Reducing patient distress: a model for dementia care.

More than 750000 people in the UK have some form of dementia; with a rise expected over the next 25 years. With early diagnosis of cancer, more patients with dementia will attend for cancer treatment. Immobilisation masks, used to ensure accurate head and neck radiotherapy, may trigger panic in patients, even without prior mental health problems. This single case study reports on the care provided to a patient with dementia and his carer, his wife Betty, during cancer treatment. Bert was diagnosed with dementia 10 years prior to his cancer diagnosis. The use of sedation appeared to trigger confusion rather than facilitate procedures. Bert's case illustrates how an individualised contract of care could be developed to help maximise interactions, ensure ongoing consent and maintain dignity during difficult and challenging medical procedures.

'Needle with ease': rapid stress management techniques.

For some patients, even looking at a needle is enough to make them feel anxious. Repeated cannulation for bloods and all other intravenous therapies, such as scans and chemotherapy treatment can become so frightening that they escalate to feeling overwhelmed and panicky. If this response persists without any intervention, it may eventually become a phobia (Choy et al, 2007). Four-hundred-thousand patients are treated at The Christie NHS Foundation Trust each year, with many receiving intravenous chemotherapy treatments. The 'CALM' service was initiated over 5 years ago to enable and support patients to achieve a calm state during procedural-related anxieties and panic. Thanks to recent funding from 'Walk the Walk' Breast Cancer Charity, the service has grown, enabling more patients to access the service. Increasing skill has led to development of training courses for health professionals. The training provides easy-to-learn skills, some of which are described here, that can be used to prevent and/or interrupt panic states triggered by medical procedures.