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The impact of pandemic‐related measures on COVID‐negative dementia inpatients
Author(s) -
Bukala Bernard R,
Carpenter Kilda J,
Fox Willow,
Reyes Demi,
Sanghvi Hazel,
Vickers Philip
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.051624
Subject(s) - dementia , pandemic , medicine , demographics , covid-19 , audit , ethnic group , test (biology) , family medicine , gerontology , demography , disease , paleontology , management , sociology , anthropology , infectious disease (medical specialty) , economics , biology
Background During the COVID‐19 pandemic, infection control measures and changes to patient flow have drastically altered the care provided to inpatients with dementia. Some of these emergency steps mainly affected COVID‐19 positive patients, whereas others had an impact on all. This project aimed to examine the pandemic’s impact on the demographics, care and outcomes of inpatients with dementia who did not test positive for the virus. Methods This analysis formed a part of an overarching initiative at Stoke Mandeville Hospital, which leveraged the National Audit of Dementia (NAD) framework to assess care during the pandemic. A tailor‐made questionnaire was composed of the relevant NAD elements and additional items, including questions on capacity assessment. The full sample included 100 patients with dementia admitted between April and July 2020. In this project, data from patients who tested negative for COVID‐19 (n=75) were compared to the local results of the last available NAD (2018; n=50). A combination of student’s t , binomial, and Chi‐squared statistical tests was applied to numerical, two‐answer categorical, and multiple‐answer categorical data respectively (with FDR correction where appropriate). Results Demographics of dementia patients admitted during the pandemic were different, with fewer males (27% vs. 40% in 2018), fewer ethnic minorities (13% vs. 36%) and fewer patients admitted from their own home (45% vs 63%). During admission, fewer functional assessments were carried out and less patient‐specific information made available. Inpatient falls were less frequent (19% vs. 64%), presumably due to decreased opportunities for mobility. Admissions were shorter overall, but discharges appeared less well planned and coordinated. Rates of delirium and mortality were unaffected. Conclusions While major outcomes appear unchanged, the real impact may be masked by limited, selective admissions. The findings highlight the need to preserve assessment and discharge planning for COVID‐negative patients with dementia during future crisis response measures.