Older people with dementia have more health conditions than those without dementia; therefore they are more likely to be admitted to hospital, usually for another primary reason. Older people with dementia also have a higher risk of experiencing preventable issues such as delirium, falls, pressure injuries, under-nutrition and dehydration in hospital.
It is essential to complete a cognitive screen for all patients aged 65 and older as many people with dementia may not have had a formal diagnosis, their symptoms may be subtle, or it may not be noted in their medical record.
Further assessment to identify the impact of the person’s cognitive impairment on their function is essential to develop a person-centred care and intervention plan.
As clinicians, we should listen to the patient, their family and carers. This topic provides an overview of dementia, its causes, symptoms and management strategies. In addition to following health service specific policy and procedures, consider the following actions and discuss them with your colleagues and managers.
All Australian hospitals are being accredited under The Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. Each of the ten standards relate to optimising clinical care and better outcomes for all patients. The Commission has identified that cognitive impairment is under-recognised in Australian hospitals leading to significant safety and quality issues in the care of patients. The NSQHS Standards can support a nationally coordinated improvement in the care of people with cognitive impairment in acute care. The Commission released A better way to care: safe and high quality care for patients with cognitive impairment (dementia and delirium) in hospital in 2014. As a stand-alone clinical care standard, this will assist you and your organisation to meet the requirements of the NSQHS Standards recognising and responding to clinical deterioration (standard 9), preventing falls and harm from falls (standard 10), medication safety (standard 4) and partnering with consumers (standard 2).