Patients with Dementia in Hospital

Hospitals can be dangerous places. This is particularly the case for people with dementia for whom hospital admission has been associated with functional and cognitive decline. Despite a high proportion of hospital inpatients having cognitive impairment, healthcare staff frequently report a lack of training in caring for people with dementia. Hospital systems and infrastructure are often designed around the needs of the organisation and not core patient groups. The challenges facing the team caring for people with dementia are not to be underestimated. There are however steps that can be taken to improve the care of patients with dementia in hospital. In this chapter we discuss the importance of patient-centred care, the hospital environment and comprehensive geriatric assessment as key frameworks for the care of inpatients with dementia. We discuss issues around sensory impairment, eating and drinking and undiagnosed dementia. Finally, we discuss some common medical issues that arise in caring for people with dementia in hospital including frailty, polypharmacy, delirium, and osteoporosis, fracture and pain. Implementing the changes needed to enhance inpatient care is a significant challenge but one which needs to be met if standards are to improve.