Why Receiving Hospital Care in the Home Helps People Living with Dementia Maintain Their Wellbeing

Experiencing a backslide in one’s level of physical fitness and wellness – also known as deconditioning – during a hospital stay is difficult for anyone and is especially challenging for people suffering from dementia. Issues like bedsores, loss of muscle mass and general weakness are sometimes felt by patients during a hospital visit. For people living with dementia, challenges like these are exacerbated alongside the mental struggle of just being in the hospital.

These concerns, however, are often not noticed in real-time. Supporting a loved one with dementia during a hospital stay and realizing that they’ve gradually been deconditioning often brings about feelings of helplessness, but the act of bringing their care into the home instead can alleviate the hardship they experience through deconditioning.

Deconditioning In Practice

So, what does deconditioning actually look like? There are many answers to this question. By definition, deconditioning is a complex process of physiological change following a period of inactivity, bed rest or sedentary lifestyle. It results in functional losses in such areas as mental status, degree of continence and ability to accomplish activities of daily living. Most notably, in a hospital, this amounts to a measurable loss of energy, strength and overall wellbeing. As one becomes lethargic, one also tends to lose motivation or become irritable. Together, these problems decrease mobility and result in more time in the bed, which takes a physical toll on the body.

Challenges Hospital Stays Pose to Conditioning

The level of conditioning our bodies maintain from simple tasks at home or just from having the freedom to move around is understated. In a hospital, mainly for safety concerns and to ensure that care can be delivered efficiently, patients must conform to a schedule and environment with which they have no familiarity. An unfamiliar environment with unfamiliar “rules” leads many patients to think they aren’t allowed to move much outside of physical therapy, which is a misnomer. On the other hand, when receiving hospital care at home, people know where they are able to move and stay mobile, within their physical limits.

As deconditioning is most common among geriatric populations, signs of weakening and decreased mobility aren’t always immediately noticeable, but rather seen over time. As a patient’s physical condition wears away, the body has to work even harder to heal the original ailment, ultimately leading to longer hospital stays and physical therapy to recondition the body on top of healing illness. These needs add up quickly for any patient, let alone those aging and/or living with dementia.

The Positive Impact of Being Home

The good news is that receiving hospital care at home has a strong effect on preventing deconditioning. The familiar faces patients see while receiving care in the home are encouraging and comforting, particularly for those living with dementia. On top of loved ones helping to ensure patients carry out their daily tasks, the home setting is familiar and easier for dementia patients to navigate – drastically decreasing the likelihood of bedsores, decreases in mobility and irritability.

While having access to a nurse at the press of a button may seem to be a safety net, in some instances it results in hospital staff doing physical tasks that patients could complete alone. In the home, while nurses still visit at least twice a day and patients still have a nurse call button, patients are less likely to call a nurse for a simple, physical task, of which they are safely capable of doing, leading them to keep moving and maintain their strength.

While hospital staff do their absolute best to ensure patients stay well-conditioned, patients’ ability to participate in their healthcare and physical conditioning all help uphold their own physical health as they heal from injury or illness. Among many benefits of receiving care in the home, more than anything else, being at home allows patients to be in a familiar, safe environment while maintaining their activities of daily living.

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Meet Our Expert

Mark Montoney, MD, MBA, Senior Medical Advisor

Mark has a deep history and passion for geriatric medicine. He was first drawn to Contessa because of its unique and specific delivery of care, which is often highly beneficial to geriatric patients. In his role at the organization, Mark advises on clinical operations, including quality and patient safety, utilization management, research and innovation, and physician leadership. Prior to this role, Mark served as the chief medical officer for Contessa, Tenet Healthcare, Vanguard Health Systems and OhioHealth, where he practiced internal medicine and geriatrics. Contact Dr. Mark Montoney