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Hospitalization and Dementia:
The Role of the Caregiver
By Sandra O’Connell

(Page 3 of 4)

Fortunately, this situation is starting to change. An article in the American Journal of Nursing described how to recognize dementia in the hospital setting and the impact it has on treatment. “Hospital patients with dementia as compared with other hospital patients experience higher rates of delirium, falls, new incontinence, pressure ulcers, untreated pain...inadequate food and fluid intake, and sleep disturbances.”   (Recognition of Dementia in Hospitalized Older Adults, Maslow and Mezey,  AJN, January, 2008.)

4.  Keep a written record of all medical information.
The hospital thrives on records; be ready to provide all the information they need – repeatedly.  Keep a list of medications, dosage levels, doctors’ names and phone numbers, past hospitalizations, and current conditions. Your documents help to insure that accurate information is in the records.  Realize that each time medical information is transferred, the possibility for error increases.  When going from the emergency room to a regular bed, coming from a nursing home to the hospital, whatever the route, verify each time that the medical record is correct.  After an illness that involved three transfers and several doctors, I found five errors in my husband’s medication records.
       
One of the advantages of an advocate is that you are there 24x7, so it is likely you will be there when the doctors make rounds.  Take notes with each visit, as most likely you will need to coordinate issues among various specialists.  This is a critical aspect of the caregiver-advocate role.  Keep track of questions as they arise and have your notes available when the doctor arrives, which may be at 7 a.m. or 10 p.m. or anytime in between.

5.  Personalize and manage the hospital environment. 
Routine and familiar surroundings are essential to a person with dementia struggling to make sense out of a strange place.  The first request should be for a private room; another patient in the room will be incredibly distracting and difficult.  Look for ways to personalize the space and provide comfort to your loved one.  Bring in a favorite coverlet or pillow, tape large photos on the wall or cabinet; ask if you may provide a drink or food that Mom especially likes.  With hospitalization, families may find an outpouring of concern which may result in a lot of visitors.  Given the already confusing surroundings, experts recommend limiting visitors.  Let people know that your loved one will rest and heal best with quiet and calm.

Since you are staying in the hospital for possibly days or weeks, pack your own bag with maintenance and comfort items which may include: lots of change for the vending machines, toothbrush, reading material, comfortable pillow, change of clothes, water, and snacks.  Do remember that hospitals limit the use of cell phones to areas where they will not interfere with equipment. 

 

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