– You are so mad! You are so ugly! Nauseous! Ouch, ouch! “Kari” slams her fist hard on the kitchen counter as she shouts loudly. The words echo in the common room of the nursing home, while other residents sit around. – Well, comes a shout from an employee, on the other side of the bench. “Kari” has just wandered into the room. What she got angry about is difficult to interpret. For two days, we filmed in an extra shielded reinforced ward at Økernhjemmet in Oslo, with the consent of guardians and the nursing home. Being scolded and receiving threats is commonplace here. The average length of stay in a nursing home is two years. Photo: Lars Thomas Nordby / news A bottle is thrown through the living room, an employee croaks, jumps away to avoid being hit. There is a new situation with an acting resident. Not long ago, he knocked over the living room table in frustration. People with advanced dementia come to this ward at the nursing home. Some are in their 60s, others in their 80s. What they all have in common is that they are more restless and acting out than other people with dementia in nursing homes. Concussions and broken doors Sometimes it takes little before a situation arises. A visit from family. Something they are unable to communicate. A few days ago, an employee suffered a concussion when a resident hit him, and he jumped away, the employees say. Another resident threw an exercise bike and destroyed an iron door between the wards. Only when it was threatened to call the police to the nursing home did the resident calm down. The number of people with dementia will double towards 2040, when there will be a need for more reinforced places in nursing homes. Photo: Lars Thomas Nordby / news – It’s not that the residents here are bad, but they have an illness. That’s the way they communicate. Turid Mood has extensive experience in elderly care. As head of institution at Økernhjemmet, she sees that the need for adapted places for the demented is great – and growing. Especially places in sheltered departments. Every day they have incidents of unrest and acting out, incidents where residents in frustration can hit, kick or punch others. Turid Mood is head of institution at Økernhjemmet in Oslo municipality Photo: Lars Thomas Nordby / news – What we see is that we are not able to solve all situations as well as we would like. – Why? – Because we have too few employees. If we have several outages at the same time, it may well happen that we will not be able to solve them all at the same time. – How do you feel as the head of the institution? – It is not pleasant at all, but it is something we have to deal with – as brutal as it sounds. Not equipped for the wave of elderly people – We are not equipped for it, says Bjørn Lichtwarck, specialist doctor and researcher at the geriatric psychiatry department at Sykehuset Innlandet. Lichtwarck has worked and researched elderly care for many years. He is worried about the future. Bjørn Lichtwark is a specialist and researcher at Sykehuset Innlandet. Photo: Lars Thomas Nordby / news Today there are 100,000 people with dementia in Norway. By 2040, the number will probably double, mainly because more of us are getting older. – If we do not build more nursing home places and more reinforced units, then we will have difficulties in handling the growing number of elderly people with dementia in a good way. Around 38,000 live in nursing homes in Norway today. The number of reinforced units, which people with dementia will need, is far lower. There are around 12,500 nursing home places arranged for people with dementia in the municipalities, according to a review carried out by the Directorate of Health in October last year. Around 900 of them are reinforced places, which means opportunities for more screening, activity and more employees. At the same time, a reinforced place in a nursing home constitutes a major intervention in a municipal budget. In Oslo municipality, a normal nursing home place costs approx. NOK 1 million a year. A reinforced space costs approx. NOK 2 million a year – twice as much, according to the Nursing Home Agency. There are around 900 reinforced places for people with dementia in Norway. There is a need for far more, the researcher believes. Photo: Lars Thomas Nordby / news More medication in regular nursing home places Lichtwarck and colleagues hold a course for other municipal employees about dementia, for more knowledge out there in Municipality-Norway is needed. – If a person with dementia is placed in a nursing home with regular staffing, many will be left to fend for themselves, and that is a risk factor for restlessness and aggression. Twice as good staffing is required in a reinforced department. This means that you can protect both employees and other residents, Lichtwarck believes. Bjørn Lichtwark holds courses in dementia for municipal employees. Photo: Lars Thomas Nordby / news – It reduces the incidence of restlessness, aggression and delusions. We experience that more drugs are used for patients where there is no enhanced supply. Increased use of medication, for example antipsychotics, contributes to increasing the risk of elderly people falling. Lichwarck believes that the quality of many nursing homes today is too poor. – Many municipalities are doing well, but the overall quality of nursing homes in the municipalities today is too poor. Can’t prevent acting out – But damn it! “Kari” pushes an employee hard in the shoulder. She follows her menacingly. The employee jumps backwards, and moves around a pole in the room as if to protect himself. They use techniques to try to calm down situations when they see that the residents are starting to get agitated, but that is not all they manage to avert. Økernhjemmet in Oslo has an extra reinforced sheltered ward for elderly people with dementia who act out. Photo: Lars Thomas Nordby / news Today, the elderly will live longer at home, including those with dementia. Lichtwarck believes that it is a kind of denial of reality to say that you should not have more nursing home places. – It is really a kind of collective denial, because the reality is that you will need it. – The average length of stay in a nursing home is 2 years, and why shouldn’t these two years be the best years of your life? It is a matter of political priority. Health Minister Ingvild Kjerkol says sheltered units are a municipal task, and that the government will contribute to securing the municipal economy. – We must have confidence that the municipalities will take on board the major changes that are now taking place. We are getting very many more elderly, more with dementia, says the Minister of Health to news. She calls situations such as the one news has uncovered as demanding for the employees, but adds that not everyone with dementia behaves out of control. Kjerkol also admits that not enough sheltered places have been built. – The rate of development has probably been too low. That is why it is important that we are predictable and say that the municipalities must be strengthened both financially, and I am concerned that we must have professionals with the right skills. State and municipality must work together here, because it is a big change that we are now experiencing as a community.
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Here employees are beaten, pushed and scolded – news Norway – Overview of news from different parts of the country
