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Is dementia nursing undervalued?


When someone with dementia is sat in a hospital bed needing feeding and changing, crying out or being aggressive, many adults recoil at seeing their contemporary in this situation and pity the nurse charged with caring for them. Put a toddler in that bed, needing similar care but not as a result of having dementia, and the nurse is seen as someone who is there to nurture and protect.

Our young are deemed as an asset; aesthetically pleasing, delightfully enquiring, there to educate, care for and hopefully, with a future ahead of them. Older people, and particularly those with dementia, are viewed by many to have lived their life and had their fun, despite the fact that their experiences can immeasurably enrich the lives of those around them.

For me it is not a battle between the generations, it is merely a need for parity. We have paediatric wards that are specifically designed to ensure that children are as comfortable as possible in the hospital environment, and therefore make the work of the professionals charged with caring for them easier, and yet people with dementia are often placed in any available ward, sometimes with patients far younger and with completely different health and social care needs.

Asking our nurses to care for people with dementia in environments that do nothing to reduce the distressing symptoms many patients experience plunges them into a world of managing aggression and agitation, or trying to combat a lack of engagement in simple tasks like taking medication or eating. As a result nursing people with dementia can be exceptionally stressful, and leave many nurses feeling very undervalued.

Failing to recognise the vital role played by those who are nursing people with dementia is directly linked to the fact that not only is the UK playing catch-up in acknowledging the seriousness and prevalence of dementia, but also that we still do not attach the same value to people living with it as we do to those at the beginning of life. Bridging this gap means appreciating that dementia patients have a very specific need for personalised and compassionate care that needs to be delivered empathetically, in an unhurried manner and with as much staff continuity as possible, all within an environment that supports dementia nurses and patients to work in harmony together. When that happens, the benefits to everyone within that equation are priceless.


Readers' comments (8)

  • Yes But

    'Bridging this gap means appreciating that dementia patients have a very specific need for personalised and compassionate care that needs to be delivered empathetically, in an unhurried manner and with as much staff continuity as possible, all within an environment that supports dementia nurses and patients to work in harmony together.'

    It doesn't matter how old or demented someone is - care is supposed to be helping the person !

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  • Politicalnurse

    I think you have made a good point about the environment but nurses are responsible for this too?

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  • Michelle

    I've always had this general feeling that within the general public (and even some of my peers) that caring for people with dementia is a lowly and unexciting job. It is upsetting to see the older generation mistreated and 'forgotten' about in society.

    Throughout my training, I've always thoroughly enjoyed working with older adults, especially those with dementia. It's an enriching experience and I wish there was more recognition of the specialist nursing that people with dementia need and deserve.

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  • King Vulture

    Missy01 | 8-Oct-2012 10:26 pm

    I agree with your points. But even if nursing patients with dementia wasn't 'an enriching experience' I still think that these patients are still people: even if we can't fully work out what they are experiencing, and they can't fully tell us, dementia patients still have experiences - surely they deserve to be cared for in ways that make 'their experience of life better' ? Even if caring for them is challenging.

    Not valuing people who seem to have no contribution to make, was the philosophy of various people/states in the first half of the 20th century, and we all know where that went !

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  • I think your comments are very valid i am a nurse and a dementia champion for my hospital. We have recently re vamp our ward with the help of the kings fund. This has made a massive difference to our Dementia patients so keep faith we are moving forward in the right direction. Also picking up the point of little or no training for staff this is certainly a area that needs working on. My staff do the best they can but more trianing would be invaluable. More money needs to go into elderly care full stop it is a area with less staff and triaing than any other area. Nurses do the best they can with what they have and are amazing, credit is never given to these nurses who believe me work above and beyond what they should in a area that is challenging and does not always get the resouces and staffing that is rightly needed. Praise to all the nurses who work in this area and any other.

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  • I worked with people with dementia, they are human beings they are somebody's relative and they have contributed to this country all their working lives and beyond. Mental health wards are closing at a rapid rate as is dementia wards this means that when families can no longer cope ( and this is a last resort) they are not being placed on wards with nursing teams trained to look after people with dementia but are being place in general hospital beds with staff that have limited understand of people with dementia. This is not right yet we have to accept the closure of good wards because the NHS are being financially squeezed by the government to get the country back on track. I really hope that the government and the banks are so proud of there's elves.

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  • The reality is that many more elderly demented people will find their way onto acute hospital wards.

    The reason for admission my well be "legitimate" ie fractured femur or pneumonia. Many will be admitted as a result of "acopia" with malnutrition and dehydration.

    Whatever the for admission these old people present a major challenge to nurses.

    Lack of or deteriorating cognitive function coupled with inappropriate, challenging often behaviour ensure that these patients are very demanding of nursing time.

    Four or five of these patients admitted to a n acute ward results either in their care needs being met and other patients neglected or more probably every patient receiving less care than is, in reality, required.

    Unless your ward is staffed to meet the needs of the elderly demented patients a blizzard of formal demands for additional staff should be descending onto the desks of those "Senior Nurses" who ensure unsafe and unsatisfactory care is the only option available.

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  • Let me briefly tell you that there are multiple forms of dementia - alzheimer’s disease being the most common one that accounts for 40 to 75% of dementia cases and is the sixth leading cause of death in United States. Additionally, dementia and its types have common signs with some variations. Let’s start with the most common signs of dementia most commonly seen in patients at the early stages of the disease. They start experiencing subtle memory loss, mood instability such as immediate occurrences of maniac (laugh) and depression (sadness) episodes, and have trouble with listening and explaining things to other people, communicational obstructions to be exact. They also segregate their selves from social gatherings and unions, face difficulty in performing daily chores and also experience muscle impairment. Additionally, some people fail to converse with other people because they fail to keep up the pace and comparatively take longer to process the coming words and repeat the same question over and over again. Most of the cases showed that, dementia patients start segregating their selves and start living alone because they could not keep up with the lives of normal people. They just are not up for the adaptation to change. In one of the form of dementia, which is Lewy Body dementia, probable signs appear to be sleeplessness. Patients experience insomnia which leads to mood swings. It has been seen that they fail to keep tracks of roads and lose their tracking skills as well. In case of Alzheimer’s, a patient the most common signs are memory loss and forgetfulness. In some cases, it has been observed that people with Alzheimer’s segregate their selves from others. Additionally, they experience complete memory loss and trouble understanding visual images and spatial relationships, lack the judgement skill and a complete withdrawal from work or social activities. One most commonly observed is the forgetfulness and inability to retrace steps. There is another type of dementia called Parkinson’s characterized as uncontrollable movement of body parts such a shaking limbs and fingers. It has been observed that patients experience writing and speech changes, their ability to respond fails badly and they lose posture and balance. One of the common sign is bradykinesia characterized as slow body movement. One thing to keep in mind before labelling someone as a dementia patient is that forgetfulness and memory loss do no really mean a person has dementia because memory loss and forgetfulness are a normal parts of aging. But if any severity has been observed in these signs, a patient definitely requires a professional advice and consultation. There is no cookie approach to cure dementia but if you observe such changings or signs in your loved ones do not take it for granted before it gets too late.

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