Your Right to Stay with a Dementia Patient in the Hospital
Most hospitals recognize the critical role a familiar caregiver plays in a dementia patient's well-being during a hospital stay. The unfamiliar sights, sounds, and routines of a hospital can significantly increase confusion, anxiety, and even trigger delirium in a patient with dementia. Your presence can provide crucial reassurance, communication, and continuity of care that hospital staff, no matter how dedicated, cannot always provide. While every hospital's specific policies on visitors and overnight stays will differ, many permit or can accommodate a caregiver's 24/7 presence, especially when it is medically beneficial for the patient. It's essential to communicate with the medical team early and often to explain why your continuous presence is necessary for your loved one's safety and emotional comfort.
How to Prepare for a Hospital Stay
Preparation is key to a successful hospital visit. Whether it's a planned or emergency admission, having information and supplies ready will make the process smoother.
Before a planned admission:
- Discuss with the medical team: Talk to your doctor beforehand about the need for a constant caregiver presence due to the dementia diagnosis. They may be able to write an order in the patient's chart supporting your request.
- Pack a 'go-bag': Include important documents like a medication list, advance directives, contact information for doctors, and insurance cards.
- Personalize the space: Pack familiar items that can provide comfort, such as a favorite blanket, photos, or a pillow.
For an emergency admission:
- Bring an advocate: If possible, have another family member or friend accompany you to the ER. One person can stay with the patient while the other handles paperwork and communicates with staff.
- Inform staff immediately: Tell ER staff that the patient has dementia and explain how best to communicate with them.
- Stay calm: Your calm demeanor can help reassure and comfort the patient during a chaotic time.
Advocating for Continuous Presence
Being a patient advocate means being the voice for your loved one. Here’s how to effectively secure your constant presence:
- Request a Private Room: If possible and covered by insurance, request a private room. This will reduce overstimulation and create a calmer environment.
- Get a Doctor's Order: A doctor's order can be a powerful tool for ensuring you are allowed to stay overnight. Explain to the doctor that your presence prevents wandering, minimizes agitation, and reduces the need for restraints.
- Communicate the Patient's Baseline: Inform all staff—nurses, aides, and doctors—about your loved one's normal behavior, routines, and abilities. This helps them distinguish between baseline dementia symptoms and new, acute medical issues like delirium.
- Explain Potential Risks: Clearly explain the risks of leaving the patient alone, such as wandering out of the room, pulling out IVs, or experiencing increased disorientation.
- Use the Hospital's Patient Advocacy Services: If you encounter resistance, ask to speak with the charge nurse, social worker, or the hospital's patient advocate or ombudsman. They are resources specifically trained to help resolve these issues.
Making the Hospital Environment Dementia-Friendly
Once your presence is secured, focus on creating the best possible environment for your loved one. Small adjustments can make a significant difference in reducing confusion and agitation.
- Personalize the room: Use the familiar items you packed to make the space feel less alien. Label the bathroom door in large, bold letters if your loved one responds to written cues.
- Manage Stimulation: Minimize distractions by keeping the TV off, lowering the telephone ringer, and reducing other noises. Too much sensory input can be overwhelming.
- Maintain Routines: Try to maintain aspects of the patient's normal daily routine as much as possible. This includes eating schedules, sleep patterns, and wake-up times.
- Communicate Effectively with Staff: Provide staff with a written document detailing your loved one's communication style, likes, dislikes, and daily habits. This helps ensure everyone is on the same page and providing consistent care.
- Stay Hydrated and Nourished: A hospitalized dementia patient may forget to eat or drink. As the caregiver, you can remind and assist them with meals and fluids to prevent dehydration, which can worsen confusion.
Comparison of Caregiver Presence vs. Absence
| Aspect of Care | With Caregiver Present | Without Caregiver Present |
|---|---|---|
| Patient Comfort | Increased sense of security and familiarity, reduced anxiety | Higher levels of fear, anxiety, and distress |
| Delirium Risk | Lowered risk due to familiar presence and sensory management | Increased risk from disorientation, lack of routine, and stress |
| Communication | Caregiver can interpret needs and history for staff; bridge communication gaps | Patient may be unable to communicate needs effectively, leading to frustration and poor care |
| Safety | Reduced risk of wandering, falls, and interfering with medical equipment | Higher risk of wandering, falls, and self-injury (e.g., pulling out IVs) |
| Care Coordination | Seamless relay of information, medication schedules, and patient specifics to staff | Information may be missed or misinterpreted during shift changes |
| Restraint Use | Less reliance on physical or chemical restraints to manage agitation | Higher likelihood of staff resorting to restraints for patient safety |
Conclusion
In conclusion, staying with a dementia patient in the hospital is not only possible but highly recommended and often necessary for their well-being. By preparing in advance, advocating effectively, and working with hospital staff, caregivers can significantly improve the hospital experience and patient outcomes. Your role as a constant, familiar presence is invaluable in minimizing stress, preventing complications like delirium, and ensuring your loved one receives the safest, most compassionate care possible during a challenging time.
Optional Link: For more detailed strategies on advocating for a hospitalized loved one, consider visiting the Alzheimer's Association website.
