NHS hospitals wind back the clock for dementia care

NHS hospitals are going back to the future to help patients with dementia by decorating their wards, rooms and corridors in 1940s and 1950s style – creating a calming, familiar environment which can help jog memories, reduce anxiety and distress | via NHS England

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Providing the best care for people with dementia and with their families is a key priority for NHS England. With the dementia diagnoses rate among older people at a record high, the Long Term Plan puts in place the building blocks for an effective and compassionate older people’s health service.

Hospitals across the country have revamped their dementia ward decor, with innovations ranging from a ‘memories pub’ to 1950s style ‘reminiscence rooms’ and even a cinema booth where patients can watch old films.

With support from local charities and staff bringing in donations, hospitals like Airedale Hospital in West Yorkshire are going the extra mile to provide a stimulating environment for patients with dementia. In Ward six, patients can relax in a ‘butterfly tea room’ complete with shop front wall mural and vintage memorabilia including a red telephone box. These items from bygone eras can give patients conversational cues and help them talk about the memories they still retain.

Full story: NHS hospitals go back to the future for dementia care | NHS England

Hospitalization at the end of life among nursing home residents with dementia

Falk Hoffmann, Anke Strautmann & Katharina Allers | Hospitalization at the end of life among nursing home residents with dementia: a systematic review | BMC Palliative Care | volume 18, Article number: 77 (2019)

Background

Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia.

Methods

A systematic literature search in MEDLINE, CINAHL and Scopus was conducted in May 2018. Studies were included if they reported proportions of in-hospital deaths or hospitalizations of NHR with dementia in the last month of life. Two authors independently selected studies, extracted data, and assessed quality of studies.

Results

Nine hundred forty-five citations were retrieved; 13 studies were included. Overall, 7 studies reported data on in-hospital death with proportions ranging between 0% in Canada and 53.3% in the UK. Studies reporting on the last 30 days of life (n = 8) varied between 8.0% in the Netherlands and 51.3% in Germany. Two studies each assessed the influence of age and sex. There seem to be fewer end-of-life hospitalizations in older age groups. The influence of sex is inconclusive. All but one study found that at the end of life residents with dementia were hospitalized less often than those without (n = 6).

Conclusions

We found large variations in end-of-life hospitalizations of NHR with dementia, probably being explained by differences between countries. The influence of sex and age might differ when compared to residents without dementia. More studies should compare NHR with dementia to those without and assess the influence of sex and age.

Full document available from BMC Palliative Care

An Incorrectly Set Watch may Suggest Cognitive Impairment in the Older Patient

Feyzrakhmanova, M. et al. |  An Incorrectly Set Watch may Suggest Cognitive Impairment in the Older Patient | Age and Ageing | Volume 48, Issue Supplement 3|  September 2019
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Background

Disorientation to time can be used as a guide to determining the presence and severity of dementia. The inability to maintain one’s wrist watch at the correct time is assessed as a possible marker of dementia.

Methods

Inpatients in a post-acute care unit with a mean age of 76.2 (±12.4 years) were assessed with regard to the time on their wristwatch. The time was recorded as correct or incorrect with a permitted discrepancy of 15 minutes. A current Mini-Mental State Examination (MMSE) score was obtained and patients were divided into two groups: MMSE above/equal to or below 24, with the latter defined as an abnormal result.

Results

The most striking finding of this study was that any patient with an incorrectly set watch had an abnormal MMSE. The majority of patients with an abnormal MMSE had their watch set correctly (38%), while only 22% were found to have an incorrectly set watch. All patients with a normal MMSE had their watch set correctly. Acknowledging the fact that conclusions of statistical methods used on a small sample size should be interpreted with caution, we report that the two-tailed Z score for 2 population proportions was 2.9277 (p=0.00338).

Conclusion

This study presents evidence to suggest a relationship between the correctness of the older patient’s watch and their cognitive status. Assessment of time on the patient’s watch could be considered as an instantaneous, approximate “test” for dementia in clinical practice. This test would have a sensitivity of 37% and specificity of 100%.