Written by admin on 2009-04-02T04:15:17+0000">April 2, 2009 – 4:15 am
If it is necessary for a person with dementia to go into hospital, whether for a short-term admission or longer-term care, it is very likely that all sorts of worries and fears will spring up in the minds of relatives. Much of this is caused by the unfamiliarity with the hospital routine and the fear of leaving someone who is much loved in a strange environment with strange people for long periods, not knowing what is happening to them while you are away. Hospitals are making great strides to try to overcome these problems but nevertheless an in-patient stay will often be a stressful event.
A new approach to nursing is being introduced into many hospitals whereby each nurse has special responsibility for a small number of patients, getting to know them and their families well. If this is the system in the ward to which your relative is admitted, find out which of the nurses knows your relative best and try to get to know them.
Of the medical staff, the doctor you will see regularly will be the most junior member of the team. He or she will have responsibility for the day to day care of your relative, referring to more senior doctors for advice when necessary. The consultant will probably only see his patients once or twice a week, having trained his team to look after their patients in the way that he expects. He is responsible for the major decisions that are made, but will usually take into account the advice and assessment of all the members of his team, not just the other doctors, but also the physiotherapists and occupational therapists where relevant, and especially the nurses who will know the patient best.
Often the consultant will be guided by a social worker or a health visitor and sometimes other members of the community health team too. He will also be available to give advice on any urgent medical problems that arise. He will probably have patients in many hospital wards, often in more than one hospital, and other medical duties elsewhere. He is therefore the most difficult person to see, but a telephone call to his secretary should make it possible for you to see him if you feel you would like to — and there is no reason why you shouldn’t. In practical terms this is often most easily arranged for a time when he is going to be on your relative’s ward.
If the admission has been made to allow assessment and investigation of the underlying causes of a dementia, your relative will undergo quite a lot of tests and will probably be examined by more than one person. This can be disturbing to someone who has a limited capacity to understand what is happening to them. The nurses and doctors will be aware of this and will try to help as much as they can. Unfortunately it isn’t always possible to avoid distressing a patient in these circumstances, although every attempt will be made to minimize the trauma. It is unlikely that any permanent distress will be caused as most people, although not all, with dementia will forget the experience relatively soon. It is important that everyone with dementia is thoroughly assessed and if the hospital admission is necessary, this usually won’t be for longer than seven to ten days.
If the admission has been arranged to allow you to have some relief, please don’t visit every day. This will defeat the whole purpose of the admission and can in fact make the relief period even more stressful than not having any relief at all. It is quite natural to worry about what is happening and to wish to find out. This can easily be achieved by telephoning the ward and asking to speak to the nurse in charge or the nurse who knows your relative best. Before doing this, however, check with the nurses when is the most convenient time to ring and let them know that you intend to. Having been forewarned, they should then make sure that they are aware of what has been happening to your relative and will be in a position to give you some meaningful information.
Intermittent admissions to hospital can be arranged in two ways. The first is a week or two, once or twice a year to allow hard-pressed relatives or other carers to get away and have a holiday. The other consists of more frequent, but often shorter, periods in hospital to allow families to recharge their batteries. The latter becomes more important when the demands of caring increase as the disease progresses. In the early stages of the illness, holiday or even intermittent care can often be provided somewhere other than a hospital, for example in an old people’s home. If the stage is reached where nursing care is required, a hospital or the equivalent is best. The person who will be most up to date with the arrangements for intermittent or holiday care will be the general practitioner.
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