Hospital Care

Behavioral symptoms are often precipitated by a move from a familiar to an unfamiliar environment. Hospitals can be a particularly stressful environment for a dementia patient, as can the acute or exacerbating medical illness that creates the need for hospitalization. The physician should communicate the dementia diagnosis to the hospital staff. This knowledge can allow preemptive implementation of measures to decrease the likelihood of delirium (Inouye et al., 1999).

Patients with advanced dementia who are hospitalized with acute illnesses have a dismal prognosis. Explaining the risks and benefits of hospitalization and aggressive therapy,

The complete reference list is available online at www.expertconsult.com.

www.hospitalelderlifeprogram.org

Description and supportive information for patients, families, and professionals about delirium and a program for its management in the hospital. www.hhs.gov/aging

Access noncommercial information on variety of aging topics; links to FDA, CDC, Administration on Aging; useful for patients and families as well as professional caregivers. www.amda.com

Professional organization for nursing home medical directors, attending physicians, and other members of the interdisciplinary team; source of clinical and practice management information for care of patients in long-term care settings.

especially when the physician has had an ongoing relationship with the patient and family, often results in a decision to focus on aggressive symptom management without hospi-talization (Morrison and Siu, 2000). A "do not hospitalize" order is often appropriate.

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