When a hospital wasn't a place of care and safety for my Gran

I was a teenager in the UK in the 1960s when my grandmother died.

In her 80s Gran developed dementia - "gone senile", is how it was referred to in those days. She became frail and rambled to people who were not there. She was cared for at home by family members and I particularly remember her telling my mum there was a young girl by her bed. Mum told her she was her guardian angel.

An infection took Gran to hospital but she never came home. I was told she had been given medication and had fallen out of bed. She lay on the cold linoleum floor until she died.

Research shows in Australia there is a five-fold higher mortality rate for dementia patients during hospitalisation, compared to older adults of the same age without dementia.

I remember thinking how terrible it was that Gran - who had survived two world wars, raised and lost children, and helped raise grandchildren - had died cold and alone in a place where she should have been safe and cared for.

Professor of Nursing Lynn Chenoweth said one in four people living with dementia are admitted to hospital in Australia in any year, and any of those admissions can be an extremely challenging experience for the individual, as well as their carers.

"The multitude of challenges faced include separation anxiety from what is safe and familiar, receiving healthcare from people with little if any knowledge of their life story and unique psychosocial needs, as well as expectations that are often difficult to achieve," said Professor Chenoweth.

"A person with dementia requires specialised care, treatment and support to keep them safe during a hospital stay, which can absolutely occur with person-centred care."

Research from UNSW Sydney's Centre for Healthy Brain Ageing (CHeBA) has evaluated the impact of person-centred care for people living with dementia who are admitted to hospital.

Healthcare guidelines promote the Kitwood model of person-centred care which says individuals living with dementia share basic needs - comfort, inclusion, social attachment, personal identity, meaningful occupation and love.

In the CHeBA study 90 sub-acute hospital nursing, allied health and medical staff participated in online or face-to-face person-centred education and were supported in delivering person-centred healthcare by senior nursing, allied health and medical staff champions.

Those 80 patients who experienced person-centred care from hospital admission to the week of discharge had a significant reduction in incidences of delirium and accidents/ injuries, a significant reduction in psychotropic medicines and readmission rates, and an increase in discharge to the person's own home compared with a group of 78 persons living with dementia not receiving person-centred care.

There was also a 50 per cent improvement in care quality for persons with dementia following staff education on person-centred healthcare.

"We found that implementing the person-centred care model provided significantly improved clinical outcomes for people with dementia; outcomes which are beneficial for the person and their family/carer and represent an enormous cost benefit for health services," said Professor Chenoweth.

I wonder if Gran would have survived her hospital stay and come home to end her days with her family at her bedside if there'd been person-centred care in those days.