Dementia and delirium
We are committed to providing the very best care possible for our patients with dementia and delirium at the Royal Devon.
Our staff are trained to understand and support people with these conditions, providing kind, compassionate and considerate care.
We participate in numerous schemes, local and national, to promote and advance the wellbeing of people with dementia in our care. See below for more information.
Dementia and delirium
Dementia is the term for a group of progressive diseases including Alzheimer’s, Vascular, Lew Body and Frontotemporal dementias that affect brain function.
People with dementia may experience symptoms such as memory loss, visual and/or auditory hallucinations, difficulty with co-ordination and movement; they may have difficulty concentrating. They are likely to experience a decline in their cognition meaning they may be unable to process new information, may have visuospatial difficulties and have difficulty with word finding and speech. As the disease progresses they may also experience difficulty expressing their needs; being unable to explain they are in pain for example. They may also experience difficulty with swallowing, walking and other daily tasks.
Some people with dementia may find coming into hospital difficult. Although they may not develop an acute delirium it may make their symptoms worse, the change in environment, not being able to recognise people and being unable to understand what is happening can be frightening for some.
Delirium is a sudden onset acute confusion; the person may experience varying consciousness, reduced ability to maintain attention, appear disorientated. Whilst dementia is a slow and gradual onset a person with delirium will develop their symptoms more quickly.
People who are over 80 years old and have already been diagnosed as having some form of dementia are particularly at risk of suffering delirium, but anyone who is unwell can experience some symptoms of delirium. There are many causes of delirium which include infection, cardiac illnesses, respiratory disorders, electrolyte imbalance, surgery/anaesthetic, drugs and drug withdrawal, urine retention, constipation, or being in pain.
Often the change in routine, environment and the fact that there are lots of new people around can increase or cause the symptoms of delirium. They might find it difficult to concentrate. They may be particularly drowsy, or alert and agitated. There may be a complete change in personality, or unusual behaviour.
Usually it gets better. In around half of people the symptoms disappear within six days. Others may still continue to experience some symptoms when leaving hospital. Unfortunately some people may never fully recover from their episode of delirium and will need further support. Delirium is a condition that can be frightening for those suffering from it, their carers and relatives. Not everyone remembers delirium, but those that do may find the memories distressing.
Supporting people with dementia and delirium in hospital
People with dementia are often more confused and frightened when in hospital which can be relieved when their carer stays with them. We support John's Campaign at both of our acute hospitals. This means we give open access visiting to carers of people with dementia and they have the right to stay all day and all night if they wish.
Small reminders of home
If you are unable to visit, it would be appreciated if some small reminders of home could be sent in that may help people feel more comfortable. Photographs that can be laminated- especially if the names of people/pets can be added to allow staff to talk about the pictures, favourite books or magazines could all help to make a person feel more at ease.
We encourage and support the use of ‘This is Me’ created by the Alzheimer’s Society and if you have one of these we would find it really useful if it could come into hospital, or be available to teams who may visit you at home. An online version of 'This is me' can be found here.
We are lucky to have access to a lovely dementia-friendly garden space at the Royal Devon and Exeter Hospital (Wonford) which provides a tranquil setting for people to be able to sit or walk safely around paths. The garden has benches to sit on and sensory areas to enjoy. Please ask staff on the ward about how you can access this.
We have dedicated wards that are designed to be dementia-friendly and our staff have regular training to ensure we are able to provide the highest quality care to patients with dementia and delirium.
Dementia and Delirium Champions
We have a network of Dementia and Delirium Champions across the Trust who work together to deliver projects that are designed to improve the experience of patients and their families/carers.
Supporting people with dementia and delirium in the community
Admiral Nurse Service
Dementia UK provides specialist dementia support for families through the Admiral Nurse Service, these nurses are hosted by the Trust to provide the specialist dementia support families need.
When things get challenging or difficult for people with dementia and their families, Admiral Nurses work alongside them, giving the one-to-one support, expert guidance and practical solutions people need. The unique dementia expertise and experience an Admiral Nurse brings is a lifeline–it helps everyone in the family to live more positively with dementia in the present, and to face the challenges of tomorrow with more confidence and less fear.
There are currently Admiral Nurses in the following areas; Barnstaple, Topsham, Woodbury, Exmouth and Budleigh, Honiton and Sidmouth.
Dementia support cafes