When a Loved One With Dementia Is Hospitalized

During a hospital stay, seniors with dementia are at risk of falls, dehydration and poorly treated pain. And they’re at higher risk of delirium, a temporary state of confusion that can make their dementia temporarily—or even permanently—worse. In general, they are less likely to experience a good outcome from their surgery or treatment.

Gerontologists and neurologists today are tackling this problem, seeking solutions for improving outcomes for patients with dementia. More hospitals now have special dementia-friendly units, and are providing better training for hospital personnel. But most experts agree on the single factor that makes the most difference: thoroughly including family caregivers in their loved one’s care at every step of the way, from admission to discharge.

A study from Henry Ford Hospital in Detroit confirmed that memory loss and cognitive impairment are top predictors of hospital readmission for senior patients who are readmitted to the hospital, and noted that involving dementia caregivers—and there are 16 million of them today—could improve outcomes and also save a lot of healthcare dollars. Study author Dr. Mark Ketterer noted, “The success of the family intervention strategy could be cost effective. Factoring in the cost of readmissions and the care associated, insurance companies could save nearly $180,000 a month for every 100 patients seen.”

Here are six things family can do to ensure the best possible outcome when a loved one with dementia goes to the hospital:

1. Prepare ahead. If your loved one will be going to the hospital for a scheduled procedure, you will most likely have plenty of time to make plans. But any senior could suffer an illness or injury that requires an emergency hospital trip, so be prepared for that, as well. Do your homework and collect supplies you would need ahead of time, as well as a list of things you’d need to grab at the last minute (such as your loved one’s medications, glasses, hearing aids and dentures). Don’t forget to pack items for yourself, in the event that you end up staying in the hospital with your loved one.
2. Stay with your loved one throughout the hospital stay. People with dementia do best in familiar surroundings—and the sights and sounds of a hospital are the farthest thing from a comforting routine! Having you there will help prevent increased confusion and fear, and will make it less likely that your loved one will have to deal with physical or pharmaceutical restraints. Plan to stay overnight if possible, and to be with your loved one even during treatments and exams. If a hospital staff member suggests that you stay in the waiting room or hall during a particular procedure, explain that your presence will help calm your loved one.
3. Serve as a liaison and advocate. You are the best person to explain to your loved one what is going on. And the reverse is true. Says the National Institute on Aging, “Remember that not everyone in the hospital knows the same basic facts about memory loss, Alzheimer’s disease, and related dementias. You may need to help teach hospital staff what approach works best with the person with Alzheimer’s, what distresses or upsets him or her, and ways to reduce this distress.” Inform all staff, from office personnel to the doctors, that your loved one has dementia.
4. Arrange for backup. While it’s best that someone close to your loved one stays with them at all times, that doesn’t have to be you. A friend or relative can take a shift while you rest. At times, double-teaming is a good idea, so that if you are dealing with paperwork, consulting with the doctor or taking notes, the other person can tend to your loved one’s needs.
5. Report problems. Even hospital staff who are trained in dementia care don’t know your loved one’s baseline “normal.” They might chalk up lethargy, confusion or agitation to your loved one’s memory loss when in fact, your loved one is experiencing delirium, having a bad reaction to a medication, or suffering from the effects of an infection. It is also notoriously difficult to recognize pain in a person with dementia when they cannot express it; be alert for moaning, grimacing, crying and other signs that mean your loved one’s pain should be evaluated.
6. Create a calm atmosphere. This isn’t easy in a hospital, but taking a few simple steps can lower your loved one’s confusion. You might want to turn off the TV, bring along your loved one’s favorite comfort objects and snacks, and perhaps play soothing music. Most likely the most calming thing in the room will be your presence!