Overall, acute hospital service activity currently attributable to caring for people with dementia is already considerable, and this is likely to increase significantly in coming decades.
Despite the fact that underlying cognitive impairment has a profound effect on in-hospital complication rates, cost of care, and longer term outcomes, a substantial proportion of cases of dementia are not identified throughout a hospital admission.
As well as changes to the physical hospital environment, this requires an enhanced focus on key strategies such as reliable identification of cognitive impairment, access to comprehensive geriatric assessment, prevention and management of delirium, and timely discharge planning.
While often attractive to policy makers, admission avoidance strategies are unlikely to represent a cure-all for the current issues surrounding acute medical care of all older people, particularly those with dementia, and making the acute hospital more dementia friendly must therefore remain an important aim.
