At a recent workshop, a nurse shared her experience with a 78-year-old patient who had Alzheimer’s disease. He had been admitted with a chest infection, but during his stay, he became increasingly distressed and confused.
At times, he shouted, refused help from nurses, and even tried to leave his bed. It is possible that the constant beeping of machines and loud conversations from other patients made him more disoriented and fearful. What was meant to be a routine admission to treat his infection turned into an overwhelming experience for both the patient and the staff caring for him.
Sadly, this situation is not uncommon. It raises an important question: how can we make hospitals more friendly for people with dementia?
Over the last fourteen years, I have worked with people who have Alzheimer’s and other dementias.
Such patients, when hospitalised, often have frightening experiences. The unfamiliar surroundings, bright fluorescent lights and the busy environment worsen their disorientation.
Patients may remove IV lines or refuse medication not because they are stubborn, but because the surroundings feel unsafe and incomprehensible. In some cases, nurses in the wards are unable to communicate clearly with patients, either because of a language barrier or a lack of training in effective communication with such patients. This results in conflict between the patient’s relatives and the nurses, who get accused of being uncaring.
Research shows that people with dementia admitted to general wards are at greater risk of worsening confusion, falls and longer hospital stays. Their physical illness may be treated, but their cognitive and emotional needs are often overlooked. This gap in care places additional strain on healthcare staff and family members, who may witness their loved ones becoming more agitated or withdrawn during admission.
Several institutions around the world are setting up dementia-friendly hospitals to make care safer, calmer and more humane. This does not necessarily mean building new facilities but making a few changes to accommodate patients’ needs.
A dementia-friendly hospital includes designing quieter wards where unnecessary alarms are minimised. Soft lighting and colour-coded hallways are used to reduce confusion. Clear, simple signs with symbols and words, colour coding, and familiar imagery would help patients find their way in the hospital.
When possible, each patient will be assigned the same nurse to care for them to avoid unnecessary anxiety. Staff would be trained in effective communication skills that focus on speaking slowly, using simple language, allowing the patient extra time for responses, and checking understanding.
Having familiar faces and voices helps orient the patient and reduces distress. At a dementia friendly hospital, a family member would accompany the patients during their hospital stay, assist the staff in identifying the patient’s routines, preferences and communication style.
This is likely to reduce patient distress and agitation as they feel safe with a familiar person. He or she would be more informed about any changes to the care plan and learn a few practical skills that would improve the quality of.
With rising numbers of people with Alzheimer’s and other dementias around the world, it is time to make their hospital stay more peaceful and dignified.
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