Dementia patients face Russian roulette in hospital

Dementia patients admitted to hospital in England play “Russian roulette” with their health, a charity is warning.

Dementia patients admitted to hospital in England play "Russian roulette" with their health, a charity is warning.

The Alzheimer’s Society said it had found “shocking” evidence of poor and variable care during its review.

The report, based on Freedom of Information (FOI) requests, found problems with falls, night-time discharges and readmissions, and said standards needed to improve urgently.

The Department of Health said the disease was a key priority as one in four hospital beds is believed to be occupied by a person with dementia.

The Alzheimer’s Society called for all hospitals to publish an annual statement of dementia care, to include information on satisfaction, falls, readmissions and staff training as part of its campaign to improve standards.

The charity received responses to their FOI request from half of the 163 hospital trusts in England; however, for some of the questions the figures were based on a fifth of trusts as not all hospitals could provide answers to all the questions.

Its report showed:

  • more than one in four people over the age of 65 who fell had dementia, but in some trusts it topped 70%
  • people with dementia stay five to seven times longer than other patients over the age of 65 in the worst-performing hospitals
  • one in 10 people over 65 who were discharged overnight had dementia – with the numbers rising to nearly four in 10 in the worst trusts
  • more than half of over-65s readmitted within 30 days – a sign of inappropriate care – had dementia in the worst-performing trust.

The Alzheimer’s Society also carried out a survey of dementia patients. It found examples of patients being treated with excessive force, not being given enough help with meals and drinks and being left in wet or soiled sheets.

Nine in 10 said hospitals were frightening and only 2% felt all staff understood the needs of people with dementia.

The charity described these findings as unacceptable and a sign that dementia patients were not getting the standard of care they should.

Alzheimer’s Society chief executive Jeremy Hughes said: “In the worst cases, hospital care for people with dementia is like Russian roulette. People with dementia and their carers have no way of knowing what’s going to happen to them when they are admitted.

“In many cases they are well looked after but, as our investigation shows, too often people with dementia fall and injure themselves, get discharged at night or are marooned in hospital despite their medical treatment having finished.”

A Department of Health spokesman said the disease was a key priority and in recent years £50m had been spent on making hospitals and care homes more “dementia friendly”, while 500,000 staff had received extra training.

“People with dementia and their carers deserve the very best support,” he added.

Suicide gene therapy kills prostate cancer cells

A new gene therapy technique is able to modify prostate cancer cells so that a patient’s body attacks and kills them, US scientists have discovered.

A new gene therapy technique is able to modify prostate cancer cells so that a patient's body attacks and kills them, US scientists have discovered.

The technique causes the tumour cells in the body to self destruct, giving it the name ‘suicide gene therapy’.

Their research found a 20% improvement in survival in patients with prostate cancer five years after treatment.

Prostate cancer is the most common cancer in men in the UK with more than 41,000 diagnosed each year.

The study, led by researchers from Houston Methodist Hospital in Texas, appears to show that this ‘suicide gene therapy’, when combined with radiotherapy, could be a promising treatment for prostate cancer in the future.

The technique involves the cancer cells being genetically modified so that they signal a patient’s immune system to attack them.

Usually, the body does not recognise cancer cells as the enemy because they have evolved from normal healthy cells. Unlike an infection, which the body reacts against, the immune system does not react to kill off the offending cancer cells.

Using a virus to carry the gene therapy into the tumour cells, the result is that the cells self destruct, alerting the patient’s immune system that it is time to launch a massive attack.

In two groups of 62 patients, one group received the gene therapy twice and the other group – who all had more aggressive prostate cancer – received the treatment three times. Both groups also received radiotherapy.

Survival rates after five years were 97% and 94%. Although there was no control group in this study, the researchers said the results showed a five to 20% improvement on previous studies of prostate cancer treatment.

And cancer biopsy tests performed two years after the trial were found to be negative in 83% and 79% of the patients in the two groups.

Dr Brian Butler, from Houston Methodist Hospital in Texas, said it could change the way that cancer is treated. “We may be able to inject the agent straight into the tumour and let the body kill the cancer cells. Once the immune system has knowledge of the bad tumour cells, if they pop up again, the body will know to kill them.”

Kevin Harrington, professor of biological cancer therapies at The Institute of Cancer Research, London, said the results were “very interesting” but more research was needed. We would need a randomised trial to tell if this treatment is better than radiotherapy alone.”

“The viruses used in this study cannot reproduce. Next generation viral therapies for cancer can selectively replicate in cancer cells, something that can kill the cancer cell directly, and also help spread the virus to neighbouring cancer cells.”

“It would be interesting to see this approach used with viruses that could reproduce to see if it makes for a more effective treatment.”