Older people with dementia have more health conditions than those without dementia; therefore they are more likely to be admitted to hospital, usually for another primary reason. Older people with dementia also have a higher risk of experiencing preventable issues such as delirium, falls, pressure injuries, under-nutrition and dehydration in hospital.
It is essential to complete a cognitive screen for all patients aged 65 and older as many people with dementia may not have had a formal diagnosis, their symptoms may be subtle, or it may not be noted in their medical record.
Further assessment to identify the impact of the person’s cognitive impairment on their function is essential to develop a person-centred care and intervention plan.
As clinicians, we should listen to the patient, their family and carers. This topic provides an overview of dementia, its causes, symptoms and management strategies. In addition to following health service specific policy and procedures, consider the following actions and discuss them with your colleagues and managers.
Dementia has many forms and symptoms
Dementia is not one specific disease; it is an umbrella term to describe a set of symptoms caused by a number of neurological diseases.
Dementia and ageing
Older people with dementia are admitted to hospital each year at twice the rate of older people without dementia.
Identifying dementia – screening and assessment
All people aged 65 and over should be screened for evidence of cognitive impairment on admission to hospital.
Managing dementia in hospital
Strategies to improve care include working with family and carers, staff and other health professionals, and adapting the environment.
Managing behavioural and psychological symptoms of dementia
We can use a range of strategies to help manage behavioural and psychological symptoms of dementia.
Dementia and discharge planning
We can help patients, their family and carers and healthcare professionals provide appropriate care after discharge.
Further information - dementia
Educational and information resources available on improving care for older people with dementia in hospital.
All public and private hospitals are required to be accredited to the Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. The primary aims of the standards are to protect the public from harm and to improve the quality of health service provision. Assessment to the second edition of the NSQHS Standards commenced in January 2019. The second edition comprises eight standards that provide a nationally consistent statement about the level of care consumers can expect from health services.
The Comprehensive Care Standard (Standard 5) aims to ensure that patients receive comprehensive health care that meets their individual needs, and considers the impact of their health issues on their life and wellbeing. It also aims to ensure that risks of harm for patients during health care are prevented and managed through targeted strategies. These include integrating patient care processes to identify patient needs and identifying actions related to falls, pressure injuries, nutrition, mental health, cognitive impairment and end-of-life care.
Information is presented in the Older People in Hospital learning topics that complements Standard 5 and other NSQHS Standards including the; Partnering with Consumers Standard (Standard 2), Medication Safety Standard (Standard 4), Communicating for Safety Standard (Standard 6) and Recognising and Responding to Acute Deterioration (Standard 8).
Reviewed 05 October 2015