Because of the various ranging side effects of dementia – which can be anything from forgetfulness and confusion to incontinence to mobility issues – people with dementia end up in hospital more often than the rest of the general population.
However, despite the frequency of admissions of people with dementia, these emergency rooms are not equipped to handle and manage people who may have dementia symptoms.
Most hospital emergency rooms are run as if every patient has perfect intellectual function – and yet this is something that many people living with dementia have some degree of impairment. That is why it is important to be able to support someone if they are admitted to hospital.
Symptoms, Diagnosis and Treatment in Hospitals
According to the Australian Institute of Health and Welfare, approximately 41% of all hospital admissions were for people over 65. Many of these people are elderly, frail and may have other medical conditions, as well dementia symptoms.
Many people who have dementia and are still living at home, end up going to hospital and never to return as they are put into respite or aged care. Dementia patients are twice as likely to suffer preventable complications such as pressure ulcers and pneumonia in hospital.
Pain management is also considerably different for people with dementia. Patients with dementia and a fractured hip tend not to be given as much pain relief as other patients with fractured hip.
Uncontrolled pain in dementia gives rise to delirium that is often undiagnosed and untreated in hospitals. As a result, half of these patients who develop delirium die in six months.
Many patients with dementia may get missed by accident at mealtimes and have problems eating and drinking which are made worse in hospital.
Changes in the Hospital
One research suggests that if a person has dementia, then they will stay in hospital longer than another person with the same clinical condition. And it has been reported that it wasn’t until after a hospital admission that it was discovered the person was not coping well at home.
However, there may be reason to believe that the reverse might be true. Not that it was discovered that the person was struggling at home before the hospital stay – but that they developed these struggles from staying in the hospital.
A person who struggles to eat and drink in the hospital may have been eating fine at home. And the person who was able to bathe themselves and go to the toilet in the familiarity of their home, may find it difficult in hospital where the facilities are so unfamiliar.
Someone who was able to live comfortably and entertained at home and sleep well, may be kept awake by the noise and light and find themselves isolated and bored during the day. Hospital stays, and the disruptions to their comfortable routine, may trigger mood swings, sleep problems, and behavioural concerns.
And when this happens, the symptoms can often be confused with delirium – a reversible state of confusion caused by stress and infection – and patients may be prescribed anti-psychotic medication to calm and quieten them, starting a never ending cycle of medication.
These is a lot that families can do to support a loved one in hospital – especially if they have dementia.
Being there for them is important; to help them eat, to help them wash, keeping them company and making sure that they swallow their medication.
Families should work together with the hospital to offer their loved ones the best care. This, by no means, is a criticism of hospital care or the work of the staff, but rather a practical response. There is no-one that knows a person living with dementia better than their family, friends and loved ones – so it’s important to speak up and notify the healthcare teams of any changes observed.
Despite best intentions to support people with dementia remain healthy and free from sickness, sometimes a hospital visit cannot be avoided. And when it occurs, if families support the person in hospital, it helps the nurses, reduces delayed discharges and maintains the dignity of the patient.