Dementia care in acute care settings

Abstract

How can we best care for patients with acute illness in a hospital setting who also have dementia? Bottom lineFamily physicians play an important role in hospital care, particularly in smaller communities. Canada's hospitals are buckling under the rising numbers of patients with dementia, but many hospitals and health policy makers seem unaware. Acute illness and hospitalization are challenging for people with dementia, as hospitals are not well structured to optimally care for these patients, resulting in negative outcomes for patients and impacting our limited hospital capacity. Evidence• Canada has one of the lowest numbers of hospital beds per capita of the Organisation for Economic Co-operation and Development nations. 1 • Seniors with dementia are 1.5 times more likely to experience harm in hospital and have twice the hospital length of stay (LOS) compared with seniors without dementia. 2 • Almost half of alternate level of care (ALC) days in Canada are now related to dementia. 2This article is eligible for Mainpro+ certified Self-Learning credits. To earn credits, go to www.cfp.ca and click on the Mainpro+ link.

Giving Voice to People with Dementia and Perspectives Regarding a Dementia-Friendly Society: A Synthesis of Qualitative Studies

“…It is important for people with dementia to be invited and actively integrated into discussions of experiences and needs in new constructions. 21 When people with dementia participate in decisions and discussions about personal beliefs and values, society characterizes person-centered practices and culture. 4 , 12 , 16 In the aforementioned building cases, various interest organizations, such as Alzheimer’s Society, represented people with dementia, a diverse group that essentially has various requirements.…”

“…3 Previous scholars have reported that evaluations from health personnel regarding the needs of people with dementia are not necessarily consistent with their actual needs and preferences. 20 , 21 Furthermore, it has been well documented that people with dementia can communicate their needs and lived experiences of having dementia. 21 , 22…”

“… 20 , 21 Furthermore, it has been well documented that people with dementia can communicate their needs and lived experiences of having dementia. 21 , 22…”

“…3 Previous scholars have reported that evaluations from health personnel regarding the needs of people with dementia are not necessarily consistent with their actual needs and preferences. 20,21 Furthermore, it has been well documented that people with dementia can communicate their needs and lived experiences of having dementia. 21,22 Therefore, people with dementia must be offered opportunities to express their thoughts, feelings, and perceptions of their needs and preferences, 8,9,23,24 both in private and public spaces, 8,25-27 so researchers and caregivers can gain valuable knowledge from their perspective.…”

Living with a diagnosis of frontotemporal dementia: An interpretative phenomenological analysis

“…However, there has been an increasing call for the views of people with dementia to be included in research (Gove et al 2018; Scottish Dementia Working Group Research Sub-group, 2014). Research has been conducted which includes the perspectives of people with a diagnosis of AD (Beard, 2004; Caddell & Clare, 2011; Clare, 2002; Clare, 2003; Clare et al, 2006; Devlin et al, 2007; Dewitte et al, 2020; Frank & Forbes, 2017; Jensen et al, 2020; Pearce et al, 2002; Phinney & Chesla, 2003; Sabat & Harré, 1992). However, in comparison to research focussing upon the subjective experiences of people with AD, there is a paucity of research which incorporates the subjective experiences of people with FTD.…”