By Lee Nyberg
A person with Alzheimer’s or dementia needs extra vigilance from family members and caregivers when in the hospital. Since patients with middle and late stage Alzheimer’s may not be able to communicate clearly, their health can be greatly improved when family and/or familiar, professional caregivers become part of the care team. Additional monitoring is necessary because the unfamiliar hospital personnel and environment could lead to agitation, anxiety, and wandering behaviors, all posing greater risks to the senior’s health and safety. At Omaha In-Home Care our experience has given us these useful tips:
1. Gather pertinent legal documents and discuss with the care team
. This includes Advanced Medical Directives and a durable power of attorney (DPOA) designation for health care. The first informs family and physicians of the preferred medical treatment the senior wishes to receive if they are unable to make their own decisions. An example of this is a “Do Not Resuscitate” order or a living will. The DPOA, also known as “health care proxy,” is the individual appointed by the senior to make medical decisions on their behalf if they are unable. Each of these documents must be signed. Family members and physicians should have copies.
2. Provide complete medical information
. Be prepared to provide 5 to 10 years of the senior’s medical events, current and recent medications, allergies, current physicians and a detailed description of the senior’s mental and physical capacities. The senior’s stage of Alzheimer’s, or the type of dementia, if known, (such as Pick’s disease or Lewy Body), is an especially important piece because this indicates specific behavior and symptom patterns. Take time to explain your loved one’s typical or unique behaviors and signs of pain; contrasting atypical behavior will be more apparent to the care team.
3. Be as active as possible
. Identify and learn how to reach the entire care team: the physician, nurses, social workers and case managers. Be a strong, yet respectful, advocate for your senior’s medical care. Request copies of physician’s orders and write new information down immediately. Communicate changes in orders and medication to nurses regularly, since they rotate in shifts. Double-check your copies of orders before any technician performs a test or procedure, since mistakes are sometimes made. It is best to have a primary caregiver stay with the patient throughout all the processes (admission, meeting with the doctor, pre-surgery preparation, post-treatment, and dismissal). A person with Alzheimer’s needs soothing and re-orienting when in a strange setting where confusing or frightening things may be happening. A person with middle and later stage dementia may need help with the most basic things, such as finding the bathroom, ordering food, even self-feeding, while some one in the early stages may indicate they are “fine” and do not need any medical care, even when they actually do.
The more advanced a patient’s Alzheimer’s or dementia, the greater their need for an advocating and guiding presence while in the hospital. Good solutions are attentive family members and friends on rotation throughout the hospital stay, or private caregivers and care managers. Home Care Assistance provides Care Managers, who are registered nurses, as part of each client’s Alzheimer’s care team.