Dementia Support Line
Preparing for a hospital stay when a person has dementia
There may come a time when a person with dementia needs to go into hospital. This could be planned, such as tests and treatment, or it might be unplanned, following an emergency. This guidance can help you prepare for both.
- You are here: Preparing for a hospital stay when a person has dementia
- How to support a person with dementia during a hospital stay
- What happens during and after a person with dementia is discharged from hospital?
Hospital care
How to prepare for a planned hospital stay when a person has dementia
If the hospital stay is planned, the person will normally be sent a letter in advance with instructions. These can include whether they can eat or drink beforehand and details on how long their stay is likely to be.
You can contact the hospital department if you have any questions or concerns about a planned visit. You should also let them know if the person with dementia has communication needs.
This could be needing an interpreter, someone to help them during conversations, or a communication tool. The hospital’s website may have information about support they can offer.
Tips to help a person with dementia prepare for a stay in hospital
The suggestions below may help someone with dementia prepare for a planned stay in hospital:
- Read through the instructions together. Note down anything they need to take with them, such as medication, glasses or hearing aids.
- If the person is worried, ask them what information you can find that may help to reassure them.
- Involve them when deciding which nightwear and clothing to pack in their hospital bag.
- Discuss any belongings they may wish to take with them to keep busy, such as a music device, books or magazines. You could also take any personal items that will help the person to feel more settled, like a smartphone or photo album. Keep important items in a safe place and avoid taking anything that is irreplaceable. Check insurance on anything valuable.
- Label any clothing or belongings with the person’s name in case these get lost.
- Ask if you can help with anything at home while they’re away – such as putting the bins out or watering the plants.
- Arrange any transport that may need to be booked ahead.
- Consider filling in a This is me form to help hospital staff to know the person’s likes and dislikes.
How to prepare in case of an unplanned hospital stay
Not all hospital admissions can be planned in advance. Sometimes a person will suddenly have to be admitted to hospital. This can be due to an illness, a concern by healthcare professionals, or an accident or fall.
Sudden hospital admission can be very frightening for a person with dementia, as they may not fully understand what is happening. The following may help to prepare and support them:
What if the person with dementia refuses to go to hospital?
Sometimes a person with dementia may refuse to go to hospital. It could be that they don’t understand what is happening or why they need treatment.
Dementia can affect decision-making. Legally, the ability to make a particular decision is known as having the ‘mental capacity’ to make it.
In some cases, a person with dementia will not be able to consent to being in hospital, as they lack the mental capacity. In this case, someone (or a combination of people) will need to make a best-interests decision on their behalf, in accordance with the Mental Capacity Act 2005.
Where the person lacks mental capacity to agree to being in hospital, their stay may also need to be authorised under the Deprivation of Liberty Safeguards (DoLS). The purpose of DoLS is to ensure that the person receives the treatment and care they need, even if it reduces their freedom and independence.
During a hospital stay, a number of important questions and decisions may need to be discussed. This may be difficult for the person with dementia if they don’t understand the question or can’t process the information. You and hospital staff should do what you can to help the person to make their own decisions.
Lasting power of attorneys (LPA) or Enduring power of attorneys (EPA) allow someone to appoint another person to make certain medical or financial decisions for them, if they are no longer able to make those decisions themselves.
If the person has made a LPA for health and welfare, their attorney (who might be you) has the power to decide if they go to hospital or not.
It’s important to note that an EPA only covers financial decisions and not health ones. This may be of limited help in a hospital situation but still worth letting the hospital know about.
If the hospital visit is for treatment that is life-sustaining, that power will only apply if the person with dementia has chosen that option on the LPA form.
The laws governing powers of attorney are different depending on where the person lives:
- LPAs are used in England and Wales
- EPAs are used in Northern Ireland.
Advance decisions and advance directives are legal documents. They allow someone to refuse, in advance, specific medical procedures or treatments. Like LPAs, advance decisions are legally binding. This means that health professionals have to follow these decisions if they can be applied in that specific situation.
Advance statements allow a person to explain what they like and don’t like, and to set out their preferences for the future. Unlike LPAs and advance directives, advance statements aren’t legally binding, but they must still be considered when people, such as doctors, make decisions on their behalf.
If the person needs to be assessed or treated in hospital for a mental health condition (not a physical one), they can be detained (or ‘sectioned’) against their will under the Mental Health Act 1983. This is regardless of their mental capacity. In Northern Ireland, this is known as the Mental Health (Northern Ireland) Order 1986. This can only happen if they are a risk to themselves or others and should be a last resort.
Planning ahead for future decisions when a person has dementia
If the person you support would like to look into these options, order a copy of our booklet, Planning ahead.
It can help to have a list ready of things to pack in case of a hospital admission. The list could include:
You may have a local scheme that can help the person with dementia to communicate their wishes in an emergency. These forms are usually completed by you and the person, such as MedicAlert®. Some forms, such as ReSPECT, need to be completed jointly with a clinician.
These forms can be a huge help to hospital staff or paramedics who may not be aware of the person’s dementia. Filling in these forms sooner rather than later can help you prepare in advance of a hospital admission. You can ask your GP if they have the forms or go to resus.org.uk and medicalert.org.uk
One of the most important things you can do to help a person with dementia in hospital is to communicate with them as much as possible. Let them know what is happening and provide relaxed conversation as much as you can. This may be difficult if you are feeling worried or stressed yourself, but the person with dementia will really benefit from this.
Communication is not just what you say. It can also be your tone of voice and body language. Depending on the person, a reassuring smile or a squeeze of the hand can make a big difference to how they feel.