We have touched on this subject in the past, but it is worth another look. The balance of providing adequate health care for dementia patients, including hospital visits, and avoiding unnecessary, excessively stressful hospital treatments, is a tough one. Unfortunately, the data points too often to the latter.
A new study quoted by MSNBC (“Dementia patients suffer dubious hospitalizations“) indicates that, “One-fifth of Medicare nursing home patients with advanced Alzheimer’s or other dementias were sent to hospitals or other nursing homes for questionable reasons in their final months, often enduring tube feeding and intensive care that prolonged their demise…” 20% of folks being subjected to dubious, frightening treatments that they cannot understand is a sad number.
The worst part of the study is not just that the treatments are questionable, but the suspected motivation for the treatments:
researchers suspect a different motive [from medical need] for many transfers: money. Medicare pays about three times the normal daily rate for nursing homes to take patients back after a brief hospitalization.
One of the reasons for suspecting money as the motivation is a very wide range, geographically, in the rate of hospital transfers and treatments:
Rates of such transfers varied from 2 percent in Alaska to more than 37 percent in Louisiana. In McAllen, Texas, 26 percent of study participants had multiple hospitalizations for urinary infections, pneumonia or dehydration — conditions that usually can be treated in a nursing home. That compares to just 1 percent of patients in Grand Junction, Colo.
There is no obvious reason for such disparities, statistically, except ethics [or strong ombudsman programs] in some locales and the absence of such in others. One way to rein in such potential abuse is for family members to remain vigilant and engaged.
If there are no family caregivers close by to keep a close eye on treatments, find a professional home care agency who can provide caregivers. They can help with emotional support for the dementia sufferer and report back to the agency and family. We have performed this function at Support For Home and other good agencies in your area can do the same.
Best wishes, Bert