There really is no place like home for the more than 6 million Americans living with dementia. These individuals face memory loss and other cognitive barriers that are severe enough to interfere with daily life, both in familiar and unfamiliar environments. This is why a trip to the hospital can turn someone living with dementia’s world upside down, often leading to delirium, functional decline, and distress.
As a geriatrician, I have learned that treating people living with dementia in the hospital is a tremendous challenge. A report published in the International Journal of Geriatric Psychiatry notes that people living with dementia have a “significantly higher risk for all-cause hospitalizations and longer hospital length of stay.” The Alzheimer’s Association points out that people living with dementia have twice as many hospital stays per year as other seniors and are more likely to have chronic conditions. Even more alarming, a study in Cambridge University Press found that people living with dementia who are admitted to the hospital for a urinary tract infection or pneumonia – two of Contessa’s most common conditions – had a higher mortality rate during admission.
Offering the option to receive hospital-level care in the home is a monumental advantage in a dementia-care strategy. Home hospital care offers the familiarity of an environment people living with dementia know well, and the comfort of a place that, quite literally, feels like home.
The Home’s Clear Benefits
By being treated at home, people living with dementia are familiar with their floor plan, furniture, and the rooms in which they reside. When they have to get up in the middle of the night, they have a lower propensity to bump into objects, have trouble finding the bathroom, or experience other obstacles that may lead to a debilitating fall. Often, their loved ones are by their side and not in a waiting room. Rather than having to meet and get to know their care teams, a caregiver support system is often built-in the home. Perhaps best of all, their favorite things are also nearby (pets, books etc.) and meals are usually made at home rather than a hospital kitchen.
What is more, people living with dementia not only struggle in unfamiliar surroundings, but their mental status is likely to decline as well. People living with dementia need more focus placed on their environment. Elements like home health support and ongoing day-to-day care are often more easily provided in the home.
The Value of Person-Centered Care
In 2018, the Alzheimer’s Association published Dementia Care Practice Recommendations, which focuses heavily on person-centered care. This approach builds care around an individual’s needs and is contingent upon knowing the patient’s unique individuality. While this is an easy concept to grasp, it isn’t always easy to execute, especially in a hospital-setting where physicians and nurses are juggling a large patient census.
But Contessa’s care-model is purposely designed to take a person-centered approach.
Home hospital care teams provide the same care as traditional hospitalists and nurses, but on a very personal level. The relationship and meeting cadence is often more intimate, personal, and regular than during a traditional hospital stay. This offers the unique opportunity to learn a lot about a patient’s home environment and lifestyle. We design a care plan that is especially suited for the patient’s day-to-day life, which is the essence of person-centered care, and is proven to deliver strong patient outcomes.
Creating an Improved Experience
Home hospital care models, like Contessa’s, offer many advantages for people living with dementia. Being in a familiar environment surrounded by familiar faces are major benefits. At home, a patient’s support system is more inherent, and they are more likely to assist in preparing food, supporting activities of daily living, and using remote patient monitoring devices.
It must be said that despite the many comforts of home, we know family members and caregivers alone are not designed to help patients make a full recovery from demanding health conditions. In Contessa’s acute care model, our teams are in patients’ homes a great deal both physically and virtually. Patients see a specially trained registered nurse at least twice a day for extended visits, round with physicians via telehealth, and are monitored by a Recovery Care Coordinator. Due to this elevated level of personal care, our team has identified early signs of dementia before a patient or their family is even aware. This leads to earlier diagnosis, treatment, and the creation of long-term care plans.
Hardly anyone enjoys a hospital stay, even less so when you’re unclear about where you are, who you’re with or why you’re there. For people living with dementia, going to the emergency department, or anticipating an extended hospital stays can be confusing and scary. Their home, a place of comfort and familiarity, is a simple solution to a complex issue in healthcare.