Last April, the journal Neurology reported on a study showing that people with Alzheimer’s disease who were hospitalized have more than double the risk of cognitive decline than the control group.
Now, newer information makes the case that the hospitalization of a person with dementia presents an even greater risk than previously thought. According to an article in the Seattle Times, people with Alzheimer’s who are hospitalized are more likely to need nursing home care or even die within a year of their experience than those who are not hospitalized. If the person leaves the hospital suffering from a condition known as delirium, which is a state of increased agitation and confusion, the risk is even higher.
Many years back, my dad needed brain surgery to drain fluid that was building up behind scar tissue left from a World War II brain injury. He did not have dementia, but the doctors felt dementia could develop if he didn’t undergo the operation.
The result of that hospitalization and surgery was that Dad went home mired in deep dementia. He didn’t die from the hospitalization, but he lived in a frightening alternate world for the next decade until death finally freed him from his suffering. We, as a family, never received an explanation. I’m not sure the medical people had one. However, since that time I’ve had an abiding interest in what hospitalization and surgery can do to elders.
Psychiatrists aren’t sure exactly what causes such a dramatic reaction to elders who are hospitalized, but the more obvious reason is that hospital stays are stressful for any of us. The constant dinging of bells, paging of personnel, strangers poking and prodding one’s body and cold surroundings – visually and often physically – well, it is tough on anyone. We shouldn’t be surprised, then, that an elder with Alzheimer’s suffers increased anxiety and confusion.
Studies have shown that emergency rooms are also a risk. New attempts to create specialized emergency rooms for seniors that are quieter and more homelike have reported positive results, but this is a dream situation that has yet to spread to the average hospital.
Many geriatricians suggest that if an elder or a person with Alzheimer’s disease lives in a nursing home it’s far better to treat urinary infections and other issues in their own environment than in a hospital. Treating the disease in the elder’s home environment avoids the stress of hospitalization and has been shown to be just as effective in curing these ailments.
If your loved one needs to be hospitalized, the Seattle Times article suggests that family members spend as much time as possible with them in the hospital room. Also, if the family members can convince the doctor and hospital staff to do what is possible to tone down the noise and confusion around the patient, the result may be a less traumatic experience for the elder.
We know that our elders are likely to suffer from being hospitalized so we must do what we can to keep them out of situations where there is no other choice. We can’t always control the need for hospitalization, of course. But do check with the physician to see if there is any other option. Why take the chance if hospitalization is not absolutely necessary?
Neergaard, L. (2012, June 18) With Alzheimer's, hospital stays can be a hazard. The Seattle Times. Retrieved fromhttp://seattletimes.nwsource.com/html/health/2018467523_apusmedhealthbeatalzheimershospitals.html
Wilson, R.S., et al. (2012, March 21) Cognitive decline after hospitalization in a community population of older persons. Neurology. Retrieved fromhttp://www.neurology.org/content/early/2012/03/21/WNL.0b013e31824d5894.abstract