Dementia & Hospitalization: 6 Pitfalls to Watch For

How to guard against common complications and mistakes in the hospital

By Leslie Kernisan, M.D., Caring.com senior medical editor, and Paula Spencer Scott, Caring.com senior editor
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Portrait of a happy nurse and patient

Hospitals are all about healing. But complications, accidents, mistakes, and unnecessary procedures happen. And these can worsen the hospital experience for any patient -- especially someone with dementia.

Be aware of the following common pitfalls, so you can take steps to either prevent them or recognize them when they're happening:

1. Delirium

Delirium is a state of acute mental confusion in which a person's state of mind suddenly becomes worse than usual. Anyone can develop it during a hospitalization as a result of an infection or other stressor, but people with dementia develop delirium at much higher rates. It's often missed by hospital staff, however, because they don't know a patient's baseline -- that is, what's normal for that person. And when someone has dementia, a certain level of confusion, apathy, and other signs of delirium are already normal.

There are many possible causes of delirium. In a hospital setting, common triggers are a hospital-acquired infection or complications from surgery.

Many hospital techniques meant to manage a confused patient may worsen confusion, including the use of restraints, tranquilizers, and sleep aids.

What you can do:

  • Know the signs of delirium.

  • Make sure the hospital staff is aware of a sudden change in mental status as soon as possible. Emphasize that even though the person has dementia, what you are seeing is a change in the level of confusion.

  • Make sure that pain is being adequately treated. (See below.) Pain can trigger delirium.

  • Work to keep your loved one oriented and calm. Not all delirium can be prevented, but a reassuring environment helps minimize confusion. Gently orient your loved one with reminders: "Here we are, still in the hospital for that operation, Dad." "You're in a hospital bed to have your heart checked." A familiar blanket or favorite picture from home and a cheerful plant can also be calming.

Find out more about identifying, managing, and preventing delirium in the hospital.

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