How does hospitalization affect someone with Alzheimer’s disease?

Any change from a familiar and/or structured environment can cause added stress in people with Alzheimer’s disease. Hospitalization can exacerbate the disease, in that it causes more anxiety, confusion and disorientation.

A 2012 study in the online issue of Annals of Internal Medicine stated that hospitalization was associated with nearly twice the likelihood of having a poor outcome, including mental decline and death, and delirium while hospitalized increased the risk by 12 percent. People with Alzheimer’s are three times as likely to spend time in the hospital, and between 20 to 40 percent are hospitalized annually, with an average four-day hospital stay.

The most common causes of hospitalization were abdominal pain, fainting, falls, heart issues and delirium. The study also noted that the risk of being placed in long-term care and/or dying was higher for people with Alzheimer’s disease who had been hospitalized.

“Hospitalization is often the tipping point,” said Dr. James Gavin, of the NYU Langone Medical Center. “The medical condition which may lead to hospitalizing may be a tipping point, but clearly the hospital (change in environment) can be, too.”

Those with Alzheimer’s may be particularly at risk of increased cognitive deterioration after undergoing anesthesia during surgery. Though the relationship between general anesthesia and Alzheimer’s has not been clarified, there is an increased risk of complications following surgery.

The affected person may awaken more slowly and is likely to experience confusion and delirium, causing longer stays in the hospital. However, many things also can contribute to these symptoms, such as medications given for nausea after surgery. These nausea medications have an “anti-cholinergic” effect, opposite the effect of cholinergic medications, such as Aricept, that are typically used to treat the disease. Additionally, many pain medications could be the cause of confusion and increased memory loss post-surgery with anesthesia.

In any case, when a loved one with Alzheimer’s disease or dementia needs to be hospitalized, keep in mind that he or she needs a constant presence of a family member or friend to offer reassurance and security and to assist medical personnel with information about the patient.

Give something to soothe the person, such as a small pillow or blanket or a photograph of a familiar person or thing. Always explain to the person where he or she is and make him or her as comfortable as possible. Be mindful of the person’s dignity and try to validate what he or she is trying to communicate or is feeling, and never talk about the person to others as if he or she is not in the room.

Questions about Alzheimer’s disease or a related dementia disorder? Contact Dana Territo, the Memory Whisperer, Director of Services at Alzheimer’s Services of the Capital Area, (225) 334-7494, advice@alzbr.org, or visit the organization at 3772 North Blvd., Baton Rouge.