A stay in hospital is a bit frightening at the best of times. This can be particularly daunting for someone living with dementia. A different routine, strange people poking and prodding, a completely different environment etc., can all contribute to making a hospital stay for someone with dementia a very difficult experience.
There are some useful, practical things you can do to hopefully make it easier, for both your elderly relative, yourself, and for the hospital staff.
Planning a hospital stay for someone with dementia
Think about any familiar items from home or things to do whilst in hospital that might make the stay easier: a treasured photograph or photograph album; a favourite puzzle or book. If they use a mobile phone, make sure the pre-paid is topped up, and that relevant contact numbers are easy to locate.
If you can, call the hospital or the ward ahead of arrival to find out what support services for dementia patients they may be able to provide; you could also make contact with local charities such as Alzheimer’s society or The Red Cross who may have volunteers in the hospital.
This is Me is a brilliant form to complete before arriving in the hospital. Designed by Alzheimer’s Society, it is a great way of providing information about your parent that will help the hospital staff take care of them.
Once in hospital
There may still be restrictions on visiting in hospital, but hopefully you will be able to go, and indeed spend significant amounts of time with your relative whilst they are there.
Share the This is Me document, and explain to as many staff as you are able, the condition of your parent and any particular things they should know about in terms of what makes them happy/sad, safe/anxious etc.
This may also possibly include the concern that your relative may wander, particularly in the night.
Eating and drinking enough may be a challenge, particularly if your relative is feeling unwell and the staff are very busy. So, being there for mealtimes, bringing in additional food if you are able to, might be extremely useful. Particularly important to try and keep your relative hydrated during their stay, to avoid UTIs and Delirium, which can appear as if there is a rapid decline in someone’s health
You may also find that you have to interpret levels of pain your parent or relative for the medical and nursing staff. Your parent may well be able to still make decisions about their own health care, but if not, you should ensure that you/someone has a Lasting Power of Attorney to be able to make any decisions on their behalf.
Hospital discharge process
Each hospital has its own discharge plans for dementia patients. You should be able to get a copy from the ward manager or the hospital’s Patient Advice and Liaison Service (PALS).
Currently, hospitals in England and Wales use a ‘discharge to assess’ model. This means that only a short assessment will be completed because the requirements for people staying in hospital are now stricter. Discharge can happen very quickly. People who need support after leaving hospital will be given a longer assessment.
The professionals involved in an assessment (both before and after leaving hospital) could include doctors, nursing and ward staff, social workers and psychiatrists: it might be worth making a note of the names of the people who are involved.
If no extra help is needed after leaving hospital
For people with dementia who are well enough to return home with no extra support, the ward staff should arrange the discharge. The person should be transferred from their ward to a discharge area as soon as possible. They should be able to leave hospital the same day.
If some continued help is needed after leaving hospital
If the person will need continued support or care after leaving the hospital, they should be assigned a case manager who will make sure that you are fully informed of the next steps. The case manager will:
- set out the person’s discharge and follow-up care
- arrange transport and ‘settle in’ support, which could include services like help with shopping
- work with other teams of professionals, such as local ‘single point of access’ schemes, to set up an assessment of the person’s longer term needs once they have left the hospital.
If a high level of support is needed after leaving hospital
After a stay in hospital, some people will need a very high level of care. In this situation, the person may be kept in hospital. If the person cannot stay in hospital, they may be discharged to a care home or to a rehabilitation bed.
Leaving hospital
You will be given a letter for the GP which provides information on the treatment and future care plans. Ensure you have enough medication if it has been prescribed, and for any medical device, have been shown how to use it.
Hopefully your parent will be happy to leave hospital and go home. If they need more care at home then NHS Nursing Care should be provided for 6 weeks after discharge, and agreed as part of the Care Plan.
