“Patients with Alzheimer’s disease face an increased chance of adverse outcomes within one year of being hospitalized . . .”
I swiped the headline without apology from this article. . . .
Setting The Stage
Last night I had dinner with my 31 year old foster son who just a year ago had surgery to remove a malignant tumor in his brain. The prognosis with or without surgery was not great. The surgeon explained that it would be impossible to get all of the tumor, but that by doing surgery he was buying some time. Either way his chances of making 40 were almost non-existent. The surgery went better than is typical and he has no residual physical damage and only the most minor loss of brain function, so minor that he is the only one who can notice. Further complicating his situation he is the custodial parent of his four year old daughter. After dinner we were talking what happens when the tumor reappears and what impact it will have his ability to be an effective parent for his daughter. As he began to tell me about his plans, a significant part of what he has set in place is half a dozen or so friends who are assigned the task of watching for signs of behavioral changes that might put his daughter in danger. He described it as being a lot like Alzheimers where those with Alzheimer’s are not aware that they are losing cognitive abilities. In believing this about Alzheimers he is perpetuating the old joke that says the best thing about having Alzheimer’s is that you get to make new friends each day. Those of us who work in the Senior Housing industry know there is not a single thing great about Alzheimers.
For the most part those who have the disease know things are really out of kilter and have no idea what to do about it. It is devastating first for those who have Alzheimer’s and for their families. Because it is such a terrible problem this article really hit home.
Senior Housing Can Make a Huge Difference
The article makes the following points:
1. Hospital stays are uniquely difficult and unsettling to dementia patients.
We know this and it is why the senior housing community should go to extraordinary lengths to avoid hospitalization
2. Hospitalization of seniors with Alzheimer’s greatly increases the likelihood of an adverse outcome including mental health declines or death.
Because of this, we need to be talking to families about the risk of hospitalization. It is also a compelling reason to have a close relationship with hospice.
3. Physicians should make every effort to keep dementia residents out of the hospital.
I am beginning to see a trend toward even in assisted living having physicians come to the community to see their patients (your residents). This is a huge win for everyone, but especially the residents.
4. When dementia residents are hospitalized physicians should work with the hospital to create a dementia friendly experience.
I would further offer that in many cases, the true experts are not the physicians but wellness staff of the senior housing community. They should helping the hospital what works best and what doesn’t. It not only benefits the residents, but becomes a marketing opportunity.
5. Every problem is compounded because many people with Alzheimer’s can’t effectively communicate.
Helping the hospital staff understand how to effectively communicate with Alzheimer’s residents creates a unique situation where the staff of the assisted living community are “The Experts.” It presents a great teaching and relationship building opportunity where the single biggest beneficiary is the resident. A few of questions for our reader community: 1. How does this fit with your experience? 2. What are you doing to minimize transfers to the hospital? 3. What are you doing to educate the medical community on how to be effective in managing Alzheimer’s patients in a hospital setting?
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Finally: If you know anyone who is looking at emergency call systems I would appreciate the opportunity to talk with them about Vigil Health Solutions.
My Dad had A.D. At one point he had to go to the hospital and it was very hard for him. He was very confused. We were told that he kept getting out of the bed and walking the halls at night. He could always talk but he ended up in a wheel chair unable to walk at all. I remember standing in front of him and asking him to put his right foot forward ( as I
watched both of his feet) and he said I already did. Neither foot moved!!
In his mind he did move his foot but some where between his brain and his foot there was a dis-connect.
From LinkedIn Groups
Group: Executives in Long Term Care
Discussion: Moving Dementia Residents into the hospital does great damage! This has huge implications for providers of senior housing.
Great article. The project I am working on is focusing on this issue. go to http://www.bsoproject.ca
Posted by Sean Weylie
From LinkedIn Groups
Group: Senior Real Estate Network
Discussion: Moving Dementia Residents into the hospital does great damage! This has huge implications for providers of senior housing.
So true! The article states “The risk is amplified for those who develop delirium during an inpatient stay.” – I experienced this first hand with my Dad – who lived with the disease – he was hospitalized and developed delirium – a nightmare for him.
Posted by Carol Marak
Great comments and so true. As a nurse, I had to perform assessments prior to returning to our facility. The hospital staff would inform me of concerns with dementia issues which the resident never had prior to admission. Countless times, families would inform me that their loved one was being discharged late in the evening. I informed them to refuse and wait until the next morning. Moving late in the evening/night just enhances their dementia.
I found this article and discussion very informative for those who are not aware of the repercussions of this disease; and also very accurate regarding what happens when a patient with Dementia or Alz or any other type of OBS is taken from a familiar environment and enters the institutionalized setting. I have had experience with many patients with this diagnosis, and after institutionalization their lifespan has become shortened a great deal, as well as the degree of the afflication. KUDOS to the author!!
Thank you for sharing. 11 years ago, I had to watch my Grandmother suffer with Alzheimer’s before she passed away. It was absolutely heartbreaking, and I wish that I could forget about it. My whole family had to sit back and watch as she lost everything that really made her who she was. It was extremely difficult for all of us, but especially her daughter, my mom. You could tell how close they were and for her to not remember some of the things that they did together was really hard for her.
It seems like you have an excellent point. Althought my Grandmother was at a very bad spot in her life, we never considered putting her in the hospital full-time. It really wasn’t ever even an option. We knew that we could take care of her just as well at home, and at least in that setting she would feel comfortable with (semi) familiar faces.
I actually work with senior citizens every day, helping them cover the out of pocket gaps brought on by government Medicare. I try and help them out in any extra way that I possibly can, so I will definitely be passing this information along. Thank you again for sharing, you have an excellent blog. Keep up the good work!
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