Dementia care in the North Wales Hospital

This week is Dementia Action Week. Run by the Alzheimer’s Society it aims to unite people, workplaces, schools and communities to take action and improve the lives of people living with dementia. Staff working on the ‘Unlocking the Asylum’ project, took this as an opportunity to look into dementia care in the North Wales Hospital.

In the first annual reports of the hospital (1850-1860), dementia is listed as one of the main five diagnosis’s given to patients. But dementia meant something quite different in the 19th century from what it does today. Dementia, basically, was a broader term used for disorders that affected the brain. By the end of the 19th century, the term became restricted to those suffering with a loss of cognitive ability (the ability of the brain to process, retrieve, and store information).

The most common dementia was named, in 1910, after Alois Alzheimer, a German psychiatrist. In 1906, Alzheimer, who looked at post-mortem brains of affected younger people, published the first case, a 50 year old woman with dementia symptoms. After her death, Alzheimer saw the microscopic plaques and tangles now known as the hallmarks of the disease.

Having studied the case notes of a handful of those patients diagnosed with dementia during the mid to late 19th century, there are some symptoms relatable to our modern understanding of dementia- some have problems with their memory, and difficulties with comprehension, reflection and understanding…

Case File 1885, Patient diagnosed with Dementia- I have seen Margaret Jones on two occasions...she sits with her hands clenched, stares in a vacant unmeaning way, cannot be made to answer questions and refuses to do any act required of her. She looks dejected and sullen.

Case File 1885, Patient diagnosed with Dementia- I have seen Margaret Jones on two occasions…she sits with her hands clenched, stares in a vacant unmeaning way, cannot be made to answer questions and refuses to do any act required of her. She looks dejected and sullen.

Case File 1885- Patient diagnosed with Dementia

Case File 1885- Patient diagnosed with Dementia

Of the 25,000 post 1948 patient files currently listed, 1700 were diagnosed with some form of dementia between 1948 and 1995. It was described as Dementia, Pre Senile dementia, Senile dementia, Post infarct dementia, early dementia, organic dementia, chronic dementia, Arteriosclerotic dementia, Alzheimer’s disease, Huntington’s disease, Huntington’s chorea and Parkinson’s disease. Today the number has risen considerably- the Alzheimer’s society predict that by 2021, 1 million people in the UK will be living with the condition. This may be due partly to the fact that we are living longer and partly because we have a better understanding of the condition resulting in more diagnoses.

As there was, and still is no cure for dementia, patients were admitted to the hospital mainly to help relieve the symptoms of the condition and were often prescribed anti-depressant medication. However there is also evidence that patients were admitted for short stays in order to give their carers a much needed break, as the disease became more and more unmanageable. It is also evident from studying these files, that it was very rare for patients with the condition to be given Electro Convulsive treatment.

Post 1948 patient file with a diagnosis of dementia

Post 1948 patient file with a diagnosis of dementia

The field of dementia care has changed beyond recognition even in the last 25 years since the closure of the hospital. In part this has been driven by the sheer numbers of people whose lives are now affected by dementia. Also, it was much less spoken about in its own right, as it is today, as it was assumed to be a condition that affected older people in psychiatric care. Of course today we know that dementia does not just affect the elderly, the Alzheimer’s Society state that 40,000 people under the age of 65 in the UK now live with early onset dementia.

Following a recent course to become Dementia Friends, staff at Denbighshire Archives learnt about the types of dementia, the most common is Alzheimer’s but diseases also include vascular dementia, dementia with Lewy bodies, Pick’s disease and Frontotemporal dementia. Being a Dementia Friend simply means learning more about dementia, putting yourself in the shoes of someone living with the condition, and turning your understanding into action.

Thankfully today it’s very much talked about and recognised, thanks to the work of the Alzheimer’s society in raising awareness of the condition. Let’s hope with ongoing research and medical advances, a cure can be found for the condition in the near future.

Dementia Friends

Dementia Friends

Please note that due to NHS regulations records of patients containing sensitive personal information are closed to the public for 100 years. These records may be available to researchers who belong to an academic institution upon request. If you are interested in using the North Wales Hospital collection for academic research please contact us.

More information about becoming a dementia friend is available here.

More information about the Alzheimer’s society can be found here.

Rhian Evans- Project Support Officer ‘Unlocking the Asylum’

Our two year project named ‘Unlocking the Asylum’ has now ended. Funded by ‘Wellcome’ the project was to catalogue the records of the former North Mental Hospital in Denbigh. Please visit our subject guide for further information relating to The North Wales Hospital.

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