Hospital admission can be a frightening and stressful prospect for any of us, but for those living with dementia this can be doubly true. COVID-19 is impacting on all of our lives at the moment and is adding further concerns if a hospital visit is required. Although the guidelines are changing regularly, there are a number of ways by which we can support someone with dementia in hospital.
The following is an excerpt from the new 10 Helpful Hints for when a Person with Dementia has to go Hospital publication from the DSDC, and is part of a larger series of Helpful Hints publications that were written with family carers in mind, which may be helpful to take into consideration in the present climate.
No-one looks forward to a hospital stay but it can be particularly confusing for someone living with dementia. The surroundings are unfamiliar, we are away from the comforts of home, and surrounded by strange faces and the noises generated from a busy ward. The change of environment can contribute to increased levels of anxiety, which can make it even more difficult for the person to settle. As we know for many people living with dementia, familiarity is very important therefore a single room could provide a greater opportunity to bring in familiar possessions from home. A single room could also be helpful in alleviating some of this anxiety, as it can be a quieter environment as the person tries to adjust to their unfamiliar surroundings. An en-suite can also be beneficial as it can help to alleviate some stress and anxiety, as the person does not have to navigate a strange environment to find the toilet.
So what may be helpful to consider during a hospital stay?
If someone needs to go into hospital and it is a planned stay, consider packing a ‘hospital bag’ ahead of time so that you have the things you will need to support the person (and yourself) through this process. But if it is an emergency you can pull together some important items that may help initially. That could be a favourite book, a photograph or item of clothing that makes them feel secure.
Always remember staff don’t know the person the way you know them, so don’t be afraid to inform them if the person with dementia is behaving in a way that is unusual for them. Explain to staff how the person would normally present if they were feeling well. In some instances we need to be prepared to advocate for the person whilst in hospital as they may find it difficult to think quickly, or to communicate clearly, to people that they don’t know, particularly when they feel unwell.
Due to the unfamiliar routine of the hospital you may notice the person with dementia is having more difficulty with eating or drinking. This could be attributed to the unfamiliar environment, food, cups, cutlery and so on as they are all different to what they are used to at home. Therefore wherever possible, support the person to eat and drink regularly by making sure items are placed where they can see them and are easily accessible. If during their stay you are concerned that they are not eating enough you could ask the staff if you can bring in favourite foods from home to try.
Out of familiar surroundings it can be difficult for the person to engage in conversation due to distractions but if you can try not to answer calls or texts while you are with the person, and instead engage with them directly. Be prepared to talk about anything and everything that might interest them, and make sure that they have as much of your attention as possible while you are together.
Supporting someone with dementia while they are in hospital can be exhausting, so it may be an idea to think about arranging a ‘rota’ of visitors to allow you to spend time away from the hospital without worrying about the person being alone.
Lastly be prepared to raise concerns with the healthcare professionals involved in the person’s care whenever you notice a change in their behaviour that doesn’t ‘feel’ right. Remember, the hospital staff do not know the person outside of this moment, they don’t know what may be normal, or not normal, so communicate anything that seems out of the ordinary as they receive treatment. Be prepared to ask about discharge policy, as well as about any assessments and support that may be available ahead of time. The sooner you have the information, the sooner you can put things in place to make the transition from hospital to home as smooth as possible.
DSDC’s 10 Helpful Hints for when a Person with Dementia has to go Hospital publication is available through the John Smith Bookshop.
More information for carers is available through DSDC’s Dementia Hub.