Fixation and sedation of dementia patients

Dementia: poor care in clinics

01/09/2014

The care of dementia patients requires a special staff effort to eliminate unnecessary risks for those affected. However, the hospitals often lack the capacity to ensure adequate care for patients with dementia, according to the results of the Pflege-Thermometer 2014, published by the German Institute for Applied Nursing Research e.V. (dip) in Cologne.

The care thermometer 2014 is according to the announcement of the institute „the largest survey to date in caring for people with dementia in hospitals.“ The result of the study presents a questionable picture of the care situation of dementia patients in the clinics. Although deficits in dealing with dementia patients have already been identified in nursing homes in the past. But in the clinics the conditions are extremely unfavorable overall. For example, 80 percent of the stations surveyed saw regular deficits in securing. For immobilization, many hospital patients with dementia also receive sleeping pills or they are fixed. In view of the study results, the dip advocated a timely improvement in dementia care in the hospitals.

23 percent of hospital patients suffer from dementia
Generally, dementia patients need according to the dip „more time and more supervision to protect them from danger and to give them direction.“ Otherwise, for example, more falls and injuries threaten. In order to check the care situation of the clinic patients with dementia, more than 1,800 ward and departmental lines from hospitals throughout Germany were interviewed in 2014 as part of the Nursing Thermometer. Almost one in four patients at the interviewed stations (23%) suffered from dementia, according to the release of the dip. However, the clinics had been insufficiently prepared for the challenges. „The study results show that supply bottlenecks occur at night“, reports the institute. Study leader Professor Michael Isfort added: „Eight out of ten interviewed stations indicate that the care of people suffering from dementia is insufficiently secured, especially at night.“ In addition, also during the day at the weekends had revealed coverage gaps.

Fixations and sedations for immobilization
For dementia patients, the overall situation in hospitals is extremely worrying. Because of the supply bottlenecks in the night and at the weekend result according to statement of the study leader increasingly questionable measures for the immobilization. „This deficiency situation often leads to unnecessary administration of sleep medication and often to questionable restraints of patients, so-called fixations“, criticized Professor Isfort. In the study were on the interviewed stations within „administered medication for sedation in patients with dementia of just one week approximately 7,600 times and performed over 1,450-times-close fixations“ Service. The researchers of the dip estimate that „extrapolated to all hospitals in Germany, about 2.6 million sedatives are administered per year and about 500,000 usually unnecessary fixations are performed.“ For the dementia patients an unworthy situation. „The study reveals serious implementation problems of suitable supply concepts“, so the message of the dip. A role also plays thereby the increasing lack of personnel in the care.

Improvements in care required in the clinics
In particular, the case-based compensation system and the high cost-effectiveness pressure were blamed for the supply deficits in the survey, reports the German Institute for Applied Nursing Research. The thinned staffing also plays an important role here. „It's time to take care of caring at the hospital seriously“, emphasized Professor Isfort, adding: „While long-term care insurance has improved the financing of care for people with dementia, hospitals have so far been waiting for increased benefits and the securing of care through good concepts to be billed.“ This crucially impedes the quality of supply. In many projects to improve the provision of dementia in hospitals, promising approaches have been tested in the past, but so far these have hardly been implemented. Only on one of ten stations come today according to the message of the dip „Concepts such as day-structuring measures or the training of dementia officers“ to wear. (Fp)