Caring for the person with dementia in hospital

Dementia is a progressive condition affecting cognition, memory, and behaviour, with significant implications for individuals, families, and healthcare providers.

Patients with dementia are highly vulnerable in hospital environments due to unfamiliar surroundings, disrupted routines, and communication difficulties. This can lead to increased anxiety, agitation, and a decline in physical and cognitive function. The traditional hospital model, which prioritises medical interventions over psychological and emotional well-being, often fails to meet their holistic needs.

Therapeutic engagement involves structured, person-centred interactions that promote communication, emotional well-being, and cognitive stimulation. Rather than focusing solely on physical care, it aims to build trust, reduce distress, and enhance the overall hospital experience.

While medical management is essential, therapeutic engagement and meaningful activity play a crucial role in improving patient well-being and hospital experience and here Dorset County Hospital NHS Foundation Trust the Dementia team have taken a proactive approach to try to address the personalised need for activity.

Meaningful activity refers to engagement that holds personal significance to an individual.

For people with dementia, maintaining a sense of routine and purpose through tailored activities can significantly enhance well-being.

For veterans with dementia, the challenge of the hospital environment can be further compounded by their past experiences. Military training emphasises structure, discipline, and resilience, which may shape how veterans respond to hospitalisation. Additionally, some veterans may have underlying post-traumatic stress disorder (PTSD) or other service-related mental health conditions that can influence their reactions to stress, noise, and certain interactions. Without appropriate engagement strategies, they may experience heightened distress, mistrust, or withdrawal.

Having completed an NIHR internship (research initiation award), this gave me confidence and knowledge to want to pursue a clinical academic pathway and my work in this area has now led me to progress a proposal for a PhD, focusing on the lived experience of veterans with dementia in the acute hospital setting, further highlighting the importance of personalised, meaningful interventions in acute care settings.

It is hoped that this research will contribute to improving care pathways for veterans with dementia, ensuring they receive hospital care that recognises and respects their unique needs.

Therapeutic engagement and meaningful activity are essential components of high-quality dementia care in NHS acute hospitals. For veterans with dementia, recognising and integrating military-specific approaches can further enhance their hospital experience, reduce distress, and promote better outcomes.

Embedding these principles into routine practice requires staff training, investment in resources, and collaboration with military support organisations. Here at Dorset County Hospital we have also been extremely fortunate to have been supported by the Royal British Legion who have provided us with some care packages to give to veterans in the hospital. The giving of the care packages by the dementia team was an excellent way to engage with patients about their military history but also to give the recognition to those who have served.