Dementia

...ba href=/dementia/a/b patients stay in hospital in the city.That type of care is more expensive than providing support at home and, health chiefs argue, is not generally what patients or their families want if an alternative is available.New systems are being in-troduced to try to ensure that proper support is available for those with the condition so they can be cared for without being admitted to hospital.A spokeswoman for Sheffield Strategic Health Authority, which monitors the PCTs' spending, said: "There are issues around bed stays; there are longer bed stays than in other areas of the country and work is being done to address this."They have also found there is an unusually high level of emergency activity in Sheffield, such as people attending accident and emergency, rather than getting medical help through more conventional means."That is something which is being looked at particularly.

A lot of work is going into looking at what is happening, and why," she said."The aim is to find what we can be doing to make things better." If the PCTs cannot break even this year they will be expected to make good this year's overspending from next year's budget, creating even more financial pressure."The PCTs have a Sheffield-wide plan for recovery, working together, and it will be a tough time but it is what they will need to do.

Initiatives are already starting up," she said.The PCTs in Sheffield are the only ones in the county facing such financial trouble.

Elsewhere in the county some are...

...ba href=/dementia/a/b patients because they (the deputies) do not have county cars at home.

Some patients are attached to tracking transmitters.

Obviously, the county needs a $9,800 study to determine how many times a year ba href=/dementia/a/b patients with transmitters wander off and are lost forever when deputies lose the privilege of forcing taxpayers to pay for their commutes to and from work.

This is a county where officials have used bond issues to spend extravagantly, so do not be surprised if they float another one to provide limousine service for the deputies.

(Unscrupulous politicians and bureaucrats love bond issues, which do not cripple budgets until after they've left office.) In a related development, sort of, the horror of wet grass has Bucks County's Pennridge School District dishing out $9,800 for a study to see whether the district should dump still more money into a plan to replace the grass with artificial turf on athletic fields.

That story, in Monday's paper, mentioned a figure of $650,000 for one field alone, but Superintendent Robert Kish said ''the long-term investment pays off.'' (It seems to me you can mow a lot of grass for $650,000, but that's just the way we rubes think.) In the Palisades School District, also in Upper Bucks, Facilities Manager David Keppel was quoted as saying this of a similar switch: ''We have an estimate of about $1.47 million for the entire project.'' (It's like getting blood out of a stone to get school authorities to spring for, say, a new $...

...ba href=/dementia/a/b.

The idea is to keep patients in the Heartland Hospice House until they are stabilized, then return them to their families at home to die.

Those who are very ill might end up dying in the house.

Patients aren't expected to occupy a bed longer than a week.

If all the beds are full, patients on a waiting list will be placed temporarily in nursing homes contracted with the company to receive medical care.

When there's an opening at the house, they'll check in.

"Our 12 beds may not be open for very long," DePietropaolo said.

Home care vs.

hospital When he was a patient with Heartland Hospice Services, Paul Schneider was in so much pain that no one could touch him.

His wife, Cecelia, remembers when the couple's kitten, Fiona, barely brushed against his toe.

"He cried out in pain like I never heard before," she said.

He was on several pain medications, but as his brain disease worsened, the level of medication needed to control the pain could only be given at the hospital.

On New Year's Day, Cecelia Schneider sprawled out on the bed next to him while he wrestled over a difficult decision.

Should he tolerate the pain and die at home, as he wished?

Or should he return to the hospital, have the medics control his pain and die in a setting he didn't want?

"I told him that he was calling the shots," she said.

"If he didn't want to go to the hospital, we wouldn't go.

But he couldn't get the pain medication at home.

"He thought for a moment and said, 'Let's do it.' " Cecelia, who...