This episode looks at mental health care at St Mary’s Hospital. We follow staff in the A&E department following the admission of a woman with severe mental health issues who has to wait 29 hours for a psychiatric bed to become available while the staff endeavour to find the specialist care she needs.
We also see the toll taken on families affected by dementia and follow staff in the Witherow ward as 75-year-old Carl’s condition worsens.
There are around 800,000 people with dementia in the UK and, due to our ageing population, this is expected to rise to 1 million by 2025. A third of people over 65 will develop dementia and two thirds of people with dementia are women.
Hospitals can be particularly disorientating and frightening places for people with dementia and Imperial Health Charity is proud to be the supporter of several key initiatives aimed at improving the quality of care for them, as well as a wide range of improvements to the A&E department.
The charity has funded the use of My Improvement Network technology, which provides a plethora of activities that includes games, music, physical exercises and opportunities for social interaction all contained within an All-in-One unit that is portable, compact and compliant with infection control requirements.
The technology has been in use on Valentine Ellis and Albert ward at St Mary’s Hospital since spring 2016 and involves activities on computers, television screens and tablets. It helps patients in a number of ways, including helping to reduce the number of falls and reducing the need for one to one Special Nurses. A study of patient falls on the Albert ward found that after the technology was introduced, falls dropped by 50%.
Katie Pritchard, Ward Manager on Albert ward, said: “The technology has made such a difference. It has transformed the way we deliver our nursing care to patients with dementia; we’ve even won a Quality Improvement Award recently. We would like to thank the charity for providing the funding for this equipment.”
Since July 2015 Imperial Health Charity has funded weekly creative workshops for elderly patients and those with dementia, organised by Paper Birch, an organisation that uses art and creative workshops to stimulate patients and encourage memories and thoughts.
Paper Birch run the workshops where patients are encouraged to use arts and crafts as a means of expression. “It's wonderful having such fantastic enthusiasm from the staff to make projects like this happen,” said Faith Wray, Paper Birch’s founder.
"Our workshops can make a genuine difference to patients and staff, as it gives ward staff the time to concentrate on patients who are in need of more frequent care. Alongside this, workshops can encourage mobility of patients and can totally change the atmosphere around a ward.”
Many dementia patients find it difficult to eat and drink enough to keep themselves well-nourished and hydrated. To address this, Imperial Health Charity funded an innovative hydration and nutrition pathway to help patients consume the amount they need, which was developed by the dementia care team at Imperial College Healthcare NHS Trust.
The Dementia Nutritional Support in Hospital Pathway (also known as NoSH) has three tiers of care and aims to improve nutrition and hydration in patients with dementia by providing a tailored response to their needs.
All patients who are admitted to the Trust with a diagnosis of dementia are automatically placed on the first tier of the NoSH programme, known as 'core support'. Patients have their weight monitored regularly and their food and fluid intakes recorded to help the nursing team ensure they are getting all they need. Patients are also given healthy snacks providing them with access to nutritious foods on demand and sugar-free squashes to add to water to help keep their fluid levels up.
For patients who require a little more support, the team has developed the 'enhanced' and 'intensive' tiers of the programme, which include daily reviews, one to one support for patients and the use of music during meal, scientifically proven to stimulate appetite.
Nurse, Jo James, dementia care lead at the Trust said: "Good nutrition is a vital part of dementia patients' recovery and goes hand-in-hand with treating their medical needs. Our new patient centred approach to nutrition and hydration allows us to keep a close eye on patients' intake while they are on the wards, which aids a speedy recovery so they can return to their own home sooner."
To help patients with dementia feel safe and secure, the Witherow ward at St Mary’s Hospital was completely redeveloped with funding from Imperial Health Charity in 2016.
Key improvements on the ward include:
To help raise awareness of the condition across the trust, the charity has paid for the recruitment of somebody with first-hand experience. Dianne Campbell was diagnosed with vascular dementia at the age of 47 and wants to use her diagnosis to help others. She’s been brought on board to host training sessions, providing a unique insight for healthcare staff.
The Learning From Life project has had a transformative effect on staff and many have told us that their perceptions of people with dementia have changed entirely.
At the same time, the platform has given a voice to dementia patients, putting them at the heart of the Trust’s efforts to make hospitals more welcoming for people living with the condition.
Our funding has covered the cost of Dianne’s part-time salary, providing staff training one day a week and supporting the dementia team with a range of other tasks.
You can read our interview with Dianne here.
Patients visiting A&E at St Mary’s will now benefit from improved facilities and an increase in treatment areas for the most serious cases following a £3.5 million refurbishment, fully funded by the charity.
The renovations have resulted in:
Dr Alison Sanders, Chief of Service for emergency and ambulatory care at Imperial College Healthcare NHS Trust said:
“The upgrade will provide more spaces for assessment and treatment of our most critically ill and injured patients and a more efficient working environment for staff. This will mean faster pathways for patients, in better surroundings and with greater privacy.”
For more information about dementia, please visit http://www.nhs.uk/Conditions/dementia-guide/Pages/about-dementia.aspx
We’re proud to support better mental health care at our hospitals and you can too. If you’d like to get involved and show your support, please visit our fundraising page to find out how you can take part in one of our regular fundraising events or organise your own.
You can also donate to help improve services around the Trust. 100% of the money raised by the charity goes back to improving patient care. Visit our website for more information.