Absolutely, I am sure, and there is quite a lot of awareness that needs to be raised among health care providers that the reason that person with dementia arrived in emergency today instead of yesterday or three weeks ago may well be that something has triggered it. There is some reason why the person has arrived in emergency today. Why did they wander; what triggered this; do they have a urinary tract infection; what's going on? They do deserve a thorough medical workup to ensure that there is no medical condition other than the dementia going on.
If, in fact, it is a chronic acerbation of the dementia itself, that's where we get to what I think our colleagues in B.C. have been saying, that we're looking for structural change where that person has a step-down unit that's appropriate to move to in order to free up that emergency bed.
I would put to this group—and I am putting words into folks' mouths, perhaps—that I think we are talking about a culture change. We're talking about not just looking out for the person who has a mental health condition or dementia; we're looking to design environments, assuming that no one is at their best in emergency, no one is at their best when they're in pain, no one is at their best when they are in acute care, and no one is at their best when they move into a long-term care home.
We need to have that basic bar where everyone will benefit from a dementia and mental health-friendly environment where the floor cleaners are not going by at two in the morning, where the lights are dimmed to the extent possible and where there is perhaps classical music playing. These things have been shown to decrease agitation, and if we could start to make that the norm rather than triggering who is on our wait-list who is really at risk for hitting out, I think we might all benefit.