Gov decides health professions should get a clue????

A question about : Gov decides health professions should get a clue????

https://m.bbc.co.uk/news/health-31557377

My mother in law has just been released from hospital since she fell over on boxing day and she is showing signs of dementia

What we can't understand is professionals (nurses, doctors, social workers) persist on talking to her like 'a rational' human being about life changing desicions, (what medication are you taking ?, i don't take any thing comes her reply), yet her medication is a full two pages of prescribed meds

and as by-standers we stand there bewildered that these professionals are simply not getting it???????

And had we not been at her side to tell the doctors the facts, it's very clear they would act upon her irrational responses, which is terrifying my wife and her sister

She has not been diagnosed with dementia, but it's very clear to us (no training) that she is totally unreliable to question, even about the time of day and it's scary that doctors and nurses seem oblivious of the problem

The fact that the UK gov has eventually decided to train ALL NHS staff how to deal with dementia you would think it absolutely essential that professionals working on an ELDERLY only ward

It does speak volumes about the credibility of nursing professionals perse

If they cannot tell whether an 82 year old woman doesn't know what they had for tea 15 minutes ago then what why the hell would they know how to fix your broken leg??????

Best answers:

• Are you sure they are not asking these questions to try and ascertain the extent of the dementia?
• From a legal standpoint there is a presumption of capacity until shown otherwise and capacity is decision specific. A person may have capacity to make day to day decisions, for example, but not more complicated ones. Have you raised your concerns with the relevant professionals?
  Edit - and even if I was having difficulty, I would still like to be spoken to like a "rational" human being. I'm still an adult, not a child, whatever my capacity.
• Have you considered that these professionals may be treating your mother in law with dignity and respect by talking to her rather than ignoring her and talking to those around her. By doing this they can assess her capacity and then get further information from her relatives?
• Have to say Im offended by the description "speaking to her like a rational human being".I was diagnosed a couple of years back with early onset alzheimers and up to the diagnosis and after the consultants have always spoken to me like a "rational human being".As ruby tuesday said they are asking questions of the patient to determine their capability mentally.
  My wife accompanies me to each appointment I attend and they are basically the same,they will tell me the names of three things in the room,pen,chair etc and tell me to remember them for later.They then ask what medicines I am taking and how often.
  They may ask do I know what floor of the clinic im on,or who the prime minister is.All questions designed to determine my mental state then and how much its deteriorated since my last visit.
  My wife has kept a notebook since my first visit and using my past answers to similar questions we can along with the consultants see my deterioration over time.
  From my own understanding and from what doctors told me dementia is very much misunderstood,I have not gone from a very healthy man to sitting in a wheelchair not knowing anyone since my diagnosis,in fact I can still walk the dog as I live in the countryside with many fields at my home.
  I take my mobile with me and my wife rings me every half hour to see im ok.What I cant do? I do have trouble recognising neighbours names but given a minute or so it comes to me.Also I do have problems if im at the local shop as theres days I cannot count the cost of things however the owners know me and my problems and soon sort me out.
  Dont be writing off your MIL either because of old age or dementia,she will welcome as I do not being talked about as if she wasnt in the room,I am under no illusions about my future and I certainly have some fear of it,but I have a wonderful wife and a large family around me which I believe will help me in the years ahead......
• What would you rather? That medical staff speak to her (as indeed they used to speak to elderly patients) in a kind of kindergarten patois?
• I have reached the point where I see no point in trying to communicate with the NHS anymore, it's like talking to a brick wall. Perhaps I should get myself diagnosed with dementia, they might take more notice of what I say.
  When I was in hospital last August I noticed that my records wrongly state that I have already had my heart operation, so I pointed out the error. In fact I pointed out the error every time a doctor walked in and referred to it. On the day I was discharged a week later, the doctor walked in and said "So, you're having another operation...."
  "How many more times do I have to tell you that I haven't had an operation!"
  "Well, all that matters now is that you're having another one"
• I think the issue is not the tone that NHS professionals use, it's the fact that they will often take what a patient is saying at face value even when it's clearly not true. OHs mum has Huntington's and in the early stages of her disease she would go through stages of psychosis and a lot of what she was saying was not logical or rational, but those 'caring' for her - doctors, social workers etc - would choose to believe what she was saying. Often the impression we got was that she was believed not in order to 'maintain her dignity' but just because it was easier for the staff to do so over things like medication and personal care. It horrified me that she would be asked about things like whether she'd taken medication and her answers wouldn't be checked, even when she didn't even have a clue where she was - if someone doesn't even know that they're in hospital then their responses about whether they've taken medication or eaten shouldn't just be taken at face value. That's not maintaining someone's dignity, that's neglect.
  The problem was that we could see that her care was suffering because it was easier for the professionals to believe that she was 'better' than she was. I really do believe that her life could have been a lot better in her last few years at home if she'd been assessed properly and had access to the levels of medication that she needed to effectively control both her physical and mental symptoms. What frustrated me was that the doctors just couldn't seem to understand that even though someone could give a seeming rational answer to a question what they were saying might not actually be correct. Tbh it's much 'easier' now that her condition is much more advanced as they now have to take more account of her physical symptoms as her speech has now all but disappeared. I'm all for treating patients with dignity and not speaking to any adult like a child (which is something that a lot of elderly care practitioners are guilty of) but there does come a point where the professionals have to realise that a patient might not have the mental capacity to give the kind of reliable information that's needed to provide effective care.
• What strikes me is that there are people complaining that the NHS are too ready to listen to patients, and then others like me who complain that they won't listen at all.
  The conspicuous thing that these contradictory behaviours have in common is that they're making less work for the NHS in each case. It's less bother to assume than take the trouble to check.
• It is important for us to talk to the person like "a rational human being". It promotes dignity, and helps ascertain the extent of confusion and whether this is a long-term or short-term memory loss issue or both. When assessing people, it is important to ask them questions, and not assume they have lost all faculties just because they have forgotten their list of medication, or what year it is, or who the prime minister is.
  Equally, it is also important to carefully listen to family members information about the patient. It can give us a much greater insight into the pattern of confusion, and how long it has been going on for, and can allow us to exclude other causes, particularly in acutely confused patients (urinary tract infections and general anaesthesia are known to cause extreme confusion). I am sorry that no one has taken the time to explain this to you, or your wife, or her sister, and can understand why this makes staff look inept, or like they don't know what they are doing, if no one has bothered to explain the reasons behind the actions. I am hoping that this is their thought process, rather than just forgetfulness or lack of communication/bad record keeping.
  As part of the screening process to determine mental capacity (essential for nursing staff to assess if in doubt, so we can be sure the patient is able to consent to care), we are asked to quote patients' responses to questions, no matter how bizarre or non-sequential they seem, to help inform the decision making process, and to involve the patient as much as possible in future decisions, and document their wishes, again even if these are non-sequential or inappropriate.
  I hope this is helpful, and I'm sorry you and your family have had such a rough time.