Almost 25% of patients with dementia are readmitted to the hospital within 30 days. Experts believe that as many as 67% of these readmissions could be avoided. Increasing numbers of older adults are diagnosed with dementia every year, and changes in Medicare reimbursement demand that acute care and other health care providers change their approach to care or suffer financial penalties.
Hospital admission and readmission diagnoses are rarely “dementia.” A lack of identification and attention to an individual with cognitive impairment – regardless of the admitting diagnosis – are destined to increase problems, costs and readmissions.
Despite years of case management and transitional care programs, readmissions have not declined. While some success has been demonstrated for patients receiving case management to cope with such ailments as heart disease or diabetes, it is recognized that transitional care programs have been silent to the unique needs of individuals with dementia and their caregivers.
Hospital patients with dementia returning home require the engagement and training of an identified caregiver. An ongoing support system also is needed for families and caregivers to cope with the transitions, changes in behaviors and functional losses that occur as the disease progresses. Providing education, identifying and securing support systems and resources are items to be addressed upon admission to acute care – not at discharge.
Many hospital patients with Alzheimer’s disease or a related dementia do not return home but are transferred to a long-term care environment. More than 50% of all residents in long-term care settings are cognitively impaired. Despite this reality, assisted living and nursing facilities also suffer from a lack of dementia knowledge and hence remain a major source of hospital readmissions.