A hospital visit can be an overwhelming experience for patients with dementia, so in Massachusetts, a committee is working to develop guidelines to make an inpatient stay or visit a bit easier.
The committee, which was formed in 2016 by the state legislature, is pushing hospitals to develop a plan within three years to better care for dementia patients, according to an article from the Boston Globe. The problem: Clinical teams are often unprepared to meet the needs of hospitalized dementia patients. As a result, the patients may leave the hospital in worse mental condition than they entered it.
"Hospitals were never designed to accommodate people with dementia," Susan Antkowiak, vice president of the Massachusetts/New Hampshire chapter of the Alzheimer's Association, told the newspaper.
The committee issued its first report in September, and many of the fixes require limited investment or time, according to the article. Lowering the volume or getting patients with dementia out of bed can ease the stress of a hospital stay, and organizations need to train clinicians to recognize the signs of dementia to address their needs.
That training is also vital in the emergency department. Between one-third and a half of elderly patients with dementia visit the ED in a given year, and they are more likely to be admitted, often needlessly, as a result of those visits. Senior citizens with dementia are also more likely to die as a result of a hospital stay.
Near misses and medical errors with dementia patients in hospitals are also common and likely underreported, studies show. Errors involving dementia often fall into one of five categories:
- Clinicians failed to share dementia diagnoses with the rest of the care team.
- Patients were not assessed for mental competence or their decision-making ability.
- Pre-existing dementia was not identified.
- The clinical team did not find a decision-maker for the patient.
- The clinical team did not contact a competent decision-maker.
One model for treating these patients focuses on a well-rounded approach that incorporates their extensive psychological, physical and cognitive needs into a post-discharge plan.