June 20th, 2011 at 9:03 am
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Hospitalizations: difficult for Alzheimer’s patients

by Carol Bursack

We’ll never really know what happened to my dad. He went into the hospital to have a fairly simple operation. Doctors were going to insert a shunt into his brain to drain fluid building up behind scar tissue left from a World War II brain injury. Shunt insertions are considered quite safe and effective. Whether the failure was caused by Dad’s age, excessive scar tissue, a surgeon who had a bad day, the anesthetic or the trauma of hospitalization will remain a mystery, but Dad as we knew him disappeared and we brought home a man with severe dementia. He was to live in that world of dementia for a decade, before he died.

Studies show hospitalization tough on seniors

A study conducted by researchers at the Beth Israel Deaconess Medical Center, VA Boston Healthcare System, and the Aging Brain Center at Hebrew SeniorLife revealed patients who the hospitalization of Alzheimer’s patients ultimately worsened the disease and led to the deaths of some patients.

As reported by Medical News Today,

Approximately 46% of AD patients in the study were hospitalized, and delirium occurred in 52% of those hospitalizations. One in seven was found to experience at least one of the three adverse outcomes studied. Any hospitalization increased the risk of institutionalization and death, and hospitalizations in which AD patients suffered delirium were associated with the highest risk of cognitive decline (22%), institutionalization (15%), and death (12%).

In an earlier post about hospitalization of elders, I referred to a New York Times blog post that maintained many elders would be better off if they are treated for illness in a home setting with nursing care, or in a their nursing home room, than if they were hospitalized. Obviously, major surgery could not be performed in a home setting, but I did witness how well my mother-in-law fared when she was treated in her own room at the nursing home for her severe pneumonia. Had she been hospitalized, I have no doubt her dementia would have worsened, as any type of stress sent her emotionally and cognitively downward.

Senior centered emergency rooms

The organization Nurses Improving Care for Healthsystem Elders, known as NICHE, has been active in supporting senior-centered emergency rooms and hospitals, encouraging low lights, soft surroundings and as little medical equipment as possible. Seniors who must go into an emergency room or hospital setting do far better when they are shielded from the clinical noise and bustle of the medical world.

Dad’s poor outcome from his surgery was due to a combination of events, but I feel strongly the trauma of the hospital setting was a part of the disaster. Elders who have fragile systems are at increased risk for cognitive damage when they are hospitalized. Dad was just one dramatic example. Numerous readers have contacted me with stories similar to mine. They want to connect with someone who understands their pain. Perhaps the researchers who conducted this recent study will help raise awareness of the dangers of hospitalizing fragile seniors. At the very least, we can hope that elder friendly environments will help minimize the damage.

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