Views & Reviews Personal View

Does anyone care?

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4310 (Published 11 August 2010) Cite this as: BMJ 2010;341:c4310

My dear old Dad, 72, a physically fit and robust man of late, has Alzheimer’s disease, we think.

Recently we have heard that as many as 275 000 people in the United Kingdom may have undiagnosed dementia. This is in addition to the more than 820 000 with a diagnosis of dementia, half of whom have Alzheimer’s disease. Millions of pounds are said to be wasted on substandard care for patients with dementia, a result of inadequate investment into research and support. From first hand experience I have no doubt that this is true. I wonder how many other patients and their carers have suffered a similar litany of woes when trying to access the most basic help for a loved one with dementia.

In early 2006, after radical prostatectomy five weeks earlier, Dad is admitted at 1 am as a medical emergency patient with acute confusion via the accident and emergency department of a large district general hospital. After waiting in A&E for four hours with my mother, with little attention being paid to him and increasing confusion, he has a fit. Attempts by two staff members to return him to a trolley result in a fractured scapula, an injury that isn’t detected for several days. A doctor finally arrives to sedate him, and he is “boarded out” as an acutely confused patient to a respiratory ward.

During the first 24 hours on this ward he breaks a front tooth and sustains a facial laceration. Mum draws attention to the injuries when she visits. Staff are not aware either of the damage or how it occurred. It is apparent he will require intensive nursing care (he needs to be “specialed,” to use the nursing term). Unbelievably the ward is unable to provide this, so day and night care is provided by …

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