Dementia and Hospitalization: A Difficult Combination

For most people, hospitalization is stressful and even frightening.  It is so much worse for a person with a brain disorder or dementia.  A person with Alzheimer’s Disease is two to three times more likely to be hospitalized than others the same age.  Many people with Alzheimer’s Disease develop delirium which causes a rapid change in behaviors.  Being in a hospital, unable to articulate what is wrong, causes longer hospitalizations and can lead to a stay in a rehabilitation facility.  In fact, persons with Alzheimer’s Disease can experience rapid mental decline for as long as five years after hospitalization occurred. 

It is important to do what can be done to prevent hospitalization for those with
dementia.  There are four primary reasons why a person with dementia is admitted to the hospital.  They are: bacterial pneumonia, urinary tract infection (UTI), congestive heart failure (CHF) or a fall.  It is important to develop a good relationship with the person’s primary doctor. It’s important to see the doctor regularly so that the doctor knows the person well.  It is important to be alert to warning signs which may mean the person is ill.  For example, a cough could be nothing or it could be the early stages of pneumonia.  Tugging on one’s clothes
could indicate an UTI. 

There are times when hospitalizations cannot be avoided.  During these times it is important to address the upset to the person with dementia.  It is helpful to limit the amount of noise and bright lights.  Because it is not possible for hospital staff to provide hands-on constant care it is important to have someone with the
hospitalized person.  It is a good idea to hire caregivers from a reputable homecare agency to be there when you cannot. There are things that can be done to make the person with dementia more comfortable. 

 For example:

• Try to provide emotional support and comfort
• Give the hospital all relevant medical records
• Provide the hospital with a list of all medications, including OTC medications and make sure these medications are noted in the person’s chart
• Stay on top of things.  Make sure you understand the care plan and expected results.  Take notes and ask questions.
• Get to know thenurses and doctors and tell them about your person.
• Have someone with your person 24/7.  This may be a good time to hire a “sitter” from a reputable homecare agency.
• Bring to the doctors and nurses attention any abrupt changes in the person’s behavior as this could mean an infection and/or delirium. 
• Keep track of any new medication and watch for side effects
• Prevent falls.  
• To reduce the chances of dehydration and malnutrition, monitor all intake
• Make sure the person is turned often if they cannot turn themselves to prevent bed sores
• Make sure everyone who enters the room washes their hands to prevent the spread of germs
•  Bring assistive devices such as glasses, hearing aids, etc., keep close track of these as they may become lost
• Cozy up the room with familiar things such as pictures, a special blanket, etc.
• Make sure there is a clock and a calendar where the pages can be torn off each day
• Keep the person intellectually stimulated through reminiscence, looking at photos, playing a game
• Learn about the hospital resources, such as the social worker, patient advocates, discharge planners, etc.