Dementia is a word used to describe a group of symptoms including memory loss, confusion, mood changes and difficulty with day-to-day tasks. There are currently 850,000 people with dementia in the UK and, as average life expectancy increases, this figure is set to rise. Dementia is more common in people over the age of 65, but early onset dementia can affect people as young as in their 30s.
Sepsis is a condition caused by the body’s immune system responding abnormally to an infection, which can lead to tissue damage, organ failure and death. It is more prevalent in those who are very young or very old and can take hold quickly. As it may be difficult for a person with dementia to convey a deterioration in their condition, it is very important for family members, nursing or care home workers and district nurses to pay close attention to changes in behaviour (increased confusion is common when a person with dementia becomes unwell) and to act on these.
The UK Sepsis Trust provides more detailed information on sepsis on its website.
Some specific medical issues more commonly arise in older dementia patients than in the population at large and can lead on to sepsis if not correctly managed:
Older men who have dementia and continence difficulties, in particular, can experience recurrent urinary tract infections (UTIs), which need treating with the correct antibiotics to bring them under control. Where a person presents with a complex UTI or recurrent UTIs, very specific antibiotics should be used rather than the usual ‘go to’ antibiotics for healthy individuals. Without the correct antibiotics, an infection can quickly take hold and sepsis can develop.
Patients with dementia who are admitted to hospital may not have the same appreciation of discomfort and/or be able to communicate this effectively and are therefore considered to have a higher risk of skin damage. This risk can be greater still if the patient has continence problems, which damage the integrity of the skin. If a wound develops and becomes infected, and the infection is not correctly managed, this also can lead to sepsis.
Helen Hammond, senior associate in the clinical negligence team at Penningtons Manches Cooper, comments: “The best way to protect this vulnerable group of patients from sepsis is to ensure that basic nursing care is provided to manage skin integrity and to ensure that individuals are seen promptly by a medical professional if they show signs of being unwell. These seemingly simple steps easily save lives.
“If you have concerns about the care a family member has received, we woud behappy to discuss these with you."
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