Going to the hospital with someone who has dementia
Visiting a hospital with a loved one who has dementia or memory loss is like the road trip in Rain Man; it can be a challenging but also a valuable experience for both the caregiver and the care receiver. And it’s not like you can or should avoid hospital visits and stays; as a caregiver you need to work together with healthcare professionals and facilities for the good of the person with dementia. The following tips may help you make a trip to the hospital nice and easy like Willie Wonka and the Chocolate Factory and not uncomfortable and awkward like Charlie and the Chocolate Factory.
In case of an emergency
You can’t plan for a specific emergency, but you sure can prepare for an emergency in general. You can do that thus:
· Make sure to think and talk about hospitalization with your loved one before the fact.
· Consider whether hospice care may be better alternative to hospitalization.
· Register your loved one for a MedicAlert® + Alzheimer’s Association Safe Return® bracelet.
· Identify a minimum of two friends, neighbors, or relatives whom you can rely on and have them accompany you to or meet you at the hospital so that one of you can take care of the paperwork while the other stays with the care receiver. Needless to say that this arrangement must be agreed upon in advance, and the person or persons have to be available at short notice.
· Pack an emergency bag.
Emergency bag contents
Personal information sheet
· Preferred name and language.
· Contact information for doctors, key family members, and helpful friends.
· Illness or medical conditions.
· All current medicines and dosage instructions.
· Any medicines that have ever caused an adverse reaction.
· Any allergies to medicines or foods.
· Need for glasses, dentures or hearing aids.
· Degree of impairment and amount of assistance needed for activities.
· Family information, living situation, major life events.
· Work, leisure and spiritual history.
· Daily schedule and patterns, self-care preferences.
· Favorite foods, music, and things the care receiver likes to touch and see.
· Behaviors of concern.
· How your loved one communicates needs and expresses emotions.
· Insurance cards (including policy numbers and pre-authorization phone numbers).
· Medicaid and/or Medicare cards.
· Durable Power of Attorney, Health Care Power of Attorney, Living Will and/or an original DNR (do not resuscitate) order.
· Bring copies of these documents.
Care receiver supplies
· Change of clothing.
· Personal medications.
· Extra adult briefs if usually worn.
· Moist hand wipes.
· Plastic bags for soiled clothing and/or adult briefs.
· Reassuring or comforting objects.
· iPod, MP3 or CD player; earphones or speakers.
· Change of clothing.
· Personal medications.
· Pain medicine like Advil, Tylenol or aspirin.
· A pad of paper and pen to write down information and directions.
· A log of your care partner’s symptoms and problems. You may be asked the same questions by many people; show them what you have written instead of repeating answers.
· A sealed snack such as a pack of crackers and a bottle of water or juice.
· Cell phone and charger with you.
At the ER
Patience is the most important quality to exhibit at the emergency room. There probably will be other people with emergency and non-emergency situations ahead of you – and you might have to wait even longer if the reason for your visit is not life-threatening. Speaking of which, keep in mind that ER staff are seldom extensively trained in Alzheimer’s disease and dementia. Also, remember that lab test results take time as well as manpower; just because you don’t see staff members doing work that doesn’t mean they are not working. All of that is if your loved one is admitted to the hospital. Have a follow-up plan for follow-up care if you are sent home.
Planning a hospital stay
· Insurance allowing, request a private room with a reclining chair or bed for yourself or a companion.
· Think about the best way to tell the care receiver that you both are going to stay at the hospital for a short while.
· Make your loved one as much as part of planning as his or her disease permits.
· Devise a schedule with friends, relatives, and if possible a professional respite carer to take turns staying in the hospital with your loved one.
· Ask staff to avoid using physical restraints.
· Ensure that a relative, friend, or professional caregiver is with your loved all the time or as often as it is humanly possible.
· Arrange for doctors to ask you any questions and have them answered in private as opposed to directing then to the person with dementia who may provide inaccurate answers.
· Assist your loved one in filling menu requests.
· Remind the care receiver to drink fluids and make frequent trips to the bathroom.
· Be aware that your loved one may require extra assistance, as the unfamiliar environment, medications, and tests may render him or her more confused than usual.
Collaborating with healthcare workers
In the introduction, we talked about how caregivers and health providers must work together for the sake of the patient. We’ve also mentioned that the ER staff is generally not expert in Alzheimer and dementia. You can make their jobs easier and attain a modicum of peace of mind for yourself if you do the following:
· Make the aforementioned personal information sheet readable with headings and short, simple sentences. Leave a copy with the chart in the hospital room and at the nurse’s station.
· Decide together with the hospital staff who will do what for your loved one. For instance, you may want to be the one who assists with bathing, eating or using the bathroom.
· Inform the staff about any hearing difficulties and other communication problems the care receiver may have, and make suggestions for what works best in those instances.
· Make sure your loved one is safe. Tell the staff about any previous issues with wandering, getting lost, falls, suspiciousness, and/or delusional behavior.
· Do not assume that the staff knows your loved one’s needs. Let them know politely and calmly manner.
· Ask questions when you do not understand certain procedures and tests or when you have any concerns. Do not hesitate to be an advocate for your relative.
· Plan early for discharge. Ask the discharge planner about eligibility for home health services, equipment or other long-term care alternatives.
· Prepare for an increased level of caregiving.