New Cross Hospital in Wolverhampton has been commissioned to pioneer a new approach to people who come into hospital and who happen to have dementia.

The New Cross Hospital dementia project is funded by the West Midlands Strategic Health Authority and is lead by project care manager, Grace Hampson.

The project is creating a dementia care bundle, namely identifying practices that, if consistently applied, will lead to a better outcome for patients.

The dementia care bundle includes:

Environment

A 20 bed ward has been created at New Cross Hospital for people who have dementia as well as the health condition for which they are being treated.

"It's been designed to help engage people with activities and things that interest them," says Grace.

"When people aren't engaged, you find them sitting slumped with their head down in a chair. That's when things start to go downhill.

"If you can engage them in all sorts of ways, they sit up with their heads held high."

Measures to make the ward dementia friendly:

• A toilet door that can be seen whereever you are on the ward. The sign is bright and highly visible.
• Other doors which patients do not need to go through, like that of a cleaning cupboard, are designed to blend in with the walls.
• Everything around the beds is easy to reach.
• The bell can be easily seen.
• A table, so that those who are well enough can sit up with others to eat.
• A garden and a reminisence area to encourage patients to engage.
• Space for relatives to stay if they want.

Hydration and nutrition

Extra attention is paid to ensure patients are eating and drinking enough.

"One reason why people might not be drinking could simply be that they do not like the drink," says Grace. "We make sure that people get the drinks that they like and some help with drinking if they need it."

Communication

All staff from porters to nurses and doctors are trained in communicating with someone with dementia.

They learn about reading body language, making eye contact, how to understand what is happening if a person is not responding verbally.

When patients are admitted to the ward, they are allocated a carer.

The carer sits down with the patient and amily members and talks in detail about the things that matter to the patient, from who they have in their family to whether they take sugar in their tea.

This enables the carer to offer indiviudalised person-centred care.

At regular intervals - they aim for around once an hour - patients are checked to see if they are happy or if they need a drink.

Outreach

Not all patients with dementia are able to be on the dedicated dementia ward.

Some, if they have a had a stroke, for example, need to be on a ward dedicated to caring for people with the same condition.

The project has an outreach team going to the wards throughout the hospital to visit patients and staff, enabling them to put the dementia care into practice.

"Our aim is to have a fully dementia friendly hospital - or as near as possible," says Grace. "We have a very ambitious training programme for staff."

Traditionally there has been no dementia training for NHS staff who have not made dementia care their specialism.

"When you don't understand what is happening with people with dementia you become fearful. When people don't respond you lose confidence. When people are ignored, there is never going to be a good outcome," says Grace. "Training everybody in basic stuff is going to make a big difference."

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