Emergency Care for Dementia
Recognising Urgent Situations
When a person is living with dementia, it is crucial to try and ‘get into their world’ as much as possible and try to understand why they are displaying certain behaviours. Only then will you be able to recognise if there is something wrong that needs urgent medical intervention. People who are living with dementia often display behaviours that are different from what they used to, but in their altered world they are reasonable. This is why we have to avoid labelling what they’re doing as ‘challenging’ or ‘difficult’, as to them, what they’re doing makes perfect sense. Understanding this, though, is the key to recognising when something is medically wrong and the person needs urgent assistance.
Immediate Steps to Ensure Safety
Ensuring the person’s safety is always paramount and if they are displaying behaviour that is unusual for them, they are at risk or they are threatening another person’s safety then calling 999 is the best option. The operator will assess whether the situation is urgent enough to warrant emergency intervention, and if it isn’t they may be able to suggest alternative sources of support. The NHS has helpful information and support line numbers for all the major dementia charities, such as Age UK and the Alzheimer’s Society, whose dementia support line is available on 0333 150 3456.
Communicating with Medical Professionals
If you are the primary caregiver for the person living with dementia, then you will probably already have the right to speak to medical professionals on their behalf as their Power of Attorney. However, not everyone is able to take this role on or wishes to do so, which is when an advocate may be the best option to be the intermediary between the person and medical professionals. Rethink Advocacy describes what they do as “If you or someone you care for is living with dementia, an advocate can help make sure views and wishes are taken into account when decisions are being made about care, treatment, living arrangements and any other relevant considerations.” Dementia charities will also be able to offer advice on advocacy.
Long-term Planning and Emergency Preparedness
If the person is already receiving care, either from a private company such as Helping Hands or from the local authority, a care plan will be in place. This plan will describe the type of care being received, safeguards in place, and a plan for emergency situations, among other information. The importance of long-term planning can’t be understated when someone is living with a life-limiting condition, as what is working for them now may change very quickly. The plan needs to be flexible, have contingencies in place in case of a rapid deterioration, and contain their wishes for how their care should proceed. End-of-life wishes should also be detailed, such as the desire not to be resuscitated. This could be in the form of a:
DNACPR (Do not attempt cardiopulmonary resuscitation)
This will be present if the person, their advocate or their healthcare team have made the decision that attempting resuscitation would not prevent their death, for instance, if they are living with underlying severe health issues. The person can make this decision if they are well enough to do so. However, a representative or medical professional can make it on their behalf if they are not.
ReSPECT (Recommended Summary Plan for Emergency Care and Treatment)
The ReSPECT process “creates personalised recommendations for a person’s clinical care and treatment in a future emergency in which they are unable to make or express choices.” Available in many areas of the country, this process will be created through conversations between the person, their loved ones, and healthcare professionals. The person’s wishes for their care will be detailed, and realistic outcomes will be discussed.
ADRT (Advance Decision to Refuse Treatment)
This “enables someone aged 18 or over, while still capable, to refuse specified medical treatment for a time in the future when they may not be able to do so.” According to the Resuscitation Council UK, it is a legally binding document that enables someone to make decisions about their future care while they are still able to, ahead of any emergency.
Home Care Options for Dementia Customers
For many people living with dementia, the desire to remain living in familiar and comforting surroundings is paramount to their continued well-being. Receiving care at home can reduce anxiety and limit confusion, as their emotional connection to the home, plus the people and pets living there will be comforting, even as dementia progresses. Eventually, though, some support at home will be necessary as the person will unlikely be able to continue looking after themselves, and this is where Helping Hands come in. We’ve been supporting people living with dementia in their own homes since we were established in 1989, and because our visiting and live-in care is fully regulated by the Care Quality Commission and the Care Inspectorate Wales, you or your loved one will be in the very best hands right from the start.