Posts Tagged ‘Unlocking the Asylum’

Entertaining Patients in the North Wales Hospital

July 5, 2019

In the first years of the North Wales Hospital staff frequently complained they were unable to find suitable recreation and amusement for patients. Just how did staff keep hundreds of patients from different backgrounds entertained, and how did this entertainment change throughout the hospitals lifetime?

When the hospital was originally built the idea of patient entertainment had not been considered. It was only when the first patients began to inhabit the hospital that the omission was realised. In 1849 the Medical Officer requested that a number of outdoor entertainments for patients be created. He requested that a portion of the land be allocated and developed into a bowling green. With the assistance of patient labour a bowling green, skittle ground, and flower garden for private patients were opened in 1851. Patients also went on guided walks into the surrounding countryside, this practice continued and the sight of large numbers of patients walking through the area would have been a familiar site to local people in the late 19th century.

Outdoor recreation remained an important part of life in the hospital throughout its history. The hospital had its own staff and patient cricket and football teams, and male patients were admitted to local league games free of charge. The summer months also provided opportunities for other outdoor entertainments such as an annual sports day, garden fêtes and flower shows.

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The hospital football team during the 1919-1920 season. Copyright Helsby of Denbigh.

When the weather was less than favourable patients had to seek indoor entertainment. Following the success of the first annual Christmas ball a weekly dance was introduced, which proved popular with patients. In 1902 a new dining hall and recreation room was added to the hospital, now in addition to dances patients also enjoyed concerts, choirs and drama productions. Patients also had the chance to play various indoor games such as whist, bingo, and chess.

As technologies developed so too did the entertainment opportunities available to patients. In 1914 two gramophones and a cinematograph were purchased. The Medical Superintendent commented in the 1915 annual report that “nineteen cinema shows have taken place during the winter. No other form of entertainment has created such an interest amongst the inmates”. The cinematograph certainly did prove very popular amongst patients, and the hospital continued to have twice weekly cinema shows. By 1954 each ward had its own radio and television, which would have been a luxury for those patients who would not have had a television at home.

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A weekly bulletin showing the types of indoor and outdoor recreational activities available to patients, 1966.

Patients also had leisure opportunities outside of the hospital grounds. In the 1950s as well as picnics to nearby beaches in Rhyl and Pensarn, the hospital was involved in a patient holiday exchange programme with other hospitals in Wales and England. During their visit the transferred patients would enjoy a range of activities such as games, films, and day trips around the local area. An itinerary for patients and staff from Central Hospital in Warwick who visited the North Wales Hospital in 1961, shows that activities included watching films, walks to Denbigh castle, and square dancing. Day trips included a visit to Chester Races, and a trip to Snowdonia.

Lindsey Sutton

Project Archivist (Unlocking the Asylum)

Dementia care in the North Wales Hospital

May 20, 2019

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’