Hospital Runs a Socializing Pub In Their All-Male Dementia Wing To Prevent Sundowning

Many may wonder why a hospital would have a pub on site. Aren’t sick people supposed to abstain from alcohol? In general, that’s true, and of course, this was taken into consideration before they set up the alcohol-free establishment.  This isn’t your average pub, there is no alcohol, no bar fights, and nobody is talking like a sailor. The aim is to keep its patrons/patients healthy and happy.

Authorities at Swansea’s Cefn Coed Hospital in Wales, United Kingdom came up with an ingenious idea to help its dementia patients in the best way possible. The hospital has a special ward for them known as Derwen Ward. It has the capacity to accommodate 20 men at a time.

Dementia is a group of conditions characterized by a persistent disorder of the mental process, loss of memory and daily functioning capacity [1]. Those above the age of 60 are the most commonly affected. Dementia is progressive, and treatment depends on the stage, of which there are seven. Dementia conditions include Alzheimer’s disease, Parkinson’s disease, vascular dementia, frontotemporal dementia, dementia with Lewy bodies, etc [3].

People with dementia tend to progressively lose their memories, and the most recent ones tend to go first. This can sometimes leave them with nothing but patterns of behavior they employed in the past. This progressive disappearance of memories can cause a condition known as sundowning [4].

Sundowning is also known as late-day confusion that tends to coincide with the fading of natural sunlight and increased shadows. It’s a condition characterized by episodes of anxiety, aggression, panic, restlessness and the inability to distinguish reality from dreams, all occurring mostly at sundown[4]. The exact cause of sundowning is not known, but it tends to affect people with dementia, particularly Alzheimer’s.  

In the case of Cefn Hospital, patients may spend all day lounging about in the ward, playing chess or watching TV. However, once it’s evening, they may begin to display symptoms of sundowning. Many of these patients use to work long days, and often ‘go for a pint’ after work, but are now unable to experience this positive social time they once had. This begs the question, Why can’t they go out and have a drink, just like they used to? This is why the Derwen Ward was set up, to help give these gentlemen a semblance of their old routine, to help prevent the anxiety and impending depression that come with sundowning.

Makeshift pub to ward off sundowning

Even though the beer is non-alcoholic and the darts are made of plastic, the old men are still happy and grateful.

Dubbed the Derwen Arms Pub, this pub looks exactly like every other local pub from Wales down England and into Ireland. The men feel comfortable, relaxed and at peace in their snazzy gentlemen’s place. Speaking to Wales Online, clinical lead Dawn Griffin explains why they had to set up the pub in the ward [5].

“In the evenings some of our gentlemen can get unsettled and agitated,” says Dawn. “They think they’ve finished their shift for the day and they are of the generation where they would go to the pub for a pint with their friends after work. We thought – what better way to help them than to get a pub on the ward? It’s about trying to normalize things they were doing before they came into the hospital.”

This wonderful idea was birthed by Dawn and the ward manager, Kate Protheroe. The makeshift pub was designed exactly like a real one, only that it doesn’t serve real drinks or have real metallic darts. This is perfectly fine. Alcohol is definitely not good for the patients because it’ll interfere with their medications. Also, getting drunk at their ages and with their conditions is out of the question. Also, many of them lack the same motor control they used to have. Someone could mistakenly toss a dart at his fellow gentleman across the room. This is why all the darts are made of plastic.

They also have a pool table, which looks exactly like any standard pool table should. Sundowning can make a dementia patient spiral into depression, which is highly unhealthy for elderly people in such fragile states of mind. The pub has been a huge success for the hospital in general, giving the men of Derwen ward a happier mood and something to look forward to every day [6]. They get together and talk, sharing the memories they still have and making new ones to fill up the void.

“The reaction has been huge,” says Dawn. “They’re socializing well. They have a day area and they use it, but they often ask us when the pub is opening. They can take their relatives and friends there for a pint when they visit.”

The Derwen Arms pub offers special dinners on certain days, such as Valentine’s Day. The elderly men now have a place to take their partners to when they visit to celebrate their love. It’s just like old times.