Dementia care in the acute hospital setting: issues and strategies

This report identifies a range of strategies to improve the outcomes for people with dementia. Executive summary: Australia is facing a huge healthcare challenge with an ever increasing demand for appropriate acute care services for people with dementia. Yet, people with dementia still struggle to get the care they need in the acute care setting. People with dementia experience unacceptably worse clinical outcomes, longer lengths of stay as well as a higher likelihood for readmission compared to people without dementia at a high cost to the health care system.1 With good care, the costs of dementia care in hospital may be the same but the outcomes for people with dementia would be improved leading to a more efficient use of health care spending. Alzheimer’s Australia held a Dementia Care in Hospitals Symposium in Sydney on the 29th of April 2014, where the most recent Australian research in dementia care in hospitals was presented and discussed by leading researchers and experts. This included latest findings on current dementia care as well as interventions and strategies to improve the quality of care. This report provides a summary of the issues and strategies that were discussed at this Symposium. To improve outcomes for people with dementia in the acute hospital setting, this report outlines urgent issues that need to be addressed. These include: • Better identification of cognitive impairment in our hospitals • Increased training for all staff including how to communicate with a person with dementia and how to respond to behavioural and psychological symptoms • More extensive and systematic involvement of carers as partners in the health care of people with dementia • Creation of appropriate physical hospital environments to reduce confusion and distress of people with dementia. This report also identifies a range of strategies to improve the outcomes for people with dementia including: 1. Identify and manage dementia at hospital admission and plan for discharge from the outset 2. Involve family carers in the care and support of patients 3. Train staff to better understand dementia and communicate more effectively with people with dementia 4. Use alternatives, such as psychosocial interventions, to the use of antipsychotic medication and sedatives 5. Adapt the hospital physical environment to reduce distractions and help orientate patients with dementia 6. Reduce avoidable hospital admissions. While there are already some successful programs in place that improve acute care for people with dementia, more needs to be done. Sustained commitment and leadership from policy makers, senior management and healthcare professionals is essential if we are to achieve the cultural change that is required to improve the outcomes for people with dementia in the acute hospital setting