Saturday, July 31, 2010

Why Angela Rippon says nurses cant cope with insanity patients similar to her mom

Angela Rippon with her mother Edna, who had dementia

Distressing: Angela Rippon with her mother Edna, who had dementia

Whenher mother was ill in hospital last year, Angela Rippon spent the first ten minutes of every visit making sure she apologised to the nursing staff.

;My mother had had dementia for five years, and was going through a phase of being extremely aggressive and angry, the veteran broadcaster explains.

;She was often very rude to the young nurses, which was quite distressing for them.

;On one occasion she shouted at one: You are useless and only herefor the money.

"There was no basis for this and, in fact, just fiveminutes later when the same nurse came back with a cup of tea for her,my mother pointed to her and said to me: She is my best friend in hereand absolutely wonderful to me.

;It is very common for people with dementia to forget what has happened or what they said five minutes earlier.

;Thetrouble is that student nurses dont get any training in dealing withdementia specifically.

"Most of them havent had any experience of itand dont recognise it, let alone know how to deal with it.

;Sowhen an old person like my mother comes into hospital for a differentmedical problem, they would just think she was a very unpleasantperson.

Quite apart from upsetting the nurses, this lack of training has a significant impact on patient care.

;Noone goes into nursing wanting to do a poor job, says AndrewKetteringham, director of external affairs at the Alzheimers Society.;But staff are often just not equipped to care for people withdementia.

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As a result, the majority of those with dementialeave hospital in worse condition than when they arrived, while athird, unable to return home, end up in a care home, according to areport from the charity last November.

As well as the personal misery this causes, people with dementia spend longer in hospital than others admitted for the same reasons, which costs the NHS at least 80 million a year.

An estimated 800,000 Britons suffer from a form of dementia - the most common is Alzheimers disease - and the number is expected to rise to nearly a million in the next 20 years.

;She was often very rude to the young nurses, which was quite distressing for them."Angela Rippon

Yet, despite the numbers affected, there is no requirement for those working in the area to have specialist training.

Indeed, it is hit and miss whether the nursing staff are even told that a patient in their ward has dementia.

As a result, the patients themselves are often left bewildered and frightened, explains Mr Ketteringham.

He adds: ;Hospitals can be a distressing environment for people with dementia. On top of their poor health, people with dementia struggle to make sense of what is happening to and around them.

;Intrusive medication and personal care delivered by strangers can be upsetting and frightening.

Angela Rippon with her mother Edna, who has dementia

Communication gap: Angela with mother Edna. Edna asked nurses to takeher home to her old house, which basic training would help them pick up

;Restlessness or walking about and problems with eating and drinking are also common.

He adds: ;These symptoms create barriers to delivering good dementia care which exacerbates the symptoms of dementia leading to a downward spiral something that could be avoided with good dementia training.

;Unfortunately, the Alzheimers Society hears too many stories of malnourishment and dehydration in hospitals.

"Its scandalous that its not mandatory to train nurses in dementia care, particularly as a quarter of hospital beds are occupied by people with dementia at any one time.

In an attempt to deal with this appalling situation, the charity, together with the Royal College of Nursing, is today launching a new booklet to give medics information about each patient.

Called This Is Me, each booklet is filled out by the patients carer or relative to provide basic details such as the patients name and address, as well as information about who knows them best, their hobbies, things that worry them, the state of their sight and hearing, mobility and sleep patterns.

It also explains other important things, such as whether their food needs to be cut up and if they can use cutlery or have swallowing difficulties.

"They would ask my mother simple questions such as: "Where is the pain?" But, because of the dementia, she couldnt find the words to answer.

Kevin Whately

;We hope this booklet will support staff to provide the best possible person-centred dementia care, by helping them to get to know the individual and understand their needs, says Mr Ketteringham.

Angela Rippon believes the booklet would have prevented or at least minimised many of the problems her mother Edna experienced before she died last November at the age of 88.

;My mother was in hospital in Plymouth with emphysema three times in her last year.

;On the third occasion, I had a phone call from a young doctor on the ward to say they were going to send her home, but the address they had was different from the one my mother was insisting she had to go to.

;She explained to them that she had to give my father his tea. In fact, my father had been dead for five years and she had moved from the family home to a nursing home years previously.

;But the doctor was taking everything she said at face value because he didnt have any information to do otherwise.

;Although I had spoken at great length to a senior nurse about her discharge, none of what I had said had been passed on to him.

;If the booklet had been at the side of her bed, or hanging with her medical notes at the end of the bed, it would have been factually useful and avoided any risk that she could have been taken to the wrong address. Thankfully, he rang me to check.

Actor Kevin Whately with late mother Mary when he received an honorary degree

Similar experience: Actor Kevin Whately with late mother Mary when he received an honorary degree

Actor Kevin Whately has had similar experiences. His mother suffered from dementia for ten years until her death last summer and the condition turned her time in a large London hospital into a nightmare.

Best known for playing Lewis in the eponymous TV detective series, Kevin recalls: ;My mother was, like many old people, very confused when she went into hospital.

;Then 80, her mental state was such that she couldnt explain where she was in pain, and we only knew there was some sort of problem when she collapsed after I had taken her out for a cream tea.

;Unfortunately, she caught a MRSA type infection straight after she was admitted and then had to be isolated in a single room.

Kevin adds: ;The ladies who brought food in for her left it for about 20 minutes and then came back to pick it up.

;Nobody had told them she was a very slow eater, which meant the food was removed before she had a chance to eat it.

;Also, although she managed to feed herself in the nursing home, she was so confused and weak that she couldnt do so in hospital. She lost huge amounts of weight.

Like Angela Rippon, Kevin found that none of the staff was trained in dealing with dementia.

;For example, they would ask my mother direct questions such as: Where is the pain?

;But, although she was a former school teacher, because of the dementia, she couldnt find the words to answer.

;She couldnt even say: I am thirsty, so if there wasnt water right in front of her she could have got very dehydrated.

;The dementia and infection combined meant it took the medical staff days to establish that the pain was caused by gallstones and, by the time they did, she wasnt in a state for them to treat her.

He believes the booklet should make a real difference. ;It will help nursing staff understand patients needs and difficulties, he says. And, until the NHS trains staff in dementia care, it is the only option.

For a copy of This Is Me, call 01753 535751 or go to alzheimers. org.uk/countingthecost

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