Families asked to feed dementia patients…. How do we design a system that is fair to both the well spread, and the very locally based families?

The quality of care that demented and dementing patients are receiving is inadequate. There is not enough funding, in any system, and especially one without rationing, to provide the quality of care needed. ( National Dementia Audit: Important improvements in dementia care, but more support needed report finds) If you have a stroke, or have cancer, the treatment deficit is similar. These people won’t have votes for much longer, but they have paid into the safety net. So what is to be done: an open and frank discussion about the need to ration, and then an informed discussion of the options and the implications of those options…. It may be reasonable that, where possible, families should feed their relatives in todays financially constrained world. But this is rarely possible in our mobile society. Many UK children think internationally rather than nationally ( hence the Brexit differences between generations), and are working intensive days. Should the next generation be contributing financially if they cannot contribute with care/feeding? How do we design a system that is fair to both the well spread, and the very locally based families? And do this before we are completely swamped?

An educational imperative on Advanced directives might help reduce the numbers….

Image result for dementia care cartoon

Image result for dementia care cartoon

Chris Smyth reports 22nd July in the Times: Families asked to feed dementia patients

Families must be drafted on to wards to feed relatives with dementia who are routinely going hungry in hospital, a comprehensive audit of NHS care concludes. One in four staff caring for dementia patients says they cannot feed them properly, with some resorting to sharing their own food, the study by leading doctors found.
Overstretched hospitals can struggle to provide meals when people need them and do not have the staff to ensure vulnerable patients actually eat what is put in front them, the figures suggest.
Oliver Corrado, consultant geriatrician and author of the report, argued that if families helped out more, it would also be good for those without relatives…….

….“we can’t subcontract out feeding people”, saying it would be “awful” if families felt they had no choice but to come in at mealtimes.
Ms Carter said the system worked well in hospitals where staff discussed with relatives what role they wanted to play and both showed flexibility.
Eileen Burns, of the British Geriatrics Society, said: “On the surface it might be perceived as simply a cost-saving exercise but in reality it is often highly beneficial for older patients with dementia. Relatives and carers can help create a supportive, familiar environment.”

Image result for dementia care cartoon

Understanding NHS financial pressures and how they are affecting patient care (The Kings Fund report) by Ruth Robertson, Lillie Wenzel, James Thompson, Anna Charles 14th March 2017

Harvard Medical School and Medical Publications: Practical advice for helping people with dementia with their daily routines – 7 ways to make life easier and more rewarding for demented people

( National Dementia Audit: Important improvements in dementia care, but more support needed

report finds) Simple Measures: National Dementia Audit: Important improvements in dementia

care, but more support needed report finds 

Image result for dementia care cartoon

Advanced directives needed. Choice in death and dying. Lord Darzi warns of “draconian rationing”. GPs need to be involved at the interface of oncology and palliative care.

An advanced directive or living will – It’s important to specify, especially lying flat. Good news if you take action.

 

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This entry was posted in A Personal View, Nurses, Post Code Lottery, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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