Dementia Precautions in Elder Care Management: Hospitalization
Adverse Effects of Hospitalization on Alzheimer's Patients: Dementia Precautions
Hospitalization often results in functional decline for elders, with a change in functioning occurring as quickly as day two of being hospitalized. For elders with Alzheimer's and other forms of dementia, effects are often more pronounced. Several studies over the years have demonstrated both physical and cognitive impacts.
The scope of the problem: Evidence shows that persons with Alzheimer's Disease are more likely to be hospitalized than other older adults. Amongst older adults, delirium is a particular risk of hospitalization and those with Alzheimer's are at greatest risk. Various clinical observations and studies have indicated these increased risks for Alzheimer's patients as well as longer-term effects such as cognitive decline and increased care needs (often leading to placement in an assisted care or nursing facility).
A recent study published in the Annals of Internal Medicine was conducted to confirm these findings by directly comparing a group of hospitalized patients to similar patients who were not hospitalized to better determine the risk for bad outcomes due to hospitalization and to delirium occurring during hospitalization.
The findings: Patients with Alzheimer's Disease who are hospitalized for any reason are more likely to die than patients who are not hospitalized. If they survive hospitalization, they are more likely to require placement in an institutional facility, such as a nursing home. Of great importance, the occurrence of delirium in patients with Alzheimer's Disease substantially increased these risks compared with patients who did not develop delirium. The authors estimate that:
6% of deaths
15% of institutionalizations,
and 21% of cases of cognitive decline
in hospitalized patients with AD can be associated with delirium.
The implications for you: If you are a loved one or someone caring for a person with dementia, this can be scary information to read. But, it is valuable to know and helpful in working with your loved one's medical providers.
First, you can work together on care planning and ways that hospitalization might be avoided in some situations (for example, outpatient treatments, deciding on care priorities). Second, you can advocate for your loved one when hospitalized and ensure dementia precautions are taken and risks of delirium are reduced (and identified and managed as quickly as possible when occurring). We encourage you to view our Caregiver Tips for Hospitalization of an Alzheimer's Patient (good tips for caregivers of any elder).
You might also want to check out our hospital discharge planning checklist for families:
Have concerns for a loved one with dementia? Want to take dementia precautions when it comes to care planning and hospitalization? Our professional patient advocates can help. Contact us at 727-447-5845 or 888-807-8551 to discuss your situation.