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Background
The number of people living with dementia is increasing as communities grow older. Many people living with dementia do not have a formal diagnosis. Most healthcare professionals do not receive specialized training on dementia.
In the hospital, people living with dementia are at greater risk of developing delirium, infections, and other complications. They are more likely to have longer hospital stays, reduced functional abilities at discharge, and higher readmission rates.
Hospitals are especially challenging for people living with dementia. The busy and unfamiliar environments, strange sounds, new people, changing schedules, and often new medications can be disorienting and even upsetting for people living with dementia. Infection prevention measures—such as restricting visitors and wearing face-covering personal protective equipment—can be further disorienting for patients living with dementia.
Hospitals have found that ongoing dementia education with connections to practice, such as dementia friendly training programs, improve dementia care. Dementia friendly efforts also align well with the Age-Friendly Health Systems initiative led by The John A. Hartford Foundation and the Institute for Healthcare Improvement.
Who should use this toolkit?
The Dementia Friendly Hospital Toolkit is intended for is intended for hospital leadership, education staff, or whoever is leading the hospital’s dementia friendly initiative. The toolkit was developed with input from and piloted by a range of hospitals across Wisconsin, from rural critical access hospitals to urban academic centers. The toolkit includes training materials for clinical and non-clinical staff, as an organization-wide approach is key to dementia friendly initiatives.
What does the toolkit contain?
The Dementia Friendly Hospital Toolkit includes:
- An organizational guide that helps hospitals develop an ongoing training plan based on their goals and learning opportunities
- Eight interactive role play scenarios, with learning objectives, facilitator guides, scripts, handouts, and options for carrying out role play trainings
- Five short training videos, with learning objectives, handouts, and options for using the videos
- Additional resources that help hospitals measure progress, align their dementia friendly work with Age-Friendly Health Systems initiatives, and provide additional context on the common needs of and supports for people living with dementia and their family caregivers
How should these tools be used?
The materials in this toolkit are designed to help hospitals:
- Set their own goals for becoming more dementia friendly
- Develop a training plan
- Provide education to staff across roles
- Support ongoing awareness and learning
- Connect with community groups and resources
- Measure progress and share success stories
The organizational guide, “Planning for your hospital,” is intended for hospital education staff or whoever is leading the hospital’s dementia friendly initiative. That section will help users develop a dementia friendly training plan for their hospital. As the hospital carries out its training plan, materials from the rest of the toolkit will be shared with hospital staff who are participating in various dementia friendly activities.
Development of this toolkit
The Dementia Friendly Hospital Toolkit was developed by a team at the University of Wisconsin–Madison School of Nursing, including faculty with clinical and research expertise in dementia care and led by the School’s Center for Aging Research and Education.
This project was supported by the Oscar Rennebohm Foundation. Additional support was provided by the University of Wisconsin School of Medicine and Public Health’s Health Innovation Program (HIP), the Wisconsin Partnership Program, and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 9 U54 TR000021 from the National Center for Advancing Translational Sciences (previously grant 1 UL1 RR025011 from the National Center for Research Resources). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.
Please send questions, comments and suggestions to HIPxChange@hip.wisc.edu.
References
- Jackson, T. A., MacLullich, A. M. J., Gladman, J. R. F., Lord, J. M., & Sheehan, B. (2016). Undiagnosed long-term cognitive impairment in acutely hospitalised older medical patients with delirium: A prospective cohort study. Age and Ageing, 45(4), 493–499. https://doi.org/10.1093/ageing/afw064
- Fogg, C., Griffiths, P., Meredith, P., & Bridges, J. (2018). Hospital outcomes of older people with cognitive impairment: An integrative review. International Journal of Geriatric Psychiatry, 33(9), 1177–1197. https://doi.org/10.1002/gps.4919
- Hebert, C. A., & Scales, K. (2019). Dementia friendly initiatives: A state of the science review. Dementia, 18(5), 1858–1895. https://doi.org/10.1177/1471301217731433
Toolkit Citation
Endicott SE, Farsetta D, Woywod P, Bratzke L. Dementia Friendly Hospital Toolkit. Center for Aging Research and Education, UW-Madison School of Nursing. Madison, WI; 2024. Available at: http://www.hipxchange.org/toolkit/dementia-friendly-hospital-toolkit
About the Authors
Sarah Endicott, DNP, PMHNP-BC, GNP-BC is a board-certified psychiatric-mental health nurse practitioner and geriatric nurse practitioner with experience caring for older adults with complex needs across care settings. Her current clinical practice is geriatric psychiatry in long-term care and on a geriatric psychiatry unit. She teaches in the Doctor of Nursing Practice program at the UW–Madison School of Nursing and serves as a preceptor for students in medicine and nursing. Her interests include the education and support of caregivers for people living with dementia.
Diane Farsetta, PhD is a biologist with extensive community engagement and nonprofit leadership experience. She is the manager of the Center for Aging Research and Education (CARE) at the University of Wisconsin-Madison School of Nursing. In that role, Dr. Farsetta facilitates campus and community collaborations on projects advancing older adult health and well-being. In 2023, she was named a Morgridge Fellow, which recognizes and furthers community-engaged scholarship at UW-Madison. Dr. Farsetta has helped develop and lead projects to engage older people from under-resourced communities as research advisors, to provide students with community-based learning opportunities on supporting the personhood of people living with dementia, and to develop an online tool offering guidance to family care partners of older adults.
Paula Woywod, DNP, MSN, RN, CHSE co-authored CARE’s Dementia Friendly Toolkit and Dementia Friendly Hospital Toolkit. Previously, she taught School of Nursing students in simulated learning environments. She has practice experience in medical surgical, cardiac, and intensive care settings. She is passionate about incorporating active learning and education to support the care for older adults in clinical and community settings.
Lisa Bratzke, PhD, RN, ANP-BC, FAHA studies cognitive impairment of patients with coronary heart disease, who, according to health data, suffer from concentration or memory difficulties. With coronary heart disease on the rise—40 percent of the U.S. population is projected to have some form of it by 2030—she is examining ways to slow deteriorating cognitive function in this population, thereby improving quality of life for individuals with chronic heart failure.