People living with dementia pay 1.4 million yearly visits to the emergency room for healthcare

Dementia is a terrifying and debilitating disease that affects memory, thinking and the ability to perform basic tasks. There are currently more than 55 million people with dementia across the globe, with around 60 per cent of whom live in low and middle-income countries.

There are nearly 10 million new cases of dementia every year, caused and exacerbated by factors such as old age, type 2 diabetes, obesity, smoking, alcohol consumption and depression. Although, in hindsight, dementia can affect everyone and anyone.

So it should come as no surprise when I tell you that a densely-populated and confusing emergency room is not the most ideal place for a person living with dementia.

However, according to a new study from the University of Michigan, people with Alzheimer's and other forms of dementia pay around 1.4 million visits to the emergency room per year – making up nearly seven per cent of all emergency visits by people aged 65 and over.

Lauren B. Gerlach, D.O., M.Sc., a geriatric psychiatrist and lead author of the study, commented: "While dementia is thought of as a cognitive or memory disorder, it is the behavioural aspects of the disease such as anxiety, agitation and sleep disturbances that can cause the most stress for caregivers and patients alike."

"Emergency departments are often not the right place to manage these behaviours. We really need to do better to support caregivers so there are options other than seeking emergency care," Gerlach continued.

The researchers found that emergency department patients with dementia received antipsychotic medication at more than twice the rate as other emergency patients over the age of 65 during their visit. These drugs are used to sedate people with dementia and calm their behavioural symptoms.

After being administered these drugs, it can also increase the risk of fall accidents and death. Also, once the emergency is over, there is concern that these antipsychotic and sedative medications could continue to be prescribed long-term, putting patients with dementia further at risk.

Additionally, the study provides further evidence that older adults with dementia may be treated differently in the emergency department.

Gerlach commented on this finding, saying: "Difficulty in the ability of patients with dementia to communicate their symptoms verbally can make it challenging to distinguish what is causing their symptoms."

"Is it related to a change in their environment, difficulty between the patient and their caregiver, or an underlying medical issue?" the psychiatrist pondered.

By consulting the results of the study, Gerlach suggests that caregiver stress and burnout from a lack of respite and support may play a role in the crucial need for seeking emergency care in people with dementia.

Nonetheless, Gerlach sees great promise in a new proposed Medicare rule that would allow healthcare teams to receive reimbursements for sessions that educate family caregivers – particularly on how to prevent and soothe the behavioural symptoms of their loved ones.

One approach to this is a support programme called DICE, also co-developed at Michigan Medicine's geriatric psychiatry division, which is now available online to dementia caregivers all over the world.

Gerlach and her researchers also encourage people to be realistic, and not to mention incredibly patient, when wishing to seek emergency care for their loved ones who suffer from dementia.