Simplifying Emergency Room Stays for Dementia Patients - A Helping Hand in German Clinics
- *
Emergency support for dementia patients in the emergency department - Timely support for dementia patients in ER settings – Assistance for Dementia during Emergency Room Visits
Hustle and bustle are common sights in the emergency room, with nurses wheeling patients in and doctors rushing to the next case. For older, especially dementia patients, this chaos can be overwhelming, potentially worsening their chances of recovery. However, volunteer emergency room guides in key German hospitals aim to change that.
At the heart of the issue lies a condition called delirium - a state of sudden, acute confusion. Dementia patients are particularly susceptible to delirium, which often occurs after surgeries and can last for several days. Bettina von Arnim, director of the Clinic for Geriatrics at the University Medical Center in Göttingen, shed light on the matter.
Calming Encounters
To prevent delirium, volunteers such as Kerstin Schneider are on hand at places like Unimedizin. Schneider shares, "Their role is to keep people grounded." Many just need someone to talk to, which helps calm them down. Simple hand-holding can work wonders too, as shown when a dementia woman stopped screaming after Schneider sat beside her.
When interacting with patients, Schneider avoids wearing a lab coat and introduces herself without medical staff. This way, she is perceived separately from the hospital staff, reducing potential anxiety or negative associations. Despite not being medical professionals, the volunteers are subject to confidentiality agreements.
More Helping Hands on the Way
In Göttingen, Schneider is one of two current emergency room guides. Eight more volunteers are expected to join soon, comprising students and seniors. No medical training is needed to become a volunteer guide. Schneider, a retired nurse and active in other volunteer organizations, usually works twice a month for six to seven hours, choosing her own days.
There's always something to do. "I've never just sat around," Schneider admits. On days when the emergency room or emergency room station isn't busy, she looks after people in the geriatric ward. To prepare for her role as a guide, Schneider has undergone training on topics such as dementia, delirium, and hygiene. However, the most important aspect is approaching affected people without bias.
Success in Göttingen
Initially, the nursing staff in the emergency room was skeptical, fearing more people would crowd the narrow corridors. But, as Schneider points out, colleagues are now happy to have the guides because they help alleviate their workload. Since September, the guides have cared for between 30 and 50 affected individuals. However, the project's potential is far greater, according to the medical director of the Central Emergency Room at the UMG, Sabine Blaschke.
Beyond Göttingen
This initiative began as a pilot project at Berlin's Charité in 2019, with the aim of improving patient recovery. By preventing delirium, patients have a significantly lower risk of death. Regular feedback rounds with questionnaires are conducted, with guides and nursing staff evaluating the project's progress. Even small improvements have been noted, with the introduction of a bag containing books and games to keep patients and guides occupied.
Plans are already underway in Göttingen to continue the test phase beyond 2025. The project has also gained traction at the Charité, with officials pledging to keep it going. Volunteer guide Schneider even hopes that similar offers may become available nationwide soon, though they currently are not covered by health insurance.
A Second-best Solution, With Potential for Improvement
The German Foundation for Patient Protection sees the project as beneficial. However, their director, Eugen Brysch, advocates for full-time specialized personnel for dementia care. He also wishes for health insurers to cover the cost of relatives' hospital stays in the emergency department when medically necessary.
While specific guidelines for emergency room volunteer guides for dementia patients in Germany are not provided, the country's emphasis on dementia care suggests a positive context for implementing such programs. Expansion and coverage would depend on integrating these services into existing healthcare frameworks.
[1] https://de.wikipedia.org/wiki/Nationale_Dementiestrategie[3] https://www.laerdal.com/en-us/solutions/quality-improvement/elfa-nursing-home-education
- The implementation of similar emergency room volunteer programs, focusing on mental health and well-being, could potentially be beneficial in other healthcare settings, such as community clinics or hospitals following the science of healthcare.
- Incorporating elements of health-and-wellness, including stress management and mindfulness techniques, into employment policies for healthcare workers could foster a more supportive work environment and contribute to improved patient outcomes, particularly for those with dementia.
