Person-centred care in hospitals may reduce dementia decline, research finds

According to research from UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA), the influence of person-centred care should be extended into hospital settings for people living with dementia. This move would have positive outcomes for aged care service providers.

The research, published in the Journal of Alzheimer’s Disease, looked at the impact of a person-centred intervention known as the Kitwood model on the quality of healthcare and clinical outcomes for people living with dementia, following hospitalisation.

Key points

• Roughly two out of every 1,000 hospitalisations in Australia are due to dementia, while one in four people living with dementia are admitted to hospital each year
• The average length of stay is five times higher than the average length of all hospitalisations, 14.8 days compared to 2.7 days
• The rate of hospitalisations has gradually increased since 2012/13 when more than 13,000 were recorded, rising to just over 25,000 hospitalisations in 2021/22

Clinical settings such as hospitals are often a challenging and confronting place for patients living with dementia, particularly as the sheer amount of noise, and patient and staff turnover can create a very disruptive environment.

“The multitude of challenges faced include separation anxiety from what is safe and familiar, receiving healthcare from people with little if any knowledge of their life story and unique psychosocial needs, as well as expectations that are often difficult to achieve,” Professor of Nursing Lynn Chenoweth said.

Ms Chenoweth also said the presence of dementia often complicates care, treatment and outcomes for individuals and the mortality rate for patients with dementia during hospitalisation is five times higher than adults of the same age without cognitive decline.

“A person with dementia requires specialised care, treatment and support to keep them safe during a hospital stay, which can absolutely occur with person-centred care,” Professor Chenoweth added.

Providing person-centred care in hospitals is something that would have a drastic impact on aged care service providers, both residential and home care. 

According to the research, there was a significant reduction in the incidence of delirium, accidents or injuries in the hospital, plus a decrease in psychotropic medicines and readmission rates within 30 days. The rate of discharge to home also increased.  

These findings reveal that patients were returning home in a stronger condition compared to patients who did not receive person-centred care, which would ultimately reduce the burden on informal carers and professionals. 

Consistent application of ongoing person-centred education for hospital staff could therefore give aged care providers more confidence that residents with dementia would return home in a stable condition without deterioration.

“We found that implementing the person-centred care model provided significantly improved clinical outcomes for people with dementia; outcomes which are beneficial for the person and their family/carer and represent an enormous cost benefit for health services”, Professor Chenoweth said.

In addition, the majority of participants who received person-centred care reported high satisfaction rates with their treatment. 

“When person-centred healthcare knowledge is translated through staff education and practice support, persons with dementia can experience improved healthcare services and clinical outcomes, while healthcare services can benefit through reductions in unplanned service use,” the Report concluded.