A trip to the hospital with a person who has memory loss or dementia can be stressful for both of you.
Relieve some of that stress by preparing for both unexpected and planned hospital visits.
Before going to the hospital
- If your insurance allows, ask if a private room is available to give your relative a more quiet and calm environment.
- Decide the best way to tell your care partner that the two of you are going to spend a short time in the hospital, and involve your care partner in the planning process as much as possible. Talking about a hospital stay in front of your relative as if he or she is not there can be upsetting.
- Make a schedule for family, friends or a professional respite-care provider to take turns staying with your care partner while in the hospital. This is particularly important if your relative needs continuous supervision.
- Pack comfort items – things to help your care partner feel safe and secure such as favorite clothes, blankets and photos.
During the hospital stay
- Once you get to the hospital, ask the staff to avoid using physical restraints.
- Have a family member or hired caregiver present at all times to help keep your care partner calm and less frightened.
- Have the hospital room modified to make the patient more comfortable.
- Help your relative or friend fill out menu requests.
- Communicate in the way he or she will best understand or respond.
The hospital room may be an unfamiliar place for your relative. Medicines, invasive tests and surgery will add to the confusion and result in your care partner needing more assistance with personal care activities.
Be aware of acute or sudden confusion or delirium, which can be caused by serious medical problems such as fever, infection, medications, and/or dehydration. Inform the doctor as soon as possible if your care partner seems suddenly worse or different.
Make sure you advocate for the person you are caring for. Others may not recognize the difference in your relative’s condition.
If anxiety or agitation occurs
- Turning off the television and other distractions minimizes background noise and prevents overstimulation.
- Talk in a calm voice and offer reassurances, repeating answers to questions when needed.
- Assume your relative has pain if the condition or procedure is normally associated with pain. Ask for pain evaluation and treatment every four hours without your care partner having to ask for it— especially if he or she has labored breathing, loud moaning, crying, or grimacing or if you are unable to console or distract your care partner.
- Listen to soothing music, try comforting rituals such as reading or reminiscing, try not to rush your partner and avoid talking about upsetting subjects or events.
At the emergency room
A trip to the emergency room may fatigue or even frighten your care partner. It's important to show patience at the ER because, if your visit isn't life-threatening, it could be a long wait. The emergency room staff often has limited training in dementias. It's your job to stay calm and positive, and offer comfort to your relative.
Do not leave the emergency room to go home without a follow-up plan. If you are sent home, make sure you have all instructions for follow-up care.
Have an emergency bag prepared for your trip to the hospital that includes items like over-the-counter pain medication, sealed snacks and bottled water.
Working with the hospital staff
Remember that not everyone in the hospital knows the same basic facts about memory loss and Alzheimer’s disease or related dementias.
You may need to help teach hospital staff what approach works best with your care partner; what distresses or upsets him or her; and ways to reduce this distress.
You can help the staff by providing them with a personal information sheet that includes your partner’s normal routine; how he or she prefers to be addressed (e.g., Miss Minnie, Dr. James, Jane, Mr. Miller, etc.); personal habits; likes and dislikes; possible behaviors (what might trigger them and how best to respond); and nonverbal signs of pain or discomfort.
Help staff understand what your care partner’s “baseline” is (prior level of functioning) to help differentiate between dementia and acute confusion or delirium.
You should let them know as much personal information as possible, decide who will do what for your family member. Ensure a safe environment for your care partner by telling the staff about any previous issues with wandering, getting lost, falls, suspicious and/or delusional behavior. Ask questions when you do not understand certain hospital procedures, and plan early for a discharge. That planning should include questions about eligibility for home health services, equipment or other long-term care options. Prepare for an increased level of caregiving.
Realize that hospital staff are providing care for many people. Practice the art of patience.
Based on the NIH/National Institute on Aging article, "Hospitalization Happens."