Hospitals are failing to care properly for the growing number of people with dementia, according to an NHS-funded report, which has prompted demands for big improvements to help patients.
Most staff do not have the skills to cope with such challenging patients, who too often receive "impersonal" care and suffer from boredom, the first National Audit of Dementia found. It says hospitals should introduce "dementia champions.''
Many hospitals have not taken simple steps to lessen the distress and confusion which dementia sufferers' often feel on being somewhere so unfamiliar – such as making signs large and easy to read, using colour schemes to help patients find their way around unfamiliar wards and not putting family mementoes such as photographs nearby.
The findings emerged from questionnaires filled in by 2,211 staff in 145 wards of 55 hospitals in England and Wales and 105 observations of care of dementia patients. Two-thirds of staff said they had not had enough training to provide proper care, 50% said they had not been trained how to communicate properly with such patients and 54% had not been told how to handle challenging or aggressive behaviour.
One said: "I have never had any training related to caring with patients with dementia or Alzheimer's. As staff have not yet had training, I feel that these patients do not receive the specialised attention that they deserve, or understanding and time from staff."
The report, commissioned by the Healthcare Quality Improvement Partnership (HQIP) and undertaken by the Royal College of Psychiatrists' Centre for Quality Improvement and other organisations, found that: "On most hospital wards there is little evidence of a person-centred approach or 'culture', or that the care received by patients is generally person-centred."
"This shocking report proves once again that we urgently need a radical shake-up of hospital care," said Jeremy Hughes, chief executive of the Alzheimer's Society. "Given that people with dementia occupy a quarter of hospital beds and that many leave in worse health than when they were admitted, it is unacceptable that training in dementia care is not the norm."
Professor Peter Crome, chair of the audit's steering group, said the report "provides further concrete evidence that the care of patients with dementia in hospital is in need of a radical shake-up". While a few hospitals had risen to the challenge of improving patients' experiences, many have not, he said. The report recommends that all staff receive basic dementia awareness training, and staffing levels should be maintained to help such patients.
Paul Burstow, the care services minister, said the audit should be "a must-read" for hospital directors.
While it had found some hospitals taking steps to improve, "far too many hospitals [are] failing to put in place dementia-friendly care. It is time for the NHS to put in place the training and support that improves the care and treatment of people with dementia, and saves money too."
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said it was "extremely worrying" that two-thirds of staff felt under-trained to provide skilled, knowledgeable care to people with dementia.
There is "an urgent need to improve the experience of people with dementia who are cared for in general hospitals", for example by employing enough staff and ensuring they have both the right skills and time to care, Carter added.
Labour accused the government of not giving dementia care high enough priority. Liz Kendall, the shadow minister for care and older people, said none of health secretary Andrew Lansley's 60 new "key indicators" of NHS performance required improvements in this area.
And coalition cuts to council services for older people meant dementia sufferers were not getting the care and support they need to continue living independently in their own homes, Kendall added.
A National Audit Office report criticises NHS care of the two million patients with neurological conditions such as Parkinson's disease and Multiple Sclerosis.
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