New Study Warns of Future Impact of Elderly with Dementia to Hospitals
Mom had three significant stays in the hospital and numerous trips to the hospital’s emergency room when she had Alzheimer’s disease. It was during those visits that I quickly learned that hospitals are not equipped to deal with people with dementia.
The first stay was right before she was diagnosed with Alzheimer’s; she was admitted to the hospital due to her chronic obstructive pulmonary disease and concerns about her heart. However, Mom was lashing out verbally at people in the emergency room and became particularly combative when she saw me. Therefore, the hospital staff asked Dad and me to stay away for a bit until she calmed down. When Dad and I finally were able to visit Mom, we found her trying to get out of bed, even though she had an IV drip attached to her arm.
The second stay was about a year after her Alzheimer’s diagnosis when doctors were worried that she was in the early stages of pneumonia. The third stay was two years after her Alzheimer’s diagnosis and again was based on the concern that she was getting pneumonia. These stays were calmer in the sense that Mom wasn’t as agitated, but she didn’t understand what was going on. In fact, during her last stay, one of the nurses was trying to reposition her in the bed. “Get your hairy mitts off of me,” she glaringly told him. And the hospital wasn’t set up with Internet in the rooms, which would have allowed me to work while staying with Mom. Therefore, I could only stay for a brief period of time before heading home to take care of my professional responsibilities.
So needless to say, I wasn’t surprised at some recent research findings that were reported by Reuters Health. The study analyzed hospitalization data from 2000 to 2008. The researchers found that during this time period, the number of Americans who were 85 and older with dementia who were hospitalized increased from 700,000 to 1.2 million annually. Furthermore, the researchers projected that by 2050, between three million and seven million elderly people with dementia may be hospitalized annually. The increase is based on the predicted growth in the number of aging Americans as well as the proportion who are expected to have some form of dementia. The researchers suggested that instead of admitting elderly with advanced dementia to the hospital (where they might have to be restrained), medical professionals should consider expanding the use of nursing homes and hospice care as long as policymakers provide increased financial support from Medicare for these changes.
Besides the fiscal issues, hospitalization also creates problems for the elderly who have dementia. "You have to talk to the families but explain to them that the hospital is not appropriate for people with advanced dementia, especially older people with advanced dementia, because hospitalization is decreasing their functioning and producing (discomfort)," said Dr. Ladislav Volicer from the University of South Florida in Tampa, who reacted to the study’s findings in an interview with Reuters Health.
Based on Mom’s experiences, I have to say I agree with Dr. Volicer’s perspective. First of all, many elderly people with advanced dementia experience a mental – and at times, physical -- decline after staying in the hospital. In fact, we saw this situation happen with my mom. She returned from the hospital and almost returned back to her pre-hospital state for a day or two, and then suffered a serious decline that ended with her dying a week later. Secondly, Mom was definitely agitated by all the different people and machines that are part of being hospitalized. If the nursing home or hospice had the ability to handle her pneumonia, I believe Mom would have been much more comfortable because she would have been surrounded by people that she knew and would have remained in a familiar setting.