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Major report calls for better nurse training in dementia care


Anonymous | 17-Dec-2011 9:42 pm I am 100% with you, in our mutual belief that the elderly deserve humane care (everyone does, but perhaps the elderly even more so) but this does, in part, come down to money. I agree that in an ideal world money would not come into it, but the NHS does not spend an unlimited amount of money. Making a case for more spending is a legitimate political 'campaign', but you actually have, at any one time, only what you have managed to get. So, I can refer to a definition of an engineer: 'An engineer can do for a penny, what any fool can do for a pound'. In other words, part of the solution in the real world, is to discover how to best spread 'best practice' once that best practice has been identified: clearly specialists in dementia care, are well-placed to help identify best-practice. But your own example, of a situation when you were 'overwhelmed by the situation of having too many patients to cope with', can only be remedied by providing enough staff to cope: managers are often trying to reduce staff, not increase staffing levels. That report also seemed to imply that even some nurses, somehow think that demented people 'are being deliberately awkward'. I had some very limited experience of my mum 'being elsewhere/deluded' as she was dying, and based on that very limited experience, it seemed to me that this 'early dementia' (which I guess is the next along from 'forgetting my husband is dead, or where I live, etc) isn't in any sense 'awkwardness' - it is confusion. The person's brain has been deprived of a lot of the 'background information' it uses to make a mental pattern of the world, and using what it does 'know', combined with what it sees, the person comes up with an interpretation of the world which is confusing and scary ! This is off topic, but it struck me as my mum lapsed towards her death. I had assumed that 'periods of being elsewhere' were effectively the 'same person in the now, but missing some recentish events'. But I decided, for my mum, that it wasn't like that. It seemed as if, somehow here mind had reverted to an earlier 'time setting' in its internal beliefs. So, it wasn't as if my 86 yr old mum had forgotten that my dad had died, and that she no longer lived in her childhood home. It was as if her mind had 'reverted' to an earlier stage of her life - as if she had the 'mind and knowledge' she would have had when she was perhaps 65 yrs old, and what she was 'seeing around her' was being fitted to that 'legacy' 'belief set'. If I had my 'mind' from 20 years ago when I woke up one morning, then on looking at the world, I would be enormously confused - so, I am wondering if a huge part of the behaviour of dementia patients, is down to that sort of confusion ? I also noticed that my mum did some very strange things (folding things, ripping paper up and making small piles of the pieces) which to me, look like 'pattern-checking behaviour'. I think she was losing brain areas (I suspect via small strokes) and I feel sure that much of the work our minds do is 'pattern creation', to create our 'internally consistent belief set, within which we fit our experiences' - so I think that particular behaviour, was my mum's brain 'realising it was damaged, and looking to repair the damage' in some way (by 'pattern creation' for the folding and pile formation behaviours). I'm getting too philosophical, so I'll stop here !

Posted date

19 December, 2011

Posted time

11:36 am