Responding to the publication today of the ‘Dignified Care? The experiences of older people in hospital in Wales’ report by the Older People’s Commissioner for Wales, Age Cymru’s Director of Influencing and Programme Development, Victoria Lloyd says:
“The dignity of older people must be at the centre of health and care services and we welcome the publication of this report.
“In particular we welcome recommendation that Health Boards and the Trust should prioritise the promotion of continence and management of incontinence.
"The review states that lack of timely response to continence needs was widely reported and is unacceptable - sadly this echoes our own findings and we are pleased that the review recognises the importance of this issue.
Privacy and independence
“Privacy and independence in personal care are essential in helping people to maintain dignity.
"We are aware of many examples of inappropriate treatment that illustrate a failure to provide adequate support to maintain independence and a lack of facilities and staff awareness to provide a satisfactory level of privacy.
“The use of block treatments or going to the toilet by the clock rather than time of need was cited to us by older people, as was being told to wet the bed because of staff shortages.
"Unfortunately ‘forced incontinence’ is frequently reported with patients being made to use a commode or incontinence pads rather than receiving assistance to use the bathroom.
"Several older people complained that being asked to use bedpans or commodes in wards where bays are only separated by curtains is inappropriate and embarrassing.
“Addressing this issue will be key to promoting independence, and improving dignity and respect in hospital care.
Dementia awareness and hospital discharge
“The recommendation that regular dementia awareness training and skills development should be a requirement for all staff caring for older people is also welcome.
"Specialist and skilled multi-disciplinary input needs to be available to support staff to deal more effectively with people with dementia – this is something we have been calling for.
“We know that currently specialist mental health beds are often not equipped to support those with frailty and physical needs, whereas intermediate care services are reluctant to admit people with dementia.
"As a result, discharge from hospital becomes extremely difficult, even when it is clear that hospitals cannot provide the most appropriate support for the patient.
"Many older people with dementia have little access to consultant geriatricians and other specialists.
"Often, and particularly when older people are resident in care homes, their dementia will be diagnosed and managed by a GP.
”It is vital that understanding of dementia is spread to general nursing staff, GPs and their staff, social workers and other professionals throughout the health and social care sector.
"There is also currently a lack of understanding around the issue of mental capacity and therefore training on dementia should include awareness of how to use the Mental Capacity Act and its implementation.
"In addition, information and support for those diagnosed with dementia must be improved, and rapid improvement must be made in the quality of care for people with dementia in hospitals.”