Chamber
Plenary, 11 Feb 2009
11 Feb 2009 · S3 · Plenary
Item of business
Accident and Emergency Services (Dementia)
I congratulate Irene Oldfather on obtaining this most important debate. I also commend the cross-party group for the sensible suggestions in its Alzheimer's report, which is a classic example of how a cross-party group can advance policy.
I know from my experience as a general practitioner of many years, from helping patients and from members of my own family how easy it is for old people to become destabilised when they are removed from familiar surroundings. Often, one does not realise that an old person has a problem at all while they are in the familiar surroundings of their house, where they know the geography and know where everything is kept. However, the moment that they move to a different situation—to someone else's home or to the strange world of hospital—they can become a different person altogether. That can be not just frightening but even life threatening.
Therefore, although the recommendations in the report concerning the recognition and care of people with dementia in accident and emergency departments are most welcome, the recommendations that are most important to me are those that would help to keep people at home in the first place. Falls should be prevented. It is easy to trip over the edge of a carpet or something that has been left lying around the house. Therefore, every person who is at risk of dementia or Alzheimer's should have their home inspected to make certain that it is easy for them to move from one area to another without tripping over something.
Care in the community is also important. In my early years in general practice, we had a first-rate geriatrician at university, Professor Williamson, who laid down two rules for looking after people, which I felt were extremely important. First, he told carers that, if they rang him with a problem, he would deal with it straight away. That enabled the carers to carry on caring for someone a lot longer than they could have done if they had felt that they would have to join some sort of waiting list. That helped people to stay in their own homes for longer. Secondly, Professor Williamson gave a great deal of respect to the home helps who looked after old people and who he said preceded health services by telling him when people were beginning to change and when things were going wrong. We could give a great deal more respect to the position of home helps in our community and recognise how they can help health in general.
Old people need rapid access to diagnostic testing and the ability to have domiciliary consultations so that, when they become ill, they can be looked after at home. All too often, consultants these days will not go out to someone's house. However, if they go to someone's house, make the correct diagnosis, get the tests done and employ the right treatment, the person can stay at home and not suffer from the problems that we are talking about when they arrive at the accident and emergency or other hospital department.
Finally—and very important, too—there is the issue of the medication that old folk receive in their homes. Too often, one goes to some cabinet, pulls open the door and loads of medicines fall out. The person does not know how the medicines are to be taken, why they are there or what to do with them. Every old person needs a regular medication review at frequent intervals and we need to ensure that they are certain about how to take their medication.
If we put into practice the recommendations in this excellent report, fewer old people will have to go to hospital and fewer people suffering from the effects of dementia will end up in accident and emergency departments.
I know from my experience as a general practitioner of many years, from helping patients and from members of my own family how easy it is for old people to become destabilised when they are removed from familiar surroundings. Often, one does not realise that an old person has a problem at all while they are in the familiar surroundings of their house, where they know the geography and know where everything is kept. However, the moment that they move to a different situation—to someone else's home or to the strange world of hospital—they can become a different person altogether. That can be not just frightening but even life threatening.
Therefore, although the recommendations in the report concerning the recognition and care of people with dementia in accident and emergency departments are most welcome, the recommendations that are most important to me are those that would help to keep people at home in the first place. Falls should be prevented. It is easy to trip over the edge of a carpet or something that has been left lying around the house. Therefore, every person who is at risk of dementia or Alzheimer's should have their home inspected to make certain that it is easy for them to move from one area to another without tripping over something.
Care in the community is also important. In my early years in general practice, we had a first-rate geriatrician at university, Professor Williamson, who laid down two rules for looking after people, which I felt were extremely important. First, he told carers that, if they rang him with a problem, he would deal with it straight away. That enabled the carers to carry on caring for someone a lot longer than they could have done if they had felt that they would have to join some sort of waiting list. That helped people to stay in their own homes for longer. Secondly, Professor Williamson gave a great deal of respect to the home helps who looked after old people and who he said preceded health services by telling him when people were beginning to change and when things were going wrong. We could give a great deal more respect to the position of home helps in our community and recognise how they can help health in general.
Old people need rapid access to diagnostic testing and the ability to have domiciliary consultations so that, when they become ill, they can be looked after at home. All too often, consultants these days will not go out to someone's house. However, if they go to someone's house, make the correct diagnosis, get the tests done and employ the right treatment, the person can stay at home and not suffer from the problems that we are talking about when they arrive at the accident and emergency or other hospital department.
Finally—and very important, too—there is the issue of the medication that old folk receive in their homes. Too often, one goes to some cabinet, pulls open the door and loads of medicines fall out. The person does not know how the medicines are to be taken, why they are there or what to do with them. Every old person needs a regular medication review at frequent intervals and we need to ensure that they are certain about how to take their medication.
If we put into practice the recommendations in this excellent report, fewer old people will have to go to hospital and fewer people suffering from the effects of dementia will end up in accident and emergency departments.
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan):
SNP
The final item of business is a members' business debate on motion S3M-3215, in the name of Irene Oldfather, on recognising the needs of people with dementia...
Motion debated,
That the Parliament notes the launch of the report, People with Dementia in NHS Accident and Emergency - Recognising Their Needs, by the Cross Party Group on...
Irene Oldfather (Cunninghame South) (Lab):
Lab
I am grateful to all those across the political parties who signed the motion. I am particularly grateful to the members of the cross-party group on Alzheime...
Ian McKee (Lothians) (SNP):
SNP
I congratulate Irene Oldfather on obtaining this most important debate. I also commend the cross-party group for the sensible suggestions in its Alzheimer's ...
The Deputy Presiding Officer:
SNP
I call Mary Scanlon, to be followed by Dr Richard Simpson.
Mary Scanlon (Highlands and Islands) (Con):
Con
It is never easy to be wedged between two doctors in a medical debate.I thank Irene Oldfather for bringing this debate to Parliament. As one of the conveners...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
I add my congratulations to Irene Oldfather for today's result. It is a testament to the hard work that she has put in, and to the hard work of others such a...
Margaret Smith (Edinburgh West) (LD):
LD
I begin by thanking Irene Oldfather not only for securing this evening's debate but, more important, for her tireless and tenacious work in trying to help ma...
The Minister for Public Health (Shona Robison):
SNP
I thank Irene Oldfather for bringing this important debate to the Parliament. We have led the way in making dementia a national priority. I welcome the suppo...
Mary Scanlon:
Con
In my reading and preparing for the debate, an issue that MSPs have raised over the years was once again brought to my attention. I refer to the problems of ...
Shona Robison:
SNP
Quite a lot of work has been done on the issue, particularly considering the new role of the senior charge nurse. We want to ensure that those in that leader...
Meeting closed at 17:39.