What support should hospitals provide for patients with dementia without family present?

A&E and a hospital ward are two different places.

Someone would need to stay with them in A&E if they weren't safe to be left. Whilst in A&E they haven't yet been admitted and are still the responsibility of family/adult social care or whoever usually cares for them.

Once admitted to a ward then most hospitals try to keep people with high needs relating to their memory on a dementia ward (although this isn't always possible) where there is in theory additional staffing to account for the patients having additional needs above what they have been admitted for. Even in this scenario families often have to advocate/assist where possible, and definitely if admitted to a general ward. That doesn't need to be 24 hours a day though (and most wards wouldn't have visiting hours that would support this either).

Most people with that level of need in hospital though would usually require assistance outside of hospital- either in a care home or from carers in their own home. On admission the ward should take details about what 'POC' they have at home and what support they need whilst on the ward.

Anyone in a care home will have a hospital passport sent with the explaining their needs in detail and it's a good idea to complete this for someone at home as well.

If she pays privately for care at home there is nothing to stop you paying for carers to continue to go in to see her in hospital to support with meals, company and advocacy if family cant be available to do this- it shouldn't be necessary but sadly as you have found acute hospitals are terrible places for elderly people with dementia to be .

This is such an important tool to you use. I completed one for my mum but they didn’t take account of it.
They asked me to fill a simple form in the go above her bed (quick reference for the staff), but they didn’t seem to look at it.
when used properly it’s SO useful.

For staff to acknowledge that what the person says may well be unreliable. Eg “I’ve had a wash”….actually no she didn’t,”I’ve changed my pad”, no she didn’t she through knickers in the bin. This type of thing caused huge problems for my mum.
the ward reported she was able to manage all ADLs independently and her previous morning visits were cancelled when she went home!
All because my poor confused mum was believed and no one double checked at all.
I stayed with her at the hospital a couple of days each week but when I wasn’t there gently guiding her, the staff simply believed everything she said.

It would be a great idea to print and complete the This is me booklet shared previously and be clear what the needs are. The best thing about a this is me is that it tells the ward important info about what matters to a person. Family names/ important pets/ what they love doing/ significant life history.
If they become more disorientated as a result of being unwell and in a strange noisy environment, this info will help the staff to reorientate them.

Link to ‘This is Me’, hospital passport from Alzheimer’s UK.

In theory, help with eating, washing, reorientation, distraction. In practice, it is really variable and depends on luck with experienced staff, not too many of whom are off sick, and a good Sister.

Do complete a hospital passport for your relative. There are some online, I will find a link. They do make a difference.

That might be how it works on a specialist dementia unit but my experience is of nurses on an elderly care ward who couldn't comprehend that someone with Alzheimer's might not remember or get confused by information.

I work on a specialist dementia unit and my patients often don’t have family to advocate for them. Mealtime is supervised and snacks and drinks are offered regularly. Toileting is prompted every 2 to 3 hours and showers or baths offered daily. I am a registered nurse and there are dementia support staff as well as healthcare assistants.