Dementia and Parkinson’s disease are chronic and progressive conditions that can significantly impact an individual’s quality of life and functioning.

Reduced cognitive function and mobility may increase the risk of adverse events, including hospitalization. Hospitalization has its own risks, such as delirium, falls, infection, and pressure ulcers.

Healthcare practitioners need to take steps to assess and manage the risks associated with hospitalization for patients with dementia or Parkinson’s disease to achieve better health outcomes and enhance patient and caregiver satisfaction.

The Risk of Hospitalization in Dementia Patients

Dementia is a term that describes a range of symptoms that affect a person’s cognitive and memory function. People with dementia may experience difficulties with communication, orientation, judgment, and decision-making.

They may also have behaviors such as aggression, wandering, and agitation, which increase the risk of trips, falls, or accidents. These can lead to hospitalization.

Several studies have shown that hospitalization rates for patients with dementia are much higher than in the general population. According to a study by Mukherjee et al.

(2018), the hospitalization rate for patients with dementia was 3.5 times higher than for those without dementia. Hospitalization rates increase with increasing severity of dementia, with patients who have moderate-to-severe dementia being particularly vulnerable.

Furthermore, hospitalization can cause a significant decline in a dementia patient’s cognitive and functional abilities. Hospitalization can also increase confusion, disorientation, or delirium in a dementia patient.

Delirium is an acute decline in cognitive function characterized by fluctuations in level of consciousness, disordered thinking, and altered perception. Patients with dementia are at an increased risk of developing delirium during hospitalization.

The Risk of Hospitalization in Parkinson’s Patients

Parkinson’s disease is a progressive disorder of the nervous system characterized by tremors, rigidity, bradykinesia (slowness of movement), and gait and balance problems.

People with Parkinson’s disease may also have non-motor symptoms such as cognitive impairment, depression, and sleep disorders. These symptoms may increase the risk of hospitalization.

According to a study by Li et al. (2018), hospitalization rates for patients with Parkinson’s disease were 1.2 times higher than for the general population.

The most common reasons for hospitalization were neurologic complications, pneumonia, and falls. Hospitalization for any reason is associated with an increased risk of mortality in patients with Parkinson’s disease.

Hospitalization can also lead to adverse events in patients with Parkinson’s disease.

Hospitalization can exacerbate the motor symptoms of Parkinson’s disease and can lead to falls, deterioration of balance, and loss of activities of daily living. Furthermore, hospitalization is associated with a higher risk of delirium in Parkinson’s patients.

Related Article How to Identify the Risk of Dementia or Parkinson’s Disease Hospitalization

Assessing the Risk of Hospitalization in Dementia or Parkinson’s Patients

Healthcare practitioners can assess the risk of hospitalization in patients with dementia or Parkinson’s disease using several tools.

The Clinical Frailty Scale (CFS) is a tool that measures physical, cognitive, and functional status to assess the risk of adverse health outcomes, including hospitalization. Patients with a higher CFS score have a higher risk of hospitalization. The Mini-Mental State Examination (MMSE) is a tool that measures cognitive function and can detect cognitive impairment in patients with dementia.

Patients with severe cognitive impairment are more vulnerable to hospitalization.

Additionally, healthcare practitioners can assess the risk of delirium using the Confusion Assessment Method (CAM). The CAM is a tool that measures cognitive function and attention and can help diagnose delirium in hospitalized patients.

High-risk patients can be monitored more closely to minimize the risk of adverse outcomes.

Strategies to Reduce the Risk of Hospitalization in Dementia or Parkinson’s Patients

To minimize the risk of hospitalization in patients with dementia or Parkinson’s disease, healthcare practitioners can adopt several strategies.

Firstly, healthcare practitioners can implement non-pharmacological interventions to manage behavioral and psychological symptoms of dementia (BPSD). BPSD includes agitation, aggression, wandering, and depression.

Non-pharmacological interventions such as pet therapy, music therapy, and aromatherapy have been shown to reduce the frequency of BPSD and may minimize hospitalization.

Secondly, healthcare practitioners can provide patient education on medication management. Patients with dementia or Parkinson’s disease may need help managing their medications and may forget to take them.

Healthcare practitioners can provide medication reminder devices, written information, or a medication schedule to their patients to minimize medication errors and adverse events.

Thirdly, healthcare practitioners can create a safe environment to prevent falls in patients with dementia or Parkinson’s disease. They can minimize environmental hazards such as area rugs, loose carpeting, and electrical cords.

Healthcare practitioners can implement physiotherapy and occupational therapy to improve balance and mobility in patients with Parkinson’s disease.

Finally, healthcare practitioners can educate caregivers on the signs and symptoms of delirium and how to respond to them. This education can help caregivers recognize when a delirium episode is starting and can prompt early intervention.

Conclusion

Patients with dementia or Parkinson’s disease are at an increased risk of hospitalization and adverse outcomes during hospitalization.

Healthcare practitioners can minimize these risks by assessing the patient’s risk, adopting non-pharmacological interventions, providing patient and caregiver education, and creating a safe environment. These strategies can enhance the quality of life of patients and caregivers, reduce healthcare costs, and ultimately, improve health outcomes.