At least 1,400 vulnerable people will spend Christmas on a hospital ward – well enough to go home, but trapped because of a social care system starved of funding – an Alzheimer’s Society investigation has revealed.
Alzheimer’s Society today warned a desperate lack of available homecare and care homes is ‘turning wards into waiting rooms’, after its investigation revealed people with dementia are being delayed up to ten times as long as those without the condition.
There is no cure for dementia, or drugs that can slow its progression, so it’s social care, rather than the NHS, that hundreds of thousands of people with dementia in the UK rely on every day. But with a £2bn social care funding shortfall, there is not enough support for people with dementia.
The investigation, which analysed data from hospital-led audits, found that last year people with dementia spent 500,000 extra days in hospital, despite being well enough to go home, at a cost to the NHS of over £170 million.
Limited data is collected on dementia care in hospitals, and only two thirds of people with dementia have a diagnosis, so this is likely to be a conservative estimate of the true picture.
Prolonged stays in hospital have life-changing consequences for people with dementia – many become too frail to be discharged to their own home, with some sadly dying before they are discharged.
Sarah Kirkbride’s dad, David, was diagnosed with Alzheimer’s disease around five years ago.
David was admitted to hospital after he collapsed at the home he shares with Sarah and her family. David had a urinary infection and, following numerous visits while heavily pregnant with her second child, Sarah became aware that her dad was not being supported by staff.
She found that the medication her dad had been given to treat his type 2 diabetes was incorrect; he was being patronised by staff when he needed to use the toilet; and poor communication from clinical staff had all lead to an emotional journey.
David was soon declared as medically fit to be discharged, but due to limited physical activity, the 75-year-old’s mobility deteriorated. A letter was given to David from the hospital with a requirement to arrange care within the next seven to ten days.
However, Sarah had not seen the letter and another copy had to be printed. Sarah was concerned that, being heavily pregnant at the time, she would not be in a position to provide all the help and support he needed and sort help from social services. A social worker visited the ward with Sarah and enabled her to speak with the doctors, which she had been unable to do on her own.
Sarah, 29 from Aylesbury, said: “Once my dad was deemed ‘medically’ fit to be discharged they were happy to discharge him. I was due any day to give birth to my baby and had made it very clear it would not be safe for him to return home until he had some support and some care to get his strength back to mobilise himself.
“I was told that his strength would not return and I was given around seven days to find respite care in a nursing home. While in hospital the care lack of personal care that was given was upsetting. They were rude to him and at one stage begged me to stay with him while he used the toilet because he was scared.
“I would visit him every day for as long as possible to make sure he was getting food inside him. No time was spent to monitor properly what the patients were eating.
Once we managed to get him into some respite care and he came home his mobility is a lot stronger and he is more independent despite care givers in the hospital telling me his was impossible. I fear for patients that have no relatives to watch over what happens while admitted and waiting to be discharged.”
Nurses on the frontline are fearful of the safety of people with dementia while they’re stuck in hospital for lengthy periods. As part of its investigation, Alzheimer’s Society carried out a survey in partnership with the Royal College of Nursing which found 1 in 10 nurses surveyed have seen people with dementia waiting in hospital for over a year.
One of the nurses surveyed described hospital as ‘one of the most confusing and upsetting environments for a patient with dementia’. Another expressed concern that people with dementia ‘are much more likely to harm themselves or others in acute settings where they are not managed appropriately or able to have the attention they deserve to maintain their safety’.
Linda Goddard, Alzheimer’s Society Operations Manager for Buckinghamshire, Oxfordshire and Berkshire, said: “With such scarce social care funding, wards are being turned into waiting rooms, and safety is being jeopardised.
“From the woman who spent two months on a bed in a corridor because there were no available care home places, to the man who died after months of waiting left him debilitated by hospital-acquired infections, people with dementia are repeatedly falling victim to a system that cannot meet their needs.
“One million people will have dementia by 2021, yet local authorities’ social care budgets are woefully inadequate, and no new money has been promised in the budget to cope with increasing demand.
“Government attention must be focussed on social care, and pounds put behind their promises, to alleviate the pressure on our NHS hospitals, and the suffering of people with dementia on its wards.”
Dawne Garrett, Royal College of Nursing Professional Lead for the Care of Older People and Dementia, said: “Nursing staff know better than anyone how often patients with dementia are stranded in hospital when they could be discharged, if only they had more social support. Hospital is not the best place for people living with dementia, where they are at risk of falling or contracting an infection.
“The College was very concerned to see no extra resources announced for social care in last month’s Budget, and backs Alzheimer’s Society’s call for increased funding for local authorities so that they can give more support to people leaving hospital”.
The charity is urging the public to unite and join its Fix Dementia Care campaign and call on the Government to properly fund social care. Sign up now to demand action to improve dementia care: alzheimers.org.uk/fixdementiacare