QUALITY STANDARDS

On rare occasions some people living with dementia may be prescribed antipsychotic medication if they are experiencing certain symptoms such as agitation, aggression and distress. This should only occur where care interventions and other targeted strategies have not been successful in reducing their distress and/or agitation. Such medication can help some people, but it can also have side-effects and should only be prescribed where other methods of managing symptoms have failed.
 
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If you need to be admitted to hospital you should be assessed for delirium.
Delirium is a condition which is more common among those people living with dementia. Being assessed for delirium means that you can receive treatment for that condition earlier if you have it. The hospital can also help lower the risk of you developing delirium during your stay in hospital.
 
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People living with dementia are at higher risk of developing delirium. If they are diagnosed with delirium they will be managed and provided with treatment to improve their delirium. Cognitive tests and delirium screening should be repeated to ensure that their condition is improving and symptoms have subsided.

If somebody diagnosed with delirium is not responding to treatment and cognitive impairment persists they should be referred onward for further assessment and treatment.
 
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If you have been diagnosed with dementia and are admitted to hospital, you may need to access special services. These services can ensure that you are supported and treated properly while in hospital and will help with discharge.

Your diagnosis of dementia will be recorded by the hospital when you are admitted and shared with these specialist services, even if you have not been admitted for a reason related to dementia.
 
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If you are admitted to hospital the person who cares for you should be involved in your care throughout your stay; particularly when you may not be able to make decisions yourself.

Medical professionals involved in your healthcare in hospital should be in constant communication with your carer. They should provide them with information, give the opportunity to discuss your needs, and allow them to make decisions. They should work to apply the Mental Capacity Act, when assessing a person who does not have the mental capacity to make decisions about their health and care.
 
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If you are a hospital inpatient you have the right for your carer to stay with you throughout your stay. The presence of your carer may be reassuring, they may help with some of the care, or simply keep you company.
Your carer should not be asked to leave once visiting hours are over, or even during protected mealtimes.
 
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If you experience a crisis, which could be due to a number of reasons, you know where to go and how to access timely support and if needed further assessment.
 
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All staff working to support you have an understanding of behaviour that challenges (BtC) and know where and how to offer support or refer on as needed. Recognising that behaviours that staff may consider challenging is often a way of you maintaining a sense of control, dignity and wellbeing, and/or to ease discomfort or distress.

BtC can be defined as: ‘An expression of distress by the person living with dementia (or others in the environment) that arises from unmet health or psychosocial need(s). The behaviours often reflect attempts by the person living with dementia to maintain a sense of control, dignity and wellbeing, and/or to ease discomfort or distress.’
 
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Some people with dementia may be eligible for NHS continuing healthcare and have funding for their social care provided by the NHS. But even if you do not meet the threshold to qualify for NHS continuing healthcare the NHS should still contribute to your health needs, either by commissioning appropriate services or by part-funding support.
 
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You are offered opportunity to maintain your brain health, independence and cognitive skills through meaningful activity whilst living in a care setting.
 
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You are provided with information about what to expect when your family member is admitted to an inpatient mental health ward. This information enables you to understand what to expect, how you will be able to contribute and be part of the assessment and care planning; if you are feeling that this would be welcomed. You are provided with support too as a carer by the ward team.
 
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