Hospitals need to change for dementia patients

Lynn Chenoweth, Professor of Aged and Extended Care Nursing and director of the Health and Ageing Research Unit at the South Eastern Sydney and Illawarra Area Health Service (SESIAHS), says that conditions being treated in Australian hospitals are changing, with dementia rising rapidly.

“Lifestyle conditions are reducing because of things like anti-smoking campaigns. It’s the neurological conditions that are increasing, with the most rapid rise, in dementia,” she said.

“Dementia is not a normal part of ageing. It’s something that can happen in older age because of brain changes, but it’s not inevitable.”

Though known risk factors for some dementias include heart disease, stroke, toxins, heavy metals, drugs, alcohol and untreated venereal disease, the causes of Alzheimer’s disease are still unclear.

“This is a terminal illness. Once dementia becomes severe, the person will deteriorate quite rapidly because they may have lost the cognitive skills even to swallow, and to make sense of their environment.”

While more research into the causes is needed, improving patient care is vital. Professor Chenoweth is investigating how medications, existing medical conditions, health care services, recreation activities and hospital and housing environments impact older people with acute and chronic illness and those with dementia.

She says nurses need to be flexible.

“What we should be doing is improving our systems to meet the person’s needs. A lot of the psychological symptoms we see are related to how people are handled, the way staff communicate with them and the way the environment is set up.

“Bright lights, noise, rushing and crowding, can trigger stress, disorientation and even catastrophic reactions, which often arise from fear – and of course this is typical in emergency department settings.”

Professor Chenoweth, who aims to uncover ways to fill these gaps, says education and government commitment are key.

“We need nurses to be properly educated in how to care for older people, particularly someone with complex and chronic illnesses or any type of cognitive impairment.

“In acute care settings these vulnerable people are often expected to conform to systems geared to the needs of compliant younger adults, but the acutely unwell older person may have completely different physical, emotional and communication needs.”