In response to the article on the BBC 'Over-75s 'perpetrators of NHS assaults' in which data gathered by NHS Protect showed that more than half of physical assaults on NHS staff in hospitals across England were by people over the age of 75. The article reports that NHS Protect say that the high proportion of the assaults reflect the “challenges of dealing with older people coping with the confusion of a hospital stay compounded by conditions such as dementia”:
This is unsurprising news. 80% of hospital admissions that lead to a stay of two or more weeks are people over the age of 65. The proportion of acute hospital beds that are occupied by someone living with dementia is estimated at around 25% in England, a figure that is probably lower than reality as many people with dementia are undiagnosed. For people with dementia a hospital is a stressful and distressing environment yet older people with dementia are admitted far more often than other members of the population. Most hospitals are not designed well for people with cognitive loss, and the environment and routines in an acute setting can be confusing, frustrating, or frightening for someone living with dementia, feelings which may be expressed through distressed behaviour.
Behaviour is a means of communication. All of us respond to situations according to our own perception of reality. When we feel threatened and frightened we either fight back or run away. A frightened older person with dementia who is in hospital may well be physically incapable of flight and, because of cognitive impairment, unable to make sense of their situation or verbalise their discomfort. It follows then that a fight response is logical and that criminalising the behaviour would be unhelpful, (what would the consequences of calling the police be exactly?)
Even though staff do their best, many will admit that they lack the knowledge and skills they need to care effectively for people with dementia. The nurse quoted in the article was upset that relatives thought that staff were, “doing something wrong”. Unfortunately staff are not given the tools they need to understand why someone with dementia may respond the way they do in a hospital environment. What this statistic about physical assaults on NHS staff really shows us is that knowledge about dementia and its impact on the patient and the development of hospital staff skills in working with patients with dementia needs to be prioritised.
DSDC has developed the Best Practice in Dementia Care programme to help you achieve national and regional care standards. The programme not only meets these standards but is accredited by the Royal College of Nursing and City & Guilds
DSDC offers in-house training. With associates and partners working across the UK and internationally DSDC can work quickly and flexibly, delivering training in our building or at a location of your choice.