Initiatives to Provide Better Care for the Elderly In-Patients with Dementia in An Acute Hospital- Experience from a Teaching Hospital in Singapore
Main Article Content
Abstract
The elderly living with neurodegenerative diseases will increase as the population age. The acute hospital beds will mostly be occupied by the elderly, as they live with multiple comorbidities. Cognitively impaired elderly are even more likely to be admitted and hospital environment is harmful for them. Providing a comprehensive care package for the elderly with cognitive issues aim to reduce hospital associated complications, especially falls and delirium and ensuring no additional geriatric syndromes are added to the patients’ lists of problems. Timely recognition and diagnosis of cognitive issues is still a challenge in most acute hospitals. Once the elderly patients with cognitive issues are identified, safety measures and personalized care plans can be initiated to reduce delirium, fall, restraint and nutrition risks. Hospital wide education initiatives on delirium and dementia related topics are vital to providing the best care for this group of vulnerable elderly.
Keywords:
Elderly, Dementia, Elopement, Restraint, Delirium.
Article Details
How to Cite
LIM, Si Ching.
Initiatives to Provide Better Care for the Elderly In-Patients with Dementia in An Acute Hospital- Experience from a Teaching Hospital in Singapore.
Medical Research Archives, [S.l.], v. 12, n. 8, aug. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5602>. Date accessed: 04 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i8.5602.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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12.) SC Lim. Falls among the persons with dementia and interventions to reduce falls in a dementia ward. Journal of Brain and Neurology 2020 Volume 3 issue 2.
13.) Lim SC. Restraint use in the management of elderly with dementia in hospital. Internal Medicine Research Open Journal. Volume 1(2):1-4, 2016.
14.) SC Lim et al. Improving outcome for the elderly surgical patients in a Singapore teaching hospital. Surg Med Open Acc J. 2(3). SMOAJ.000 537.2019.
15.) Dementia statistics | Alzheimer's Disease International (ADI) (alzint.org)
16.) Lim SC, Chiam WM, Goh CH, Zhang D, Png GK and Li FY., Initiatives to Improve Awareness of Delirium in a Teaching Hospital in Singapore: for Better Patient Care.
17.) SC Lim. The role of dementia ward in an acute hospital. J Geontol Geriatr Res. 2017.6.6.10 00453.
18.) Sloane, Philip & Hoeffer, et al. (2004). Effect of Person-Centered Showering and the Towel Bath on Bathing-Associated Aggression, Agitation, and Discomfort in Nursing Home Residents with Dementia: A Randomized, Controlled Trial. Journal of the American Geriatrics Society.
19.) Kitwood T, Bredin K,.,Towards a theory of dementia care: personhood and well-being. Ageing Soc. 1992; 12():269-87.
20.) Steenbergen E et al (2013) Perspectives of person-centred care. Nursing Standard. 27, 48, 35-41.
21.) Lim Sc, Kaysar Mamun, Jim K H Lim Comparison between elderly inpatient falls with and without dementia, Singapore Med J, 2014 Feb;55(2):67-71. doi: 10.11622/smedj.2014017.
22.) Lim SC. Falls among the persons with dementia and interventions to reduce falls in a dementia ward. Journal of Brain and Neurology. 2020;Volume 3, issue 2.
23.) Si Ching LIM. Nutrition and the Role of Tube Feeding in the Elderly. J J Geronto. 2016, 2(1): 017.
24.) SC Lim and Peter CL Chow. Managing eating disorders in elderly with dementia and the ethical considerations for tube feeding. Int J of Psych 2018. Vol 3 Issue 1. ISSN:2475-5435
25.) Robert S Wilson et al. Loneliness and risk of Alzheimer disease, Arch Gen Psychiatry, 2007 Feb;64(2):234-40.
26.) Aida Suárez-González et al. Detrimental effects of confinement and isolation on the cognitive and psychological health of people living with dementia during COVID-19: emerging evidence. Dementia Research Centre, UCL Institute of Neurology at Queen Square, University College London, Last updated 1st July 2020, available at website ltccovid.org
27.) M Melzer et al. Mortality following bacteremic infection caused by extended spectrum beta lactamase producing E.Coli compared to non-ESBL producing E. Coli. J of Infection. Volume 55, issue 3, Sept 2007;254-259.
28.) E.D’Agata et al. Patterns of antimicrobial use among nursing home residents with advanced dementia. Archives of Medicine 2008.
29.) SC Lim et al. Role of a therapeutic garden in a teaching hospital in Singapore. Nov Res Sci. 13(2), NRS.000806.2023.
30.) Espeleta Wrenzie del Valle, SC Lim*. Outcome Of Outdoor Activities as Part of Person-Centered Care in The Dementia Ward of An Acute Hospital. 13(3): 2022. ANN.MS.ID.000815.
2.) Statista Research Department, Nov 7, 2014.
3.) Mythily Subramaniam, et al. Prevalence of dementia in people aged 60 years and above: results from the WiSE study. Journal of Alzheimer’s Disease 45(2015) 1127-1138.
4.) Jim George at al. How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions. J of the Royal Society of Medicine; 106(9):355-361.
5.) Stig Berg, Torbjorn Svensson. An Orientation scale for geriatric patients. Age and Ageing, Volume 9, Issue 4, Nov 1980, pages 215-219.
6.) Rowe Meridith. Wandering in hospitalized older adults: Identifying risk is the first step in this approach to preventing wandering in patients with dementia. American Journal of Nursing. Oct 2008. Vol 108, Issue 10 p. 62.
7.) SC Lim et al. Project to reduce elopement of vulnerable patients from the A&E. Acta Science Neurology, Volume 2 Issue 7 July 2019.
8.) SK Inouye et al. The HELP: a model of care to prevent cognitive and function decline in older hospitalised patients. Hospital Elder Life Program. J Am Geriatr Soc.2000 Dec;48(12):1697-706.
9.) Inouye, S. K et al. Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA 275, 852–857. doi: 10.1001/jama.1996.03530350034031.
10.) S. K. Inouye, et al. “A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics,” Annals of Internal Medicine, vol. 119, no. 6, pp. 474–481, 1993.
11.) Eresha Fernando et al. Risk factors associated with falls in older adults with dementia: A systematic review. Physiother Can Spring 2017; 69(2):161-170.
12.) SC Lim. Falls among the persons with dementia and interventions to reduce falls in a dementia ward. Journal of Brain and Neurology 2020 Volume 3 issue 2.
13.) Lim SC. Restraint use in the management of elderly with dementia in hospital. Internal Medicine Research Open Journal. Volume 1(2):1-4, 2016.
14.) SC Lim et al. Improving outcome for the elderly surgical patients in a Singapore teaching hospital. Surg Med Open Acc J. 2(3). SMOAJ.000 537.2019.
15.) Dementia statistics | Alzheimer's Disease International (ADI) (alzint.org)
16.) Lim SC, Chiam WM, Goh CH, Zhang D, Png GK and Li FY., Initiatives to Improve Awareness of Delirium in a Teaching Hospital in Singapore: for Better Patient Care.
17.) SC Lim. The role of dementia ward in an acute hospital. J Geontol Geriatr Res. 2017.6.6.10 00453.
18.) Sloane, Philip & Hoeffer, et al. (2004). Effect of Person-Centered Showering and the Towel Bath on Bathing-Associated Aggression, Agitation, and Discomfort in Nursing Home Residents with Dementia: A Randomized, Controlled Trial. Journal of the American Geriatrics Society.
19.) Kitwood T, Bredin K,.,Towards a theory of dementia care: personhood and well-being. Ageing Soc. 1992; 12():269-87.
20.) Steenbergen E et al (2013) Perspectives of person-centred care. Nursing Standard. 27, 48, 35-41.
21.) Lim Sc, Kaysar Mamun, Jim K H Lim Comparison between elderly inpatient falls with and without dementia, Singapore Med J, 2014 Feb;55(2):67-71. doi: 10.11622/smedj.2014017.
22.) Lim SC. Falls among the persons with dementia and interventions to reduce falls in a dementia ward. Journal of Brain and Neurology. 2020;Volume 3, issue 2.
23.) Si Ching LIM. Nutrition and the Role of Tube Feeding in the Elderly. J J Geronto. 2016, 2(1): 017.
24.) SC Lim and Peter CL Chow. Managing eating disorders in elderly with dementia and the ethical considerations for tube feeding. Int J of Psych 2018. Vol 3 Issue 1. ISSN:2475-5435
25.) Robert S Wilson et al. Loneliness and risk of Alzheimer disease, Arch Gen Psychiatry, 2007 Feb;64(2):234-40.
26.) Aida Suárez-González et al. Detrimental effects of confinement and isolation on the cognitive and psychological health of people living with dementia during COVID-19: emerging evidence. Dementia Research Centre, UCL Institute of Neurology at Queen Square, University College London, Last updated 1st July 2020, available at website ltccovid.org
27.) M Melzer et al. Mortality following bacteremic infection caused by extended spectrum beta lactamase producing E.Coli compared to non-ESBL producing E. Coli. J of Infection. Volume 55, issue 3, Sept 2007;254-259.
28.) E.D’Agata et al. Patterns of antimicrobial use among nursing home residents with advanced dementia. Archives of Medicine 2008.
29.) SC Lim et al. Role of a therapeutic garden in a teaching hospital in Singapore. Nov Res Sci. 13(2), NRS.000806.2023.
30.) Espeleta Wrenzie del Valle, SC Lim*. Outcome Of Outdoor Activities as Part of Person-Centered Care in The Dementia Ward of An Acute Hospital. 13(3): 2022. ANN.MS.ID.000815.