Best Practices for Hospital Visits with Dementia

A trip to the hospital can be stressful for anyone, but especially for people living with memory loss and their care partners. Preparing in advance and following best practices regarding hospital visits with dementia can help relieve some of that stress.

Thinking Ahead

Pack an emergency “grab-and-go” bag before a hospital visit is needed. Having the following items ready can help make the visit go more smoothly, especially if it is an unexpected trip:

• Health insurance cards.
• Lists of current medical conditions, medications being taken, and allergies.
• Health care providers’ names and phone numbers.
• Copies of advance directives and/or health care power of attorney.
• Snacks and bottles of water.
• Incontinence briefs if usually worn, moist wipes, and plastic bags.
• Extra set of clothes, including a warm sweater.
• Comforting objects or music player with earphones.
• “Personal information sheet” listing:
  • Preferred name and language.
  • Contact information for key family members and friends.
  • Need for glasses, dentures, or hearing aids.
  • Behaviors of concern.
  • How the person communicates needs and emotions.
  • Living situation.

Before a Planned Hospital Stay

Keep in mind that hospitals are not typically well-designed for people living with dementia. Preparation before a surgery or other planned stay can make all the difference. Here are some tips:

• Build a care team of family, friends, and/or professional caregivers to support the person during the hospital stay. Do not try to do it all without help.
• Ask the doctor if the procedure can be done during an outpatient visit. If not, ask if tests can be done before admission to the hospital to shorten the hospital stay.
• General anesthesia can have side effects, so see if local anesthesia is an option.
• Ask if regular medications can be continued during the hospital stay.
• If insurance will cover it, ask for a private room with a reclining chair or bed, which will be calmer than a shared room.
• Tell the person about the hospital stay shortly before leaving home and let them know someone will be there with them.

At the Emergency Room

A trip to the emergency room (ER) can tire, frighten, or further confuse a person living with dementia. Here are some ways to cope:

• Ask a friend or family member to come along to the ER. They can stay with the person while the care partner answers questions or fills out forms.
• Be ready to explain the symptoms and events leading up to the ER visit—possibly more than once to different staff members.
• The person might not be able to tell others about any pain. Look for cues indicating that the person is in pain, such as sudden changes in behavior.
• Tell ER staff that the person has dementia. Explain how best to talk with the person.
• Be patient. It could be a long wait if the reason for the visit is not life-threatening.
• Comfort the person. Stay calm and positive.
• If the person must stay overnight, ask a friend or family member to stay with them.

It is very important to not leave the emergency room without a plan. If the person is being sent home, make sure to get a “safe discharge plan” in writing and that all instructions for follow-up care are understood by whoever will be providing that care. If it is not safe for the person with dementia to return home, or the care partner is unable to care for them at home, tell this to the hospital discharge planner so they can help to find alternatives.

Other Tips for Hospital Visits

Ask doctors to limit questions to the person if they are unable to answer accurately. Instead, talk with the doctor in private, outside the person’s room.

Help hospital staff understand the person’s normal functioning and behavior. Ask them to avoid using physical restraints or medications to control behaviors.

Tell the doctor immediately if the person seems suddenly worse or different. Medical problems such as fever, infection, medication side effects, and dehydration can cause delirium, a state of extreme confusion and disorientation.

Ask friends and family to keep others informed. They can make calls or use email or online tools to keep others updated about the person’s progress so that the care partner can focus on the person.