DETROIT – Being in the emergency room can be a frightening, overwhelming experience for anyone, but that’s especially true for people living with dementia.
A new study from Michigan Medicine suggests older adults living with dementia are frequent visitors to the ER.
One of the biggest challenges with patients suffering from dementia is that as the disease progresses, it can be difficult for them to communicate to us what they’re experiencing. Often we have to rely on caregivers for information and one of the most common reasons we see people with dementia in the ER is for behavioral or mental health crises.
“While we often think of dementia is a cognitive or memory disorder, it’s often these behavioral aspects of the disease that can be most distressing for patients and their care partners,” said Dr. Lauren Gerlach, a geriatric psychiatrist with Michigan Medicine. “These types of symptoms can include things like agitation or aggression, things like hitting or kicking, unrelenting anxiety, or what we call psychosis, which can include things like distressing hallucinations or paranoia.”
Gerlach and her research team found older adults living with Alzheimer’s disease and other forms of dementia visit the ER 1.4 million times a year. That’s nearly 7% percent of all emergency visits for any reason by people over the age of 65.
Patients with dementia received antipsychotic medications at more than twice the rate as other ER patients over the age of 65.
“That can be concerning because these medications are associated with a high risk of side effects,” Gerlach said. “They can lead to falls, which then can lead to future emergency department visits if they’re continued.”
Gerlach said the study suggests there’s a lot of opportunity to prevent future emergency visits by better supporting dementia caregivers.
“I often guide my patients and families to the Alzheimer’s Association, which has wonderful caregiver training resources, as well as support groups and 24/7 hotlines to help caregivers who might be struggling managing these behaviors at home,” Gerlach said.
Some of the potential triggers for these behavioral challenges include an underlying medical illness, a new medication, changes in their home environment, untreated pain, or even constipation. Identifying that trigger can help resolve the behavior, but it often takes some work to uncover what’s really going on.