Some dementia patients given medication without it being on care plan, according to report

THE Mental Welfare Commission has said it is “disappointed” at the number of dementia patients in local hospitals who are given medication without it being part of their care plan.

The organisation has just published its first report into how dementia sufferers are cared for in community hospitals after visiting 287 patients in 56 smaller hospitals across the country.

While the report found treatment was “generally good”, the commission raised concerns about the number of staff with specialist training and whether all patients were looked after in a suitable environment.

More than half (55%) of patients they saw had been in hospital for at least a month, with nearly one in five (18%) having been there for longer than three months.

The report said “more work could be done” to make hospitals “dementia friendly” – with five of the wards said to be “very or fairly unpleasant”.

Visits revealed one ward had no showers for the 12 patients who were in it while in another hospital the commission found a two-bed room used for two men with dementia opened onto a road – with this described as “far from ideal”.

Meanwhile, another ward was a “totally unsuitable environment for dementia care”, according to the report.

An estimated 90,000 Scots suffer from dementia, with the commission looking at care in community hospitals because a “large proportion” of patients in them have the condition.

Just over a quarter (26%) of patients the commission saw had medication prescribed for them “if required” if they became agitated or distressed.

However, more than half of this group did not have a care plan for the use of these drugs, the report added.

There were 57 patients where it was felt a care plan should be in place to deal with such behaviour, but who did not have one.

However, 30 of these patients were being prescribed medication to be given “as required” for agitation, the commission stated.

The report stressed: “Where ‘if required’ medication is prescribed for agitation, we would also expect to see a care plan which sets out other interventions staff should use to minimise a patient’s stress and agitation.”

When patients are discharged home, about a fifth need support to be put in place “but in about three-quarters of these cases delays were caused by the need to organise support”.

The commission also pointed out that often patients had been receiving support at home before being admitted to hospital, but this was automatically cancelled after a short period.

Executive director Kate Fearnley said: “We were pleased to see that, generally, carers and patients were positive about care and treatment, but we are concerned that there is a lack of focus on patients’ needs related to their dementia.

“Over half the patients we saw had been in a community hospital for a month or longer and this means that people with dementia are often spending long periods in an environment that may not be dementia-friendly.

“Care plans were thorough in relation to physical care but only a few said how a patient was to be supported with personal care, and how they would be encouraged to maintain their skills and independence as much as possible.”

The commission found while hospital staff could usually call on more specialist help, not enough employees had been given dementia training.

Ms Fearnley stated: “The key point is that these aren’t dementia-specialist services, but about a quarter of their patients have dementia, so we think more attention needs to be paid to their needs.”