Written by admin on 2009-04-02T03:57:47+0000">April 2, 2009 – 3:57 am
It is commonly assumed that most people with severe dementia live in institutions, especially hospitals. Nothing is further from the truth. Most studies that have looked at this have discovered that only 15-20 per cent or less of people with dementia are living permanently in an institution, and that a large proportion of those who are, are living in old people’s homes rather than geriatric hospitals. In the UK there is very little accommodation specifically set aside for the care, whether long-term or short-term, of people with dementia. Where it is available it is often of the lowest possible standard, although it is gratifying to see that enlightenment is beginning to creep into the health and caring services; the provision of care is increasing slowly and the standard of care provided is improving. This, however, is not often the case for younger sufferers with dementia. There is little specialized accommodation for them; many of them are expected to be cared for alongside older patients with dementia and this of course causes many problems both for the sufferer and for the carers. In consequence, many relatives of younger sufferers soldier on at home despite the fact that it is made more difficult because of other commitments — to teenage children, for example.
In general, elderly people with dementia are two and a half times more likely to be admitted to a hospital or other institution, and having got there to stay about six times as long as other elderly people who do not have dementia. It is also more likely that an elderly man with dementia will be admitted to somewhere where he can be cared for, than a woman. It can be seen, however, that this is very similar to the general pattern among elderly people, in that there are far more elderly women living on their own than there are men.
Dementia is a common reason for people admitted to hospital as a result of some other disease, pneumonia or a heart attack say, to have their discharge delayed. Often this is because all concerned, both those outside in the community who are looking after them and those responsible for their care in the hospital, don’t feel that they should go back to live alone; as a result they may spend a long time waiting for a place to become available in alternative accommodation — usually a social services welfare home (often specifically set aside for the elderly mentally infirm) or a private nursing home.
Dementia is also the largest single cause of permanent residence in the long-stay ward of a geriatric hospital; between a third and a half of patients in such accommodation are usually found to suffer from one or other of the illnesses that cause dementia. These figures are increasing substantially, and it is particularly worrying with regard to the demands being made upon local authority welfare homes since the majority of these were never designed for, or staffed to cope with, people suffering from dementia. Even so, the most important point to remember is that most people with dementia are cared for at home. This is as it should be and it is up to the society in which we live to make it as easy as possible for those who wish to do so to continue to cope with a person who has dementia for as long as possible, and often until they die.
As well as the community resources that are generally well-known, it is also possible to make good use of hospital facilities to help support and maintain a person with dementia in the community. This will probably become the pattern more and more as time goes on. It is also heartening to note that despite beliefs to the contrary the younger generations today look after their elders as well as, if not better than, at any time in the past. The generalization that families do not care for their elders is untrue. There is little doubt that the quality, even if not the duration, of life is very likely to be better for old people, whether they have dementia or not, if they are allowed to live at home or in as normal a family environment as possible. The concept of community care, as long as it is supported by adequate hospital backup, probably represents the best way forward as far as those with dementia are concerned, and may also be the most cost-effective.
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