John Gladman

Professor of Medicine of Older PeopleConsultant Geriatrician

Lead Older People Health & Well-beingtheme for CLAHRC-NDL

Nottingham:Population 300,000

Greater Nottingham:Population 675,000

Halifax:Urban Population: 300,000

Greater Halifax:Population: 400,000

Nottinghamshire’s gifts to the world

Acute medical unit careHealth care in care homes,

Mental health problems in general hospitals

General hospital care of peoplewith dementia

Dementia in crisis

Never have I seen a workforce so ill-prepared for the job at hand …

A specialist medical and mental health wardfor confused in-patients

Person-centred care

Mental health staffing

Environmental change

Staff training

Purposeful activity

Greater family involvement

The TEAM study

Randomised controlled trial

• MMHU vs ordinary care• 600 participants• Outcomes at 3 months

• Days at home• Mortality• Institutionalisation• Symptoms• ADL• Cognition• Mood• Behaviour• QoL• Experience of care• Carer QoL• Carer satisfaction• Economics• Qualitative

Results …

Other hospital dementia research

The tail of dissatisfaction

Incontinence

Persistent vocalisation

Balance and the mind (falls)

Communication aids

But let’s talk!