Quality of life needs to be improved for Scotland's 58,000 dementia patients

31/07/2007

A report published by the Mental Welfare Commission for Scotland says that hospital based care for patients with severe dementia should be driven by patient need rather than resources. The report, called "Older and Wiser" presents findings from unannounced visits to 16 wards that provide long-term nursing care for people with dementia across Scotland.

The Commission staff met with patients, interviewed relatives and carers, and asked ward staff about improvements they would like to see for their patients. Patient files were also reviewed to get a picture of the care and treatment being provided to individuals on the ward. The inspectors also took time to gain an overall impression of ward environments and their appropriateness for patients with severe dementia.

The quality of physical environments for dementia patients, including access to 'off ward' activities came out as being of especial importance, as several patients had not crossed the hospital threshold for over two years, and many had not even been out in the last year.

Commissioner Jamie Malcolm said: "With dementia rising, it is essential that we can all feel confident that should we, or someone we care about, need hospital treatment that this would be provided in a pleasant environment, by staff who have the skills and resources necessary to provide kindly and sophisticated care.

"While adequate resources are essential, the quality of life for many of the patients we saw could be hugely improved by some small, inexpensive changes. Things like more accessible transport, better information for carers, improved signage and a deeper understanding of individual life histories would make an enormous difference."

On the whole, the relatives interviewed praised staff and the level of care provided, and their suggestions for improvements included:
• more staff time to spend with patients
• more stimulation and activities on the ward
• more time away from hospital
• wider and more appropriate television channel choice
• improved food
• places to store patients’ favourite food
• en-suite toilet facilities
• more storage space for clothes

Jamie Malcolm continued: "We were interested to see that six of the wards visited could offer overnight accommodation to relatives of patients who were very ill. We thought this to be sensitive to the needs of relatives and very good practice, and would encourage other services to provide the same facilities."

The Commission also recommended the widespread use of detailed life histories, as the availability of a life history for care staff can greatly assist in planning care and in enhancing communication with the person affected by dementia. Staff knowing who they are looking after, their likes and dislikes, their background and some idea of their life history is essential to the provision of good care.

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Relevant links

• Mental Welfare Commission for Scotland (Opens a new window)