By the way... Bring back bed rails for dementia patients

One of my patients, who was in decline due to senile dementia, was cared for by his loyal wife for five years before he died. He was bedridden for most of that time.

Due to his mental state, he was unco- operative and at times aggressive — this is an unpleasant and often shocking facet of dementia, and sadly all too common.

If it weren’t for cot- sides on the hospital bed that was installed in their home, which acted as a restraint to prevent the man trying to get out of bed, he would frequently have fallen and been injured. Those cot-sides were a vital tool in keeping him safe.

Yet cot- sides (sometimes called bed rails) have been banned in many places, partly out of fear of people getting caught in them — making the nursing care of such confused and disturbed patients very difficult.

It has emerged that security guards, untrained in patient care, are being used to restrain dementia patients in some hospitals.

Only a few years ago there was an outcry about the use of sedatives to contain distressed and often aggressive patients, the charge being that ‘chemical straitjackets’ were a shortcut to subdue unruly patients so staff could have an easy time.

While clearly it is wrong to use a ‘chemical cosh’ to subdue patients, where is the solution? If the answer is to depend on the skills of trained staff, how can this be achieved in a climate where the shortage of nurses is so great that numerous nursing tasks are carried out by untrained personnel?

Dementia patients in a state of distress may need constant attendance by two staff, occasionally more, if injury is to be prevented. At least in the days of cot- sides such patients were not falling out of bed continually.

A family friend has recently told me that when he was in hospital, her husband fell out of bed 27 times before he eventually died — mostly for want of the forbidden cot- sides.

Who thought that one up?