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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

Alzheimer's and hospitals

136 replies

handcream · 04/10/2014 20:16

I need some advice and whether I was unreasonable.

My DM has been admitted to hospital. She was moved 4 times in less than 12 hours but that isn't my concern. On a general ward a lady with severe Alzheimer's was put next to her, the nurses tried to change her, she was incontitent and she tried to bite and kick the three nurses who were dealing with her, she was shouting, swearing and screaming out. She was the same ages as my DM. After about an hour of listening to this and realising that it was nearing bedtime I felt I had to say something.

I asked that one of them be moved. I was fearful for my Mum in the middle of the night with this lady next to her.

Ironically they decided to move Mum anyway and she ended up opposite an elderly lady who rang the alarm bell every 30 mins and opposite a side room where the man insisted on shouting out and screaming when the ward phone rang (and wasn't answered in a timely fashion).

Was I unreasonable to think there must be better way to deal with patients with this horrible illness.

I would also consider that this ward had near enough mixed wards, think of a long corridor with bays of four beds, next to each other. Mum's bay was about 2 feet from the males one.

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Original poster

handcream · 05/10/2014 18:29

My Fairy, I have said I didn't mean that Alzheimer's suffers should be taken home, you have clearly missed this.

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Original poster

handcream · 05/10/2014 18:32

For those who are wondering how we all seem to know their medical history, well you have clearly never been in hospital, the nurses and doctors crowd around the bed and pull the curtains.

You can hear every single word, in fact the women next to DM started talking to her about what she had heard about Mums's condition!

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Annarose2014 · 05/10/2014 18:47

Sadly, in my experience if you are in a Nursing Home, frequent hospitisation from UTIs appear to be an inevitability. It is a combination of incontinence, adult pads and not being given a great deal to drink. People with dementia do not ask for a drink. Some care homes give their residents fluids only with meals.

The amount of time I've said to families "Every time you visit Mum/Dad don't leave till they've taken at least two glasses of water for you" and they just stare at me, confused. It never occurred to them, and I guess why should it? But no matter how much you pay for a NH, you can never ensure their fluid intake.

Bulbasaur · 05/10/2014 18:54

My great grandma had Alzheimer's before she died and she was lovely. She just loved the company. Had no clue who anyone was, but liked that we were all there to see her. Not everyone gets violent and mean.

FIL did get attacked by a lady with it though while he was staying in a nursing home. He was afraid of her after that. He's got some interesting stories about the people there.

I will agree care homes are not ideal, even here in the US where you can pay for really nice ones, they don't always help patients with what they need. FIL needs a special diet and because they've refused to accommodate him he's ended up in the hospital several times. He's just decided to move into a small house with people popping by every now and then so he can make his own meals and stay healthy(er).

IamHelenaJustina · 05/10/2014 19:00

Regarding staffing - the nurses should be assessing the patients and those at risk of harm to themselves or causing that to others may be assigned a one to one member of staff - i the ward can get somebody which is not always possible. The vast majority of nursing staff do an amazing job day in, day out nursing complex and frightened patients. It's impossible to staff wards so lavishly that this is never an issue. If the money was there - which it isn't - the nursing staff aren't.
The answer is to get patients with dementia out of general wards as quickly as possible and back to their normal environment. Partly that's hospitals working better but also families need to adjust their expectations. Elderly patients with severe dementia, infections or other complications should be the beneficiaries of excellent end of life care, NOT 'throw everything at them' continuing medical care.

Mini05 · 05/10/2014 19:00

MyFIL as dementia, last year he kept getting pains in his chest. They kept thinking it was his heart! Turned out it was indigestion.

Whilst on the cardiac ward, he was the only one with dementia! Once again nurses didn't really know how to deal with it. Let's face it it was a heart ward.

One day he got off the ward!!! And went missing for about 3 hours. The police were called and they found him a good few miles from the hospital walking down a busy main road. He hadn't a clue how he got there, or where he was!!

I think it's very sad that people with dementia don't have hospital wards just for there condition so they have nurses who understand there condition
But as the mess the NHS are in there's not a chance!

Original poster

handcream · 05/10/2014 19:08

That's the 3rd time someone has mentioned uti's and care homes.

Two of the dementia patients had them. Isn't this a flag to investigate?

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MammaTJ · 05/10/2014 19:24

No, not really. UTIs can be caused by not drinking enough. Those with dementia may well refuse to drink and obviously cannot be forced to. Simple as that really!

SauvignonBlanche · 05/10/2014 19:25

YABVU, I don't think its right to have people with mental health issues on a general ward.

Of course it is, if they have been admitted for treatment of a physical condition. A risk assessment should be done for any confused patient and additional staffing considered if required.

hawaiibaby · 05/10/2014 19:36

I was in the gynae ward this week for treatment of an ectopic and next to an older woman who was shouting out, very confused and had other things happen but as pp have said, she needed treating for a gynae issue so a separate ward wouldn't work. It was tough being where I was overnight, in pain and getting little sleep due to the disruption but it was tough for her too, I don't think there's an answer, the staff do what they can.

Original poster

handcream · 05/10/2014 19:38

What additional staff would that be then.....

We can complain and demand - we can say 'this should, that should happen' but it doesn't. So, we need to all decide how we are going to care for our relatives and friends, help when they are in hospital, my DM needed to be assisted in eating and taken for a walk around, she needed to be cleaned up around her face - the nurses don't have the time to give this sort of care to everyone - they just don't so we all need to decide how we are going to manage going forward.

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BarbarianMum · 05/10/2014 19:47

But you can encourage people to drink, and remind them to drink and help them to drink. A good care home will do these things. My lovely neighbour was in a good care home for 2 years - they used to spoon cups of tea into her 4 times a day. When it shut she was moved to another home where (we heard later) they put the tea next to her where she forgot about it. She contracted a UTI and died within 2 weeks

pudcat · 05/10/2014 19:47

I went every day to feed my Mum in hospital. The staff were feeding a lot of the patients so they were grateful for me going.

Original poster

handcream · 05/10/2014 19:50

Pud - that's the sort of thing I was suggesting. I know most have to work but share it out amongst friends and relatives. If you expect the NHS to do this and more you will be sadly disappointed.

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pudcat · 05/10/2014 19:53

A good NH will help with drinking. At the home Mum was in there seemed to be someone whose job was to go round everyone and try to get them to drink, and then go round again, and so on through out the day. But you cannot force anyone to drink you can only offer and encourage. Also with Alzheimers and dementia there are incontinence problems so often the bladder is not emptied fully. Also with incontinence (and no dementia) the sufferers will not drink as they think that will stop them having accidents.

CMOTDibbler · 05/10/2014 19:54

UTIs - my mum isn't bad enough yet to be in a care hom (yet, they manage on a knife edge), but eating and drinking is a massive issue for her. She doesn't recognise being hungry or thirsty, doesn't recognise things as being food or drink, and her swallowing is getting a bit dodgy so she spits food. Unless someone is sitting with her, literally showing her what to do - telling her isn't enough as her language is so impaired, she just won't eat or drink. Even so, dad struggles to get her to drink more than 1/3 of anything given to her, and thats with 1:1 input. If you push the matter, she'd spit it at you.

If she wasn't at home with dad, she'd have lots of UTIs, especially as she has uncontrolled diabetes as she refuses the injections

SugarPlumTree · 05/10/2014 19:57

My Mother has fewer UTI's now in a NH as they ensure he drinks nough. If she doe get one it is treated there and she has never needed to be admitted to hospital.

If she does get admitted she is up the creek from people who can help point of view as only has me and my Brother as has alienated all her friends and rest of her family. Brother is abroad and she told me the other day to go and forget she is my Mother, so Assumably would refuse to see me.

Doilooklikeatourist · 05/10/2014 19:58

We give Dad drinks every time we see him
His wife ( 2nd wife , much younger ) visits every day and makes sure he drinks loads
UTI are very common in dementia

You don't die from dementia , it's either a fall , an infection or malnutrition ( after losing the swallow reflex )

Original poster

handcream · 05/10/2014 20:06

So when DM gets home I was thinking of saying that she needs to put out two bottles of water (big ones) every day and drink them. I know that will be measurable but is that going to be too much.

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IamHelenaJustina · 05/10/2014 20:15

You need to have a frank chat with your mum about urinary matters OP. If she thinks she won't make it to the loo in time she won't drink the extra. Lots of people won't.

MyFairyKing · 05/10/2014 20:24

Bladder muscles become weaker as you get older which means urine gets retained in the bladder and poorer bladder emptying. This leaves older people prone to infections and there is not always an awful lot you can do to prevent it. Not a medical bod, so hope it's not too medically incorrect!

Original poster

handcream · 05/10/2014 20:27

Thanks Iam- I know when I drink lots I have to near a loo, but older people seem to have a fear of this

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ILovePud · 05/10/2014 20:31

Also bear in mind tea and coffee are not the best drinks as they can contribute to dehydration, your water in jugs plan sounds like a good idea. Hope your DM has had a better day on the ward.

x2boys · 05/10/2014 20:40

Of course there are dementia wards there always. Has been the problem is/when on these wards if people with dementia/need medical care my self and my colleagues cannot provide it as/we are registered mental nurses therefore have no training in general care so they have to be transferred to medical /surgical wards

Original poster

handcream · 05/10/2014 20:48

She should be out tomorrow. Actually I can see that she finds it rather safe there, amongst the dementia patients, the constantly ringing phone, the smell of sick (and worse) really doesn't seem to bother her that much.

I know it's me!

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