Restraining and sedating dementia patients ‘routine’ in hospitals in England, study finds
People with dementia are being subjected to restraints and non-consensual sedation while in hospitals in England, according to the first study of its kind,These restrictive practices were found to be an “embedded aspect of routine ward care”, according to the analysis, with such examples including dementia patients having their bedside rails raised, doors and pathways blocked by furniture, experiencing verbal commands to sit down or go back to bed, and physical interventions such as non-consensual sedation,The report, by academics at the University of West London, involved analysis of 225 days of ethnographic observation across nine NHS wards in England alongside more than 1,000 interviews with healthcare professionals,They also found that many hospital staff did not see these practices as being restrictive due to their routine use throughout NHS wards, with staff questioning how else they could care for patients with dementia to keep them safe without harming themselves or others,Up to 50% of all acute hospital admissions are patients who are also living with dementia, according to government figures.
Many of these hospital admissions occur when a patient with dementia may require inpatient care, such as after a fall or separate illness,Prof Andy Northcott, professor of medical sociology at the University of West London and lead author of the study, said: “This study is the first observation of its kind that looks at the experience of people living with dementia through a hospital admission, and how they are contained at the bedside throughout it,“Once a person with dementia is admitted for anything, they’re essentially expected to stay in bed and there’s a series of subtle to quite overt restrictive practices that are used to ensure that the hospital can manage around them,”He added: “These practices are largely done to be in the patient’s best interest but they have a huge impact on the person they’re done to,The immediate negative impact is that they might not necessarily know where they are, and have the expectation to sit still.
Staff don’t like the restriction, they just feel that’s the only way they can manage a person living with dementia, because they feel liable if that person was to have a fall.”The negative impact of dementia patients experiencing restrictive practices ranged from becoming agitated, the report found, to becoming upset and wanting to leave the ward, while not understanding where exactly they are.Andy Woodhead, who has vascular dementia and was admitted to hospital after a fall, said he experienced such restrictive practices by hospital staff.“I was confined to the bed and wasn’t able to go to the bathroom, and so had to use a urine bottle,” he said.“I was made to feel as if I was being a bit of a nuisance.
”The report recommended that in order to reduce to use of restrictive practices, staff should be encourage to use alternatives such as supported walking, helping patients with personal care, and listening and engaging patients in conversation.Paul Edwards, chief nursing officer at Dementia UK, said: “It is well known that the care of people living with dementia in acute hospital settings can be variable and can fall short of what patients and families should expect.This reflects a system under immense pressure, where staff often lack the time and specialist knowledge needed to provide the dedicated support people with dementia require.“People living with dementia and their families deserve care that recognises their needs and supports them at their most vulnerable.”An NHS England spokesperson said: “People living with dementia should always be treated with dignity in every care setting – restrictive practices should only be used as a last resort and if absolutely necessary for patients’ safety.
“The NHS has provided staff with guidance and training resources to on how to keep patients safe with the least restrictive practices.”.
Mother’s Day UK recipes: three delicious ideas to make for your mum from Ravinder Bhogal
Few things say “I love you” more than an unbidden cup of tea, but if you want to show true appreciation to the maternal figure in your life this Mother’s Day, there’s nothing better than a few indulgent snacks to go with it. I love the British tradition of afternoon tea, but I find finger sandwiches in hotel lobbies a little too fussy. I would much rather a fortifying savoury sandwich, a slab of good, old-fashioned cake and buttery biscuits that crumble into a million sweet crumbs.This very simple cake can be baked in a regular cake tin, but cooking it in a bundt tin makes it much more of a showstopper. If you want to forgo the icing, serve with a dollop of creme fraiche and berries instead
Benjamina Ebuehi’s recipe for caramelised white chocolate and rhubarb cheesecake | The sweet spot
It’s often my own impatience that forces me to make no-bake cheesecakes over baked ones. They’re not at all as faffy, though it’s pretty hard to beat the lighter, silkier texture you get with a baked version plus the extra effort is worth it on a special occasion such as Mother’s Day. I’ve sweetened the filling for this one with caramelised white chocolate – it brings a beautiful, creamy, dulce de leche-type caramel flavour that even the biggest white chocolate haters should enjoy. If making your own caramelised white chocolate feels a step too far, however, just buy bars of blond chocolate instead. Top with gently poached rhubarb for a pop of colour and to cut through the richness
Noma chef resigns amid allegations of physical abuse of staff
René Redzepi, the head chef and co-founder of Noma, has announced his resignation from his internationally acclaimed Copenhagen restaurant following allegations he physically abused his staff.Redzepi had been facing protests in Los Angeles before a four-month pop-up that launched this week. His resignation on Wednesday comes after the New York Times detailed allegations of physical and psychological abuse, including claims that he “punched employees in the face, jabbed them with kitchen implements and slammed them against walls”.He wrote in an Instagram story: “I’ve decided to step away and allow our extraordinary leaders to now guide the restaurant into its next chapter.”Redzepi said the recent weeks had “brought attention and important conversations about our restaurant, industry and my past leadership”, writing: “I have worked to be a better leader and Noma has taken big steps to transform the culture over many years
Light red wines for spring drinking
Can wine ever be good for you? The question has surely occurred to most of us after a night on the chȃteau de migraine, especially if we’ve read the increasingly dire warnings on alcohol consumption. Still, as with chocolate, a lot depends on what type of alcohol you drink. After all, a 90% cocoa solids situation is probably going to do less harm than, say, a family tub of Celebrations, and, while all alcohol is, I hate to break it to you, alcohol, there are definitely better choices you can make.The Guardian’s journalism is independent. We will earn a commission if you buy something through an affiliate link
Rachel Roddy’s recipe for risotto in bianco | A kitchen in Rome
Parmigiano reggiano, grana padano, lodigiano, trentingrana and the other members of the grana-type cheese family (there are many, and all are worth seeking out) are far from cheap. Which is why it is important to use every last bit, including the rind with the last few millimetres of cheese still attached. That functions as a sort of highly flavoured and fatty stock cube that can be added to soups and stews. The best place to keep your precious rinds is in a plastic bag or airtight container in the freezer, which also preserves flavour and stops them drying out, until they’re pulled out and added directly to whatever needs a boost, or to make one of the nicest, most delicately flavoured and cheesy broths, which in turn makes a lovely risotto.I have written about risotto many times here, with each version a new favourite, and providing lessons in a dish that, regardless of how much I learn and practise, I am always chasing: the right proportions of rice to broth, as well as a pleasing consistency and texture
‘Highly problematic behavior’: Noma residency in LA starts with PR crisis
It was always going to be an indulgence for René Redzepi, the Danish-Albanian chef of Noma fame, to bring his exacting, innovative vision of haute cuisine to Los Angeles and spend several weeks tickling the palates of well-heeled diners at a hilltop estate once dubbed “the most beautiful home in Hollywood”.The Guardian’s journalism is independent. We will earn a commission if you buy something through an affiliate link. Learn more.The timing has certainly been unfortunate, since the US is now fighting a destabilizing war in the Middle East and food prices are climbing so steeply that many ordinary Americans can no longer afford to eat at McDonald’s, much less contemplate the counterintuitive delights of tacinga cactus, bougainvillea petals, mealworms and giant tuna eyes
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