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Just the Facts and More: Hospitalization
Spending time in a hospital can be a confusing, uncomfortable, anxiety-filled experience for anyone. But for the person with Alzheimer's disease, who may easily become confused or disoriented, the experience of going to the hospital and having to stay overnight can be traumatic.
Moving a person with Alzheimer's from the quiet, familiar setting of home to the somewhat cold, unfamiliar world of a hospital or clinic may emphasize memory loss and difficult behavior. Add to that the stress of the illness, the prospect of surgery, the effect of anesthesia, and possible drug interactions, and it's easy to understand why it is important to prepare the person for the hospital experience.
One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 Chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.
The primary resource for this fact sheet was Barbara Sand, RN, MSN, Assistant Professor, College of Nursing, University of Nebraska, Lincoln, Nebraska.
Special thanks to the following Chapters of the Alzheimer's Association: Cleveland and Northwest Ohio.
Posted August 3rd, 2007
Moving a person with Alzheimer's from the quiet, familiar setting of home to the somewhat cold, unfamiliar world of a hospital or clinic may emphasize memory loss and difficult behavior. Add to that the stress of the illness, the prospect of surgery, the effect of anesthesia, and possible drug interactions, and it's easy to understand why it is important to prepare the person for the hospital experience.
| Action Steps |
Keep the person's best interest in mind.
- Consider how to avoid overnight hospitalizations. You may want to ask your physician whether the procedure can be done in the physician's office, a clinic or ambulatory care center, or a same-day or freestanding surgery center.
- Don't speak about the person's hospitalization in his/her presence as if (s)he were not there. Instead, involve him/her in discussions and decision-making as much as possible.
- Plan for hospitalization. You may be able to schedule an elective surgery. If so, you may want to arrange a face-to-face family meeting or conference call to discuss responsibilities. For example, one family member could take the person to the hospital for pre-admission testing, while another could remain at the hospital during surgery. Alternating visiting hours helps to share the burden of caregiving.
- If possible, try to get a private room. Although a private room is more expensive than a semiprivate room, the added privacy often helps to calm the person with Alzheimer's.
- Prepare for the hospital visit. Shortly before you leave for the hospital, use your best judgment to explain to the person that the two of you are going to spend a short time in the hospital. You may want to bring a box of familiar objects such as photographs, knickknacks, and an afghan or bedspread to help make the patient feel comfortable away from home.
- Stay with the person as much as possible. If the person must stay overnight, try to be in the room when (s)he awakes in the morning, when medications are given, when IVs or catheters are inserted, or when the physician makes rounds.
- Communicate with the person. For example, if the person can read, you may want to hang a note close to the hospital bed that says: "Mom, you've fallen down and broken a bone. Please rest quietly." Seeing this type of message may help calm the person when she wakes up in strange surroundings.
Work with hospital personnel.
- Make sure that all hospital personnel working with your family member are aware that (s)he has dementia. Although staff should be trained in meeting the needs of Alzheimer patients, you may want to provide them with additional input on your family member's personal habits and information on diet or eating habits. For example:
- "This person can feed him/herself, but can only be given one food at a time."
- "This person will be incontinent if not taken to the bathroom every 2-3 hours."
- "This person can't tolerate any chocolate in his/her diet."
- To make sure you've covered all important points, you may want to type a list of tips for hospital staff before you leave for the hospital.
- If your family member with Alzheimer's tends to wander, alert hospital staff and see that they take measures to ensure the person's security.
- Ask questions about anesthesia. General anesthesia can sometimes depress the person's central nervous system. For this reason, some physicians prefer to use local anesthesia or spinal anesthesia. Talk to your physician and surgeon about these options.
- Try to obtain an early discharge. Work with your physician, nursing staff, and the hospital's discharge planner or social worker to make the transition from the hospital to home care or a less threatening health care setting.
Before Admission
- Find out if the diagnosis requires admission. Find out if procedures, tests, or treatments demand admission to the hospital. In addition, determine if tests can be completed before admission (pre-admission testing) to shorten the hospital stay. Ask the physician about the anticipated "length of stay" or how long the person will be in the hospital.
- Don't be afraid to comparison shop. Check average daily costs of several hospitals where your physician works.
- Ask about consulting physicians. Find out if your physician plans to consult with other physicians and if these consultants could be seen before the person is admitted.
- Consider having the person record his/her wishes concerning medical care, such as life-prolonging treatment, in the event of a life-threatening situation.
During the Hospitalization
- Keep complete records.
- Monitor tests and medications that are ordered daily, and if and when they can be stopped.
- Ask about hospital equipment and if and when procedures or equipment can be discontinued.
In the Event of Surgery
- Ask questions. Be sure you understand the name of the operation, what the operation involves, and the person's diagnosis.
- Find out how often the surgeon performs the surgery and if the surgeon is an intern, resident, or board-certified surgeon. Also determine who will assist the surgeon and if an assistant is necessary.
- Pinpoint the expected length of hospitalization and the expected length of recovery. For example, will the individual tire more easily? When will the person be able to resume normal activities? How long must the person wait before doing any exercise such as walking? How long will the person be in pain?
| Resources |
One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 Chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.
The primary resource for this fact sheet was Barbara Sand, RN, MSN, Assistant Professor, College of Nursing, University of Nebraska, Lincoln, Nebraska.
Special thanks to the following Chapters of the Alzheimer's Association: Cleveland and Northwest Ohio.
Other Resources include:
- Charles B. Inlander and Ed Weiner. Take This Book to the Hospital with You. New York: Pantheon, 1991.
- Nancy L. Mace and Peter V. Rabins, MD. "The 36-Hour Day." Baltimore: The Johns Hopkins University Press.
- "Financial and Health Care Benefits You May Need," Alzheimer's Association, 1991.
- "Steps to Choosing a Physician," Alzheimer's Association, 1991.
© 1992 Alzheimer's Disease and Related Disorder Association, Inc. All Rights Reserved.
Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.
