Hospitals and dementia

This new audit tool, the EAT-Acute Care, focuses on acute care settings. It has been developed to enable a systematic review of ward environments and the creation of better hospital environments for patients living with dementia.

Background/Objectives
Dementia-friendly initiatives are becoming common in society, politics, and research, including health care. Regarding efforts to improve care for patients with dementia in hospitals, the term dementia-friendly hospital is being used increasingly. However, a theoretical understanding of this term and the underlying concept are missing. This integrative review aims to identify current descriptions of dementia-friendly hospitals and to analyze their characteristics.
Manietta, C., Purwins, D., Reinhard, A. et al. (2022) Characteristics of dementia-friendly hospitals: an integrative review. BMC Geriatr 22, 468

Acute hospitals, in particular the emergency department, can be disorienting for people living with dementia. As part of a larger project to improve care for people living with dementia, dementia-inclusive modifications were made to two emergency department bays in a large acute care hospital in Ireland. Modifications to spatial configuration included noise reduction, altered lighting and the addition of an orientation aid and fixed seating for relatives.
Bracken-Scally, M., Keogh, B., Daly, L., Pittalis, C., Kennelly, B., Hynes, G., Gibb, M., Cole, N., McMahon, C. G., Lawlor, B., McCarron, M., & Brady, A.-M. (2021). Assessing the impact of dementia inclusive environmental adjustment in the emergency department. Dementia, 20(1), 28–46.

Person-centred care is widely advocated when caring for people with dementia. When a person with dementia is admitted for hospital care, hospital wards are obliged to not only address the cause for admission but also provide dementia-specific care during the hospital stay. Research has shown that the delivery of person-centred care to people with dementia is often inadequate or absent in the hospital setting. Moreover, whilst registered nurses often wish to improve the in-hospital care of patients with dementia, there is evidence of experienced barriers. This study aimed to describe registered nurses’ experiences of facilitators for the delivery of person-centred care to inpatients with dementia.
Brossard Saxell, T., Ingvert, M., & Lethin, C. (2021). Facilitators for person-centred care of inpatients with dementia: A meta-synthesis of registered nurses’ experiences. Dementia, 20(1), 188–212.

The term dementia-friendly hospital is increasingly used to describe a variety of initiatives and strategies that are implemented to meet the challenges faced by patients with dementia during hospitalization. However, no definition of the dementia-friendly hospital currently exists. This qualitative focus group study aimed to describe stakeholders’ perspectives of the dementia-friendly hospital. Four stakeholder groups were included: people with dementia, relatives, hospital staff, and representatives from the Danish Alzheimer Association. The thematic analysis suggests that a person-centered approach is a key feature.
Toubøl, A., Moestrup, L., Ryg, J., Thomsen, K., & Nielsen, D. S. (2021). Stakeholder perspectives of the dementia-friendly hospital: A qualitative descriptive focus group study. Dementia, 20(5), 1501–1517.

Researchers have conducted a systematic review of non-pharmacological interventions for patients with dementia and cognitive impairment on regular wards in acute care hospitals (not intensive care units or emergency departments).
Karrer M, Schnelli A, Zeller A, Mayer H (2021) A Systematic Review Of Interventions To Improve Acute Hospital Care For People With Dementia. Geriatric Nursing 42(3) 657-673.

see Going to the Hospital: Tips for Dementia Caregivers

Considerations for looking after a patient with dementia in an acute care setting.