Disruptions in Care

Disruptions can ruin our day even when we’re healthy. Traffic jams, cancelled doctor’s appointments, forgetting our keys… these things make us cranky and steal our sense of control over life. For people with dementia, disruptions in care can come with much worse consequences.  Even a short hospital stay may have a terrible impact on their fragile health.

Between the Pond and the Woods

We all crave smooth sailing, no disruptions.

Ten days ago my mom had a sudden drop in blood pressure that landed her in the hospital for observation. She was only there for two days, but the change in routine was devastating. Now she’s having problems walking and her speech has deteriorated to an all time low. I’m not sure if these skills will be restored to their previous baseline. It’s an alarming situation.

We were lucky that when Mom went into the hospital my sister was able to get a day off work and stay there while the hospital staff conducted testing and administered treatment. But the regular staff did not have much training or sensitivity regarding the dementia component of my mom’s problems. The failure to understand how dementia interacts with other medical matters can add to the patient’s stress.

A September 2013 article in Science Daily, describes a study conducted by Donna M. Fick, Distinguished Professor of Nursing at Penn State.  Professor Fick found a 32% incidence of new delirium among dementia patients who were hospitalized. Dementia patients who experienced delirium stayed in the hospital several days longer than patients without delirium, and  showed a decline in physical and mental abilities at one month follow up visits.  Fick believes, “This study is important, as delirium is often overlooked and minimized in the hospital setting, especially in persons with dementia.”

Another study by Dr. Tamara Fong, a Harvard researcher, found that hospitalization seems to increase the chances of Alzheimer’s patients moving into a nursing home — or even dying — within the subsequent year. Although more research must be done to determine the actual cause and effect here, William Thies of the Alzheimer’s Association says “It is perfectly clear that hospitalization is very hard on people with Alzheimer’s disease.”

There are some things families can do to minimize the impact of hospital stays:

  • Thies advises families to be alert for any new symptoms and seek care early to avoid hospitalization. It’s also better to learn to manage Alzheimer’s behavioral problems — such as hallucinations — before they escalate.
  • When a hospital stay is unavoidable, work with staff at the medical center to minimize delirium by avoiding nighttime disruptions of patient sleep, and limiting time in the emergency room.
  • When possible, a family member should stay at the hospital to reassure the patient and make sure they have familiar items like reading glasses or things that bring them comfort.

My family didn’t know all these things two weeks ago. I hope you can protect your loved ones by learning from our experience.



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