Older people with dementia are admitted to hospital each year at twice the rate of older people without dementia. They have longer lengths of stay, are at risk of falls, gait and balance impairments, inattention, hypotension, eating and hydration problems, sleep problems, pneumonia, untreated pain, delirium, urinary tract infections, sepsis, pressure injuries, fractures, functional decline and even death.1, 2 3 The longer a person stays in hospital, the worse their outcomes.4
For people with dementia, the hospital environment, routines and interactions with multiple people can be overwhelming, and can increase their confusion and trigger changes in their behaviour and emotions. It is important that we address these behaviours and do not label patients with dementia as ‘difficult’.
Carers and family members often find hospital environments overwhelming. It is important to include them in your assessment and be alert for signs of for carer stress and carer fatigue. Involve carers and family members when developing a person-centred care plan. If the person does not have family or carers, seek information from other sources, such as their GP and service providers.
1. Joosse, L.L., D. Palmer, and N.M. Lang, Caring for elderly patients with dementia: nursing interventions. Nursing: Research and Reviews 2013 3: p. 107-117.
2. Alzheimer's Australia, Dementia care in the acute hospital setting: Issues and strategies. A report for Alzheimer's Australia. Paper 40 2014.
3. Bail, K., et al. Potentially preventable complications of urinary tract infections, pressure areas, pneumonia, and delirium in hospitalised dementia patients: retrospective cohort study. BMJ Open, 2013. 3, 1-8 DOI: 10.1136/bmjopen-2013-002770
4. Health Foundation, Spotlight on dementia care: A Health Foundation improvement report 2011, The Health Foundation: London.