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Jul 9, 2019

Hospital Stays for People with Dementia: Part 1

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A trip to the hospital can be stressful for people with dementia and their caregivers. Part 1 features tips for planning for an unexpected emergency room visit.


Hospital Emergencies: What You Can Do

A trip to the emergency room (ER) can tire and frighten a person with Alzheimer’s or other dementia. Here are some ways to cope:

  • Ask a friend or family member to go with you or meet you in the ER. He or she can stay with the person while you answer questions.

  • Be ready to explain the symptoms and events leading up to the ER visit—possibly more than once to different staff members.

  • Tell ER staff that the person has dementia. Explain how best to talk with the person.

  • Comfort the person. Stay calm and positive. How you are feeling will get absorbed by others.

  • Be patient. It could be a long wait if the reason for your visit is not life-threatening.

  • Recognize that results from the lab take time.

  • Realize that just because you do not see staff at work does not mean they are not working.

  • Be aware that emergency room staff have limited training in Alzheimer’s disease and related dementias, so try to help them better understand the person.

  • Encourage hospital staff to see the person as an individual and not just another patient with dementia who is confused and disoriented from the disease.

  • Do not assume the person will be admitted to the hospital.

  • If the person must stay overnight in the hospital, try to have a friend or family member stay with him or her.

Do not leave the emergency room without a plan. If you are sent home, make sure you understand all instructions for follow-up care.

What to Pack

An emergency bag with the following items, packed ahead of time, can make a visit to the ER go more smoothly:

  • Health insurance cards

  • Lists of current medical conditions, medicines being taken, and allergies

  • Healthcare providers’ names and phone numbers

  • Copies of healthcare advance directives (documents that spell out a patient’s wishes for end of life care)

  • “Personal information sheet” stating the person’s preferred name and language; contact information for key family members and friends; need for glasses, dentures, or hearing aids; behaviors of concern; how the person communicates needs and expresses emotions; and living situation

  • Snacks and bottles of water

  • Incontinence briefs, if usually worn, moist wipes, and plastic bags

  • Comforting objects or music player with earphones

  • A change of clothing, toiletries, and personal medications for yourself

  • Pain medicine, such as ibuprofen, acetaminophen, or aspirin—a trip to the emergency room may take longer than you think, and stress can lead to a headache or other symptoms

  • A pad of paper and pen to write down information and directions given to you by hospital staff

  • A small amount of cash

  • A note on the outside of the emergency bag to remind you to take your cell phone and charger with you

By taking these steps in advance, you can reduce the stress and confusion that often accompany a hospital visit, particularly if the visit is an unplanned trip to the emergency room.

Before a Planned Hospital Stay

With Alzheimer’s disease and related dementias, it is wise to accept that hospitalization is a “when” and not an “if” event. Due to the nature of the disease, it is very probable that, at some point, the person you are caring for will be hospitalized. Keep in mind that hospitals are not typically well-designed for patients with dementia. Preparation can make all the difference. Here are some tips.

  • Think about and discuss hospitalization before it happens, and as the disease and associated memory loss progress. Hospitalization is a choice. Talk about when hospice may be a better and more appropriate alternative.

  • Build a care team

  • Ask the doctor if the procedure can be done during an outpatient visit. If not, ask if tests can be done before admission to the hospital to shorten the hospital stay.

  • Ask questions about anesthesia, catheters, and IVs. General anesthesia can have side effects, so see if local anesthesia is an option.

  • Ask if regular medications can be continued during the hospital stay.

  • Ask for a private room, with a reclining chair or bed, if insurance will cover it. It will be calmer than a shared room.

  • Involve the person with dementia in the planning process as much as possible.

  • Do not talk about the hospital stay in front of the person as if he or she is not there. This can be upsetting and embarrassing.

  • Shortly before leaving home, tell the person with dementia that the two of you are going to spend a short time in the hospital.

For More Information About Hospitalization and Alzheimer's

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center 1-800-438-4380 (toll-free) adear@nia.nih.gov www.nia.nih.gov/alzheimers

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