When older adults with dementia end up in the emergency room, many hospitals may end up transferring them to another facility. But a new study shows this might not always benefit people living with dementia.
Researchers from Regenstrief Institute and Indiana University School of Medicine conducted a study that reviewed the electronic health records of older adults, both with and without dementia. The study, originally published in September and publicized this week, concluded that patients older than 65 with dementia had a lower likelihood of receiving a specialized procedure or intensive care unit (ICU) admission within the first 48 hours of transfer among hospitals.
The findings are relevant for memory care operators, who sometimes must send memory care residents to the hospital even if they are unsure if such a move is ultimately necessary.
“These factors should be considered when determining the consequences of interhospital transfer,” the study’s author wrote. Further study is needed to confirm these observations in other patient populations, and the effects of these differences with regard to other patient-oriented outcomes.”
The study examined the records of 1,340 patients transferred to a tertiary hospital, 100 of which had a dementia diagnosis. Dementia patients were more likely to be both older with the median patient at 82, and receive a geriatrics consult or palliative care consult.
Older adults with dementia were less likely to need resuscitation support when they are admitted after an intra-hospital transfer, according to the study. They were also less likely to be admitted to the ICU, and were less likely to receive intensive care or procedures within 48 hours of the transfer.
The report indicates that after adjusting for various factors, including demographics, code status, insurance and pre-transfer living situation, older adults living with dementia had greater odds of no ICU care or procedure within 48 hours.
However, a dementia diagnosis did not “significantly influence the odds of death” among those within the study.
The study’s results strengthen the authors’ beliefs that better care coordination can help make people with dementia and their families more aware of the risks, benefits and alternatives of hospital transfers.
“We ought to be very considerate and focused on patient centered care, particularly in this population,” said Nancy Glober, study first author and emergency medicine physician.