What is Dementia?
The word dementia describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life. A person with dementia may also experience changes in their mood or behaviour.
Dementia is caused when the brain is damaged by diseases, such as Alzheimer's disease or a series of strokes. Alzheimer's disease is the most common cause of dementia but not all dementia is due to Alzheimer's. The specific symptoms that someone with dementia experiences will depend on the parts of the brain that are damaged and the disease that is causing the dementia.
Each person is unique and will experience dementia in their own way. The different types of dementia tend to affect people differently, especially in the early stages. How others respond to the person, and how supportive or enabling the person's surroundings are, also greatly affect how well someone can live with dementia.
A person with dementia will have cognitive symptoms (problems with thinking or memory). They will often have problems with some of the following:
- day-to-day memory - difficulty recalling events that happened recently
- concentrating, planning or organising - difficulties making decisions, solving problems or carrying out a sequence of tasks (eg cooking a meal)
- language - difficulties following a conversation or finding the right word for something
- visuospatial skills - problems judging distances (eg on stairs) and seeing objects in three dimensions
- orientation - losing track of the day or date, or becoming confused about where they are.
As well as these cognitive symptoms a person with dementia will often have changes in their mood. For example, they may become frustrated or irritable, withdrawn, anxious, easily upset or unusually sad.
With some types of dementia, the person may see things that are not really there (visual hallucinations) or believe things that are not true (delusions).
Dementia is progressive, which means the symptoms gradually get worse over time. How quickly dementia progresses varies greatly from person to person.
As dementia progresses, the person may develop behaviours that seem unusual or out of character. These behaviours may include repetitive questioning, pacing, restlessness or agitation. They can be distressing or challenging for the person and their carer
A person with dementia, especially in the later stages, may have physical symptoms such as muscle weakness or weight loss. Changes in sleep pattern and appetite are also common
When a person with dementia finds that their mental abilities are declining, they often feel vulnerable and in need of reassurance and support. The people closest to them - including their carers, friends and family - need to do everything they can to help the person to retain their sense of identity and feelings of self-worth.
At UHMBT we aim to deliver care centred around the needs of the person with dementia. Its important that we involve not only the person themselves, but their families and carers in the assessment, care planning and updates on the care we give.
As members of the Butterfly Scheme, we offer, with consent, an option of joining for people who come into hospital with dementia, acute or longstanding memory problems and confusion.
With the aid of a discrete butterfly, it allows all staff to know that the person may need extra care and attention, and above all are always safe. The butterfly is then put on their electronic record for any future needs.
UHMBT ensures all clinical staff complete dementia awareness training through the Butterfly Scheme, together with expert facilitators trained at University of Stirling delivering classroom based teaching for Allied Health Professionals with accreditation.
We aim to offer a forget me not passport of care for every inpatient admission. This is completed by the families and carers, telling us how to care for the person in their unique way, offering individual detail to give that personalized approach.
Our Registered Nurses are offered an Older Person Pathway Training Programme managed by the Matron for Dementia.
UHMBT offers a dementia menu for those who need it, and is unique to the Trust. With support from identification through the Butterfly Scheme, it encourages family and carers to be involved in choosing from the menu and helping at mealtimes, as they know the person best.
The menu offers lighter meal options, such as foods which need reduced supervision and can be eaten without cutlery. It also provides the opportunity for patients have snacks, eating “little and often” as needed. The menu provides extra nutrition as needed, whilst ensuring a dignified approach to mealtimes.
Each clinical area should have a dementia champion to support dementia awareness. This will include updating staff on how person centred support can be given, be a point of contact for families and carers, and ensuring clinical practice is up to date for their areas.
For every unplanned admission, everyone aged 75 or more is screened for frailty which always includes dementia or cognitive impairment (confusion memory problems). All patients who are identified as frail on the screen are now entitled to comprehensive geriatric assessment which is a complete assessment of needs and involves family and carers, to a complete history of the person. This is done by a Care of the Elderly Team, who can be found at both Royal Lancaster Infirmary and at Furness General Hospital.
Dianne Smith, UHMB FT Matron for Dementia
Phone: 01524 516207
Mobile: 07805 895 862
Dianne Smith is the Matron for Dementia at UHMB FT whose role is to manage the Care of the Elderly Teams, ensure person centred, safe and dignified care is delivered throughout the Trust, by training and development of staff, appropriate dementia friendly environments, and high quality standards are maintained.