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Dementia patients getting poor care, experts claim

Alzheimer’s and dementia patients are receiving poor care in inappropriately “clinical” conditions, according to a team of independent specialists.

And one frequent visitor to the Alzheimer’s and Related Diseases Unit (ARDU) at King Edward VII Memorial Hospital has also condemned the conditions and quality of care there.

Tim Forester Morgan and Sarah Mould from the UK’s Dementia Training Company inspected the facility in December and concluded that the treatment of dementia patients at the hospital was outdated, while facilities were unwelcoming and institutionalised.

“I’m sorry to say that there were no observations of meaningful engagement between patients and staff,” Mr Forester Morgan wrote after concluding his tour of ARDU, which, along with the hospital’s Continuing Care Unit, caters for around 150 patients who have deteriorating mental capabilities. The vast majority are elderly and at the hospital indefinitely.

“Firstly, care practice needs to be addressed. Review of restraint would be highly recommended. On the day of my visit, a patient had both ankle and waist restraints. He clearly looked distressed. Although permissible under Bermudian law, restraint should only be used as a last resort.

“There were a high number of patients sitting in wheelchairs. Wheelchairs are a mode of transportation and are not designed to be sat in for any great length of time. When I spoke to the staff team about this, I was told that there were insufficient numbers of appropriate chairs in this space.”

Mr Forester Morgan also witnessed patients sitting in their pyjamas and criticised the lack of basic equipment.

A large number of patients were sitting at empty tables in the day lounge, he said.

“There should be an array of media, objects, magazines, games, available for patients to engage with. These should be easily available and accessible and should be placed within the reach of people sitting at the tables.

“Nightwear should be worn at night — unfortunately, this is not currently the case.”

Mr Forester Morgan described bedrooms as being of a “high standard”, but added: “However, they were rather clinical and did not reflect the person/people whose room it was. I was informed that some patients have lived on the ward for many years — as such, I would expect that the bedrooms should reflect their uniqueness.

Another regular visitor to the ward said that patients were not being properly treated at the unit.

And they claimed that patients had less freedom and were living in a harsher environment than Westgate inmates.

“KEMH treats ARDU and the CCU as not part of the hospital, because it considers patients to be there for non-medical reasons — as a result their conditions are not being properly addressed,” the visitor, who asked not to be named, said.

“Sometimes there’s no nursing supervision and patients start crying out and getting agitated. It becomes very distressing for them.”

The visitor said she had seen patients in wheelchairs attempting to get out of the unit, but being blocked by locked doors.

“Staff appear apathetic and don’t seem to have up-to-date information on patients’ conditions, while bedridden patients are given very little attention,” the visitor said.

The experts did praise some aspects of the ARDU. Mr Forester Morgan said he “loved” the unit’s small activity room, saying: “It was the only space in the hospital where I felt I wanted to sit down — I wonder if this may be how a lot of the patients at KEMH feel.”

And he heaped praise on KEMH’s Activity Team and its leader.

“She lights up the space with her energy and passion. The hospital is phenomenally lucky to have someone with this level of commitment and drive,” he said, before noting that the team was “stretched across the whole hospital and as such, their impact on the patients with cognitive impairments on the specialist wards may be minimal”.

The team described the unit’s garden as “fabulous”, but pointed out that it should be made more accessible to patients.

The Royal Gazette sent a copy of the findings to the hospital, but the Bermuda Hospitals Board did not respond by press time last night.

Improvements needed: Alzheimer's patients are receiving inappropriate care according to independent specialists

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Published May 03, 2013 at 9:00 am (Updated May 02, 2013 at 9:31 pm)

Dementia patients getting poor care, experts claim

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