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 For example, they may become frustrated or irritable, withdrawn, anxious, easily upset or unusually sad.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. It’s 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.
This includes support from pre-op care planning for scheduled care, and unplanned and emergency assessment, care and discharge planning for home.
Many people with dementia may lack the capacity to make some decisions about their treatment and care needs. If so, the trust will be guided by the Mental Capacity Act principles and follow its guidance accordingly. This may include carrying out treatment, care and keep them safe in their best interests if they lack the capacity to make the decision themselves.
If you are a family member or carer and need to be involved in treatment and care decisions on behalf of someone with dementia, you may have Power of Attorney for Health and Wellbeing. If so, staff will need to see evidence of this. Please contact the department and send a copy of the relevant documentation so it can be uploaded onto the electronic patient record.
At the Trust we aim to ensure our environments are dementia friendly when people with dementia are using our services.
This includes appropriate picture signage and colour themed bays for orientation in our inpatient wards. We also encourage family members to bring in photos and mementoes of home to help reassure and support our dementia care.
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 and offering individual detail to give that personalized approach.
The passport is kept by the person and should be sent home with them on discharge and brought in for any inpatient or outpatient treatment and care.
Each clinical area should have a dementia champion to support dementia awareness. Their role includes updating staff on how person centred support can be given, be a point of contact for families and carers, and ensure their colleagues are up to date with clinical best practice. They are supported with training days throughout the year, and we also have dementia champions in our local care homes who participate in this awareness training.
UHMBT ensures all clinical staff complete dementia awareness training through the Butterfly Scheme and on corporate induction to their roles. There is also a comprehensive training package in place together with expert facilitators trained at the University of Stirling, delivering classroom based teaching for Allied Health Professionals with accreditation.
UHMBT offers a dementia menu for those who need it, which 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 require reduced supervision and can be eaten without cutlery. It also provides the opportunity for patients to have snacks, eating “little and often” as needed. The menu provides extra nutrition whilst ensuring a dignified approach to mealtimes.
The menu has recently been updated to include even more hot finger food options, a picnic plate and a spicy box for snacks.
We have also added a shopping list for staff to consider ordering alternative drinks to offer on the wards.
We encourage family and carers to look through the menus which are kept on the wards when they visit to choose options and snacks that may be suitable for their family member.
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.
- Phone the Dementia Care of the Elderly Team at Royal Lancaster Infirmary - 01524 516207 (internal extension 46207)
- Phone the Dementia Care of the Elderly Team at Furness General Hospital 01229 494295 (internal extension 54295)