THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
In the U.S. right now, about 7 million seniors are living with dementia, with the CDC estimating that number to double by the year 2060. More imminently, a study has found that seniors with dementia are two times as likely to go to the emergency room (ER) than other seniors. To be clear, seniors refer to people above the age of 65. The subject of today’s discussion is not the fact that seniors go to hospitals, but that a category of seniors go to emergency rooms more frequently than others. That category is no other than, of course, dementia.
Before we delve into the details, let’s consider what dementia really is. Have you ever watched a movie where there’s an old folk who has dementia, and it progressively worsens until they can’t even recognize their own children? Well, I have, and that’s actually a fair representation of what the condition is.
Dementia itself is not a specific condition but a general term for loss of memory, language, decision-making, problem-solving, and other thinking activities that can significantly interfere with doing everyday activities. Of the types of dementia, Alzheimer’s is the most common, accounting for up to 80% of cases. Other types include vascular dementia, Lewy body dementia, and mixed dementia.
When people age, especially when they go north of 65, you start to expect some degree of memory impairment. That’s when forgetting passwords, some words, names of old classmates, and car keys becomes common, but that does not mean the senior has dementia. Hey, even I forget where I left my car keys on occasion, and I most definitely do not have dementia.
With dementia, the severity of the condition is a lot worse, and the individual may start forgetting the road to their home or the name of very close individuals, like, you guessed it, their children. And unfortunately, there is no cure for dementia. However, there are effective management options to alleviate the effect of the condition and reduce the impact on everyday activities.
Now, to the actual talking point of this article, people with dementia are two times more likely to visit the emergency room than other seniors. Furthermore, when they get to emergency rooms, patients with dementia are more likely to receive tests like CT scans and urinalysis. Also, they are more likely to receive antipsychotics although they are less likely to receive opioids. Perhaps the biggest concern with the treatment of dementia patients in ERs is the lack of proper communication and their erratic behavior.
The study conducted on this subject indicates that these statistics are a reflection of the challenges that seniors with dementia face every day. While no one wants to go to the emergency room, visits to the emergency room by dementia patients are particularly undesirable because studies reveal that it is not the best treatment option for older adults.
With that said, it is time to shift the focus to the “why?”
Why are dementia patients two times more likely to go to emergency rooms? Well, the answer may lie with the caregivers. Considering the symptoms associated with dementia, like anxiety, agitation, and sleep challenges, you can imagine how stressful it will be for not only the patients but for the individuals supporting these patients.
It’s really no surprise that these caregivers are quick to call for visits to emergency rooms when problems arise. It is therefore plausible to imply that if better support is given to these caregivers, the visits to ERs by dementia patients will reduce. These caregivers need to be made to understand that emergency rooms are not the best treatment sites for their elderly folks with dementia.
This article was written by Dr. Adil Manzoor, DO, a Board-Certified Internist & Board Certified Pediatrician who works as a Hospitalist and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice, Mobile Medicine NJ & House call Doctors. He is also currently pursuing an Executive MBA and a Master’s of Science in Healthcare Leadership at Samuel Curtis Johnson Graduate School of Management and the Weill Cornell Graduate School of Medical Sciences.
References
- https://www.washingtonpost.com/wellness/2023/07/30/dementia-alzheimers-emergency-room-visits/
- https://www.ncbi.nlm.nih.gov/search/research-news/19247/
- https://www.webmd.com/alzheimers/news/20230731/dementia-patients-sent-er-staggering-rates-study
- https://www.cdc.gov/aging/dementia/index.html#:~:text=Dementia%20is%20not%20a%20specific,a%20part%20of%20normal%20aging.
