British Geriatrics Society

The 2012/2013 Operating Framework for the NHS in England was published towards the end of last year, and although not immediately translatable to the health service in the devolved nations, over time policy often follows similar lines throughout the United Kingdom.

Happy new year. Unfortunately for many in the United Kingdom, it may not turn out to be so, and the National Health Service will not be immune to the increasing fiscal gloom.

In December, the report into the findings of the first National Audit of Dementia Care in General Hospitals was published. (Click here to download)

An interim report was published in December 2010 and was reviewed in the May 2011 edition of this Newsletter. The report was commissioned and funded by the Healthcare Quality Improvement Partnership. The collaborators in the project were the professional bodies for five of the main disciplines involved in providing dementia services, and one of the main voluntary sector providers of support and services: The Royal College of Psychiatrists; the British Geriatrics Society; the Royal College of Nursing; the Royal College of Physicians (London); the Royal College of General Practitioners and The Alzheimer’s Society.

Almost 60 per cent of people with dementia die in care homes compared with 32 per cent in hospital. Older people entering nursing homes are much frailer than in previous decades and 70 per cent suffer from dementia, with half of this group dying in the first year after admission to nursing home care. Yet dementia is not recognised as a terminal condition by either staff or relatives.

Staff often feel overwhelmed by the level of frailty as well as the challenges of caring for people with dementia. The lack of understanding that a familiar setting is preferable at this stage means people with advanced dementia can often end up in hospital at the end of their life. Professional carers can also feel threatened and blamed by relatives. They regard death as a taboo subject and face major challenges speaking to relatives about impending death.