1. Laurel Waller, Executive Director
Impact of Alzheimer’s Disease & Cognitive Impairment on Health Outcomes in Acute Care
Laurel Waller, Executive Director |

2. Our mission To eliminate Alzheimer's disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision A world without Alzheimer’s.

3. Dementia Alzheimer’s Dementia Alzheimer’s disease A set of symptoms
Gradual in onset
Decline in cognitive ability, judgement, orientation, function at home/work/community
Alzheimer’s disease
The most common cause of dementia in people over age of 65

4. Continuum of Alzheimer’s Disease
Normal
Alzheimer’s disease
Adapted from Sperling et al. 2011

5. Alzheimer’s disease & related dementias are effecting our care systems, whether we know it or not.

6. Alzheimer’s disease & related dementias are effecting our care systems, whether we have the capacity or not.

12. Care Partner Health & Well Being at Risk
Physical and emotional impact of dementia caregiving is estimated to have resulted in $9.7 billion in health care costs in the U.S.

16. Dementia
Delirium
Depression

19. Detection
Diagnosis

21. Barriers to Diagnosis
Misidentification of early stages of dementia as “normal” part of aging
Social skills often maintained early in disease
Denial by patient and/or family
Social stigma associated with diagnosis
Lack of definitive screening and diagnostic testing

25. 8 Domains Affected by Alzheimer’s
Memory
Where am I? Why am I here? What is connected to my arm?
Concentration (Attention, Perception, Abstraction)
What should I be doing? Who are all these people?
Orientation
Where am I? Where is my family?
Judgement/Problem Solving
I don’t need to stay here. Who will feed my cat?
Activities of Daily Living
I can get up and walk to the bathroom
Mood
I can’t sleep in a room with a stranger. I am sad, scared and in pain.
Spirituality
No one here really knows me and what I need to feel in control

27. Adverse Health Events 3 to 6 times more likely to develop delirium
1.6 to 5 times more likely to fall
5 times more likely to develop new urinary incontinence
6 times more likely to develop fecal incontinence
5 times more likely to develop pressure sores
Driver of costs, adverse health events

28. Adverse Health Events More likely to have untreated pain
2 to 4 times more likely to lose ability to perform ADLs during a hospital stay
Significantly less likely to regain preadmission functional abilities
2 to 4 times more likely to be discharged directly to a nursing home
3 to 7 times more likely to be living in a nursing home 3 months after discharge

29. Communication/Behavior
Increased potential for catastrophic reactions
New Environment
Overwhelmed
Fatigue
Pain
Behaviors are communication signals

30. Safety Concerns 6/10 people with Alzheimer’s will wander.
Dementia Capable environment
Preventing Falls
Clear Directions

32. The CARE Act requires hospitals to:
Record the name of family caregivers on the medical record of a loved one
Inform the family caregiver when their loved one is discharged to the patient's residence
Give the family caregiver education and instruction in all after-care tasks described in the discharge plan
ADDITIONAL INFORMATION (do not read as part of presentation)
West Virginia specific language
A hospital shall provide a patient or the patient's legal guardian with an opportunity
to designate one lay caregiver following the patient's admission into a hospital.
The hospital shall record the patient's designation of a lay caregiver, the relationship of
the lay caregiver to the patient, and the name and contact information of the patient's designated lay
caregiver in the patient's medical record.
The hospital shall notify the patient's designated lay caregiver of the patient's discharge to the patient's residence as soon as possible
As soon as possible and, in any event, upon issuance of a discharge order by the patient's
attending physician, the hospital shall consult with the designated lay caregiver along with the patient
regarding the lay caregiver's capabilities and limitations and issue a discharge plan that describes a
patient's after-care needs at his or her residence.
At minimum, a discharge plan shall include:
(1) The name and contact information of the lay caregiver designated under this article;
(2) A description of all after-care tasks necessary to maintain the patient's ability to reside
at home, taking into account the capabilities and limitations of the lay caregiver; and
(3) Contact information for any health care, community resources and long-term services and
supports necessary to successfully carry out the patient's discharge plan.
The hospital issuing the discharge plan shall provide the lay caregiver with instruction
in all after-care tasks described in the discharge plan. At minimum, the instruction shall include:
(1) Education and instruction of the lay caregiver by a hospital employee or individual with
whom the hospital has a contractual relationship authorized to perform the after care task
(2) An opportunity for the lay caregiver and patient to ask questions about the after-care
tasks; and
(3) Answers to the lay caregiver's and patient's questions provided in a competent manner
and in accordance with the hospital's requirements to provide language access services under state
and federal law.

34. Resources
Improving Hospital Care for Persons with Demetnia, Nina M. Silverstein & Katie Maslow
The Alzheimer’s Health Care Handbook, Mary S. Mittleman, Dr. PH & Cynthia Ep
Alzheimer’s Association Facts & Figures
Alz.org/Health-Care-Professionals

35. Care & Support 24/7 Helpline, 800.272.3900 Care Consultations
Support Groups
Lending Library
Community Education
Educational Outreach
Professional Training

37. How You Can Help Host a community workshop Join advocacy efforts
HOPE for Alzheimer’s Act
Free educational materials for staff & patients
Alz.org/TrialMatch

38. Facebook.com/AlzheimersAssociationWVChapter Twitter.com/FightAlzWV
Laurel Waller, Executive Director |