In her article, Hospital Stays Can Be A Hazard For Alzheimer’s Patients, Lauran Neergaard says, “For people with Alzheimer’s, a hospital stay may prove catastrophic.” I think she is correct. Dementia and Alzheimer’s patients are often unable to process the confusion and fear they feel when in the hospital, increasing their vulnerability and the likelihood of becoming agitated. In addition, middle and later stage patients cannot advocate for themselves, question procedures, or follow instructions.
The article was based on a Harvard study of 771 Alzheimer’s patients. The key findings were these:
1. People with dementia are more likely to be hospitalized for preventable conditions than others because they lose their ability to control their chronic conditions, like diabetes or high blood pressure, and they may be unable to communicate symptoms.
2. People with dementia are more likely to be hospitalized for conditions which are easily treatable, if found early enough, such as urinary tract infections or dehydration.
3. Hospitalization increases dramatically the likelihood an Alzheimer’s patient will need to move to a nursing home or will die with the next year.
4. Alzheimer’s patients are more likely to suffer from “delirium,” a state of confusion and agitation, which affects some people during hospital stays.
The Harvard researchers recommend the following for families:
- Watch for new symptoms, such as unusual behavior or irritability, both signs of pain. Seek care to avoid hospitalization.
- If your loved one does go to the hospital, actively work to avoid delirium: try to limit time in the emergency room, choose a private room, and request that hospital staff not wake the patient in the night.
- Have family members or a trusted Alzheimer’s caregiver stay with and reassure patients.
- Bring the patient’s glasses and hearing aids.
The above family tips are right on target. Hospitals can be frightening to all of us, and especially to middle and late stage Alzheimer’s patients. Since most people are fearful when they go to the hospital, they help to create an atmosphere of tension and fear in the hospital, a vicious cycle. Generally, people with Alzheimer’s are very attuned to the atmosphere of a place and the feelings of the people around them. Additionally, the hospital’s artificial lighting, long corridors, and constant background noise can be unsettling, and cause agitation. The shock and fear of being in an unfamiliar place where strangers are doing unfamiliar and possibly painful things to us is extraordinarily confusing and anxiety causing to Alzheimer’s sufferers, since they cannot process the new environment or the pain, which originally brought them to the hospital. Given all this, I would add the following to the above list: family or professional caregivers should stay with the Alzheimer’s patient at all times, from admission to release, and advocate strongly for them. Write everything down, ask questions, be an active part of the Alzheimer’s care team. This presence and advocacy will help provide the best support for the dementia patient. (see “When a Loved One is Hospitalized” for more tips.)
Home Care Assistance in Lincoln is proud to advocate and care for our clients when they are at home, or in the hospital. We provide RN supervised care management and client specific training for each caregiver to help our clients receive the support they need.