By Natalie M. Bruck, BS. (I am a Physician Assistant student at Rush University with anticipated graduation in December 2018. I wrote this blog because I find that caregivers are an incredibly important part of the team to care for persons living with dementia.)
Caring for a loved one with dementia is a big job, but when a loved one with dementia is hospitalized, many new challenges appear. Research has shown that individuals with dementia who are hospitalized have an increased risk of developing complications during their hospital visit and tend to have longer hospital stays compared to patients without dementia. Fortunately, you, the caregiver, can do many things to improve a hospital stay for your loved one living with dementia. Here are 10 things you can do:
1.) Come Prepared
For planned hospital stays, you should bring important medical information such as a list of medications and allergies, contact information for their health care providers and copies of advanced directives. This will allow for a smooth hospital stay and the health care team will have all the information they need to provide the best care. In addition to medical information, bringing changes of clothes, toiletries and familiar objects from home will allow for a more comfortable stay at the hospital.
While it may seem challenging, there are ways to prepare for an unexpected emergency room trip. It may be helpful to pack a bag with clothing, toiletries and important health information which can be kept in a closet at your home, but is ready to use if a loved one needs to go to the emergency room suddenly. Being prepared will allow you to grab a bag quickly and head to the hospital without worrying that you forgot something important.
2.) Communication with Hospital Staff
Good communication with the hospital staff is important. You should be prepared to provide a description of your loved one’s medical condition and describe what is “normal” for them. The care team then can identify any changes in your loved one’s condition that may indicate that something is wrong.
3.) Bring Familiar Items from Home
Hospitals can be stressful and unfamiliar environments for patients with dementia. A family member or caregiver being present with the patient at all times can be comforting. Bringing items from home that are familiar to the patient such as a blanket, sweater, music or movies can make your loved one feel at ease and in an environment that is similar to their home.
4.) Minimize Background Noise
Hospitals can be noisy places which can make patients with dementia feel agitated or anxious. Minimizing background noise during times of stress or agitation can be helpful. You can ask the nursing staff to lower the volume on any noisy machines and also keep the television at a low volume. You also can request a private room which can make it a quiet, more familiar environment for your loved one.
5.) Organize a Team
When a loved one is in the hospital, gather your family and friends in order to create a support team. A team can limit stress on the patient, family and friends. Having one person in charge of sending updates to family members on the person with dementia’s condition. Make sure that family members look out for one another and no one is feeling overwhelmed.
6.) Talk to a Health Care Provider Immediately if Something Changes
While health care providers know which medical treatments are the best for their patients, no one knows your loved one better than you. Because you know him or her the best, help health care providers by letting them know about any changes that are not typical for your loved one. Changes can often be normal, but in many cases can be a sign of something more serious.
7.) Avoid Longer Stays and Unnecessary Treatments
If your loved one is scheduled for surgery, ask their health care provider what you can do to shorten their hospital stay. Sometimes, you may be able to have separate appointments before their surgery which can shorten the amount of time they spend in the hospital. For patients with dementia, make their stay as short as possible to prevent complications and get them back to their normal routine. Also, be sure to ask their healthcare provider about anesthesia and what procedures are being done. Knowing what health care activities are taking place will help you look out for any side effects, changes or complications.
8.) Be Aware of “Elderspeak”
Many caregivers, both family members and hospital staff, may talk in elderspeak. Elderspeak is language that uses simple vocabulary, changes in tone, changes in pitch and inappropriate terms of endearment. While many people may think that calling patients, “honey,” or, “sweetie,” could be comforting, the patient may feel upset, annoyed or looked down upon. Elderspeak can be upsetting for patients and may make them agitated and angry. If you encounter family members, friends or staff using elderspeak, don’t be afraid to speak up for your loved one.
9.) Remember to Take Care of Yourself
Being in the hospital can be stressful. As your loved one’s caregiver, you need to take care of yourself. Remember to take frequent breaks and don’t be afraid to ask for help when you need it. Having other family members visit is helpful. Taking shifts also can ease some of the stress.
10.) Know Appropriate Follow Up Care
When your loved one is released from the hospital, make sure you and the care team have scheduled follow up appointments and tests. Make sure you are comfortable with this plan, and bring up any questions or concerns you may have regarding your loved one’s care.
Hospital stays for anyone can be quite stressful, and when an individual with dementia is hospitalized it adds a level of complexity which can lead to medical complications. Fortunately, caregivers and family members can do several things to make their loved one’s hospital stay easier, more enjoyable and safer for everyone.
 Bail K., Goss J., Draper B., Berry H., Karmel R., Gibson D. The cost of hospital-acquired complications for older people with and without dementia; a retrospective cohort study. BMC Health Services Research. 2015; 15:91.
 Fick D., Foreman M. Consequences of not recognizing delirium superimposed on dementia in hospitalized elderly individuals. Journal of Gerontol Nurs. 2000 Jan;26(1):30-40.
 Going to the Hospital: Tips for Dementia Caregivers. National Institute of Aging. 2017. https://www.nia.nih.gov/health/going-hospital-tips-dementia-caregivers
 Williams KN., Herman R., Gajewski B., Wilson K. Elderspeak Communication: Impact on Dementia Care. American Journal of Alzheimer’s Disease & Other Dementias. 2008; 24. 11-20.