Older adults with dementia face increased mortality risk due to care transitions

By: Mohan Garikiparithi | Brain Function | Thursday, April 14, 2016 - 01:00 PM

Older adults with dementiaOlder adults with dementia face an increased mortality risk due to care transitions. The findings of the study uncovered that moving dementia patients from one place to another or having them stay overnight at a different location led to aggravated health outcomes. Although sometimes inevitable, unnecessary transition can be associated with medication errors, hospital readmissions, and an increased mortality risk.

The researchers from the UBC Centre for Health Services and Policy Research in Vancouver followed 6,876 dementia patients over the age of 65. Twenty-three percent of the group did not have any chronic condition other than dementia, and 44 percent had two or more coexisting health conditions.

The researchers noted a spike of transitions during the first year of dementia diagnosis. Sixty-five percent experienced at least one transition during the first year, 17 percent experienced three or more transitions including hospitalization, and over 60 percent were hospitalized during their first year of diagnosis.

The researchers also found an increase in transitions during the year prior to and the year of their death. Among other factors that contributed to a higher amount of transitions are being on antipsychotic medication or benzodiazepine and living in rural areas.

Receiving constant care from a known primary physician and receiving care consistent with dementia guidelines were associated with fewer transitions. The researchers offered recommendations in order to ease transitions and improve care by having a connection with a primary physician, embark on an early advanced care planning, having a patient advocate to help coordinate care, and increasing caregiver’s awareness of community support.

Tips for smooth transitions in dementia care

Dementia can be a scary diagnosis not only for the patient but for those around them as well. As memory begins to fade, this can cause heightened stress and anxiety for all parties involved over time. In order to minimize the stress associated with transitions that come along with dementia care, following these tips can be beneficial.

Create familiar environments as best as possible. If an older adult is moving from their own home to an assisted-living facility, make their new place as ‘homey’ as possible. Add in their furniture or other belongings that can help increase the feeling of being at home.

Schedule their move during their best time of the day. For example, if they are better in the first part of the day rather than at night, schedule the move in the morning hours to reduce stress.

Create a scrapbook or a board to help the staff get to know the patient quickly. Have the staff review these pieces prior to the patient’s arrival so they can become familiar with them.

Listening to their favorite music can help reduce stress and anxiety in some patients. Consider bringing in a radio or CD player and provide their favorite tunes to play.

These tips can help make the transition period a bit easier all the while reducing stress and anxiety for the patient.


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Sources:
http://www.healthinaging.org/news/research-summaries/article:03-21-2016-12-00am-for-older-adults-with-dementia-transitions-in-care-can-increase-risk-for-serious-problems/
http://onlinelibrary.wiley.com/doi/10.1111/jgs.14033/abstract
http://www.elmcroft.com/moving-loved-one-with-dementia/


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