✦ LIBER ✦

Decline in quality of life for patients with severe dementia following a ward merger

✍ Scribed by Kathleen Bredin; Dr. Tom Kitwood; John Wattis

Publisher: John Wiley and Sons
Year: 1995
Tongue: English
Weight: 550 KB
Volume: 10
Category: Article
ISSN: 0885-6230
DOI: 10.1002/gps.930101109

No coin nor oath required. For personal study only.

✦ Synopsis

The effect of a ward merger on the quality of life of patients with severe dementia in a mental hospital was investigated by means of the observational method of dementia care mapping (DCM). Nineteen patients in two long-stay wards were included in the study prior to the merger. Fourteen of these were observed in the merged ward, together with five newly admitted patients. Key DCM indicators showed that the quality of life of patients included in both phases of the study had declined significantly. This may be explained, in part at least, in terms of a 'cycle of demoralization and depersonalization' in the interaction of staff and patients. Further research is required into the dynamics of this cycle.

KEY wom-patients with dementia; quality of life; ward merger; dementia care mapping Changes in Government policy related to longterm care have led to a general reduction in the number of long-stay beds in NHS hospitals, including provision for patients with dementia. As a result, many patients have been relocated, and serious questions have been raised about the effects of the relocation process on their wellbeing. There is particular cause for concern in the case of those who have dementia, because their need for security is very great (Miesen, 1992) and their ability to make sense of what is happening to them is very limited.

An important, although crude index of the effect of relocation is patient mortality. A review by Borup (1983) of 28 relocation studies found evidence of increased mortality in 21 out of 28 instances, and a more recent study by Robertson et al. (1993) of the relocation of patients with dementia found increased mortality among those whose lives were most disrupted. Evidence related more directly to quality of life has, however, been remarkably lacking. The method of dementia care mapping (DCM) is well suited to the study of

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