Research to identify hospital patients who suffer from cognitive impairment – which can indicate dementia and the more acute problem of delirium – is being showcased this week at the 2014 Alzheimer’s Association International Conference in Denmark, thanks to the work of Dr. Shirley Neitch and colleagues from around West Virginia.
The research project was the outgrowth of a West Virginia project called Make a Plan (MAP) for Alzheimer’s, a consortium of stakeholders familiar with the issues germane to Alzheimer’s.
“Our chapter welcomes opportunities to provide and enhance care and support for individuals with Alzheimer’s and other dementias and their care partners,” said Laurel Kirksey, executive director of the Alzheimer’s Association, West Virginia chapter. “This project provided a unique opportunity to create an observation method to assist staff in acute care settings to recognize cognitive impairment in an effort to help improve patient outcomes for West Virginia’s citizenry. We look forward to the opportunity to pilot this project in partnership with direct care staff.”
Neitch, a geriatrician and the section chief of geriatrics in the department of internal medicine at the Marshall University Joan C. Edwards School of Medicine, has researched dementia for decades and says identifying patients with cognitive impairment in an acute care setting is difficult because the symptoms or signs are often very subtle.
“Many people can identify severe delirium or advanced Alzheimer’s because it’s visible, but earlier or milder cognitive impairment is more difficult to assess,” she said. “The protocol we’ve developed and dubbed Universal Observations is an empowering and useful tool for all health care workers in the acute care setting that helps them identify patients who need to be screened for dementia.”
Universal Observations is a system of red flag observations of patient behaviors, including patients who are given food trays but never eat, patients who appear to be bewildered or fearful, or those who wander or engage in non-purposeful activity. Unlike screening tools for defining dementia, which are numerous, Neitch says there are few guidelines to identify exactly which patients need to be further screened.
“This protocol allows everyone in the hospital setting, from food service workers and maintenance folks to the doctors and nurses, to have input on what they see. Our motto is, ‘if you see something, say something.’ Our hope is that cognitive impairment, which can have a significant impact on patient outcomes, will be picked up, identified and addressed.”Neitch says the next step for the project is implementation of a pilot program, which she hopes will occur in the next year.
The project was funded by the Claude Worthington Benedum Foundation and is the collaborative work of Neitch; Jane Marks, B.A., CDP, Dementia Specialist/Consultant; Mary Emmett, Ph.D., CAMC Research Institute; the Acute Care Workgroup of West Virginia’s Make a Plan for Alzheimer’s Program and the Alzheimer’s Association, West Virginia Chapter.
Marks is presenting the research poster in Denmark.
