society helpline: 0300 222 11 22 Dementia UK helpline (Admiral Nursing Direct): 0845 257 9406 or email direct@dementiauk.org

Carer support / Community resources:

Enfield Carers Centre: 020 8366 3677 10am – 4pm Monday to Friday

ican service: ican@enfieldcarers.org.

Enfield Age UK: for more information on the iCan service or to be referred email: ican@ageukenfield.org.uk or call 0208 375 4102

The Haynes Dementia Hub at Haringey: Email: thehaynes@haringey.gov.uk

Phone: Tel: 0203 0742710