We just had my mother in our local hospital due to one of her TIA spells she has. My wife and I were were explicit as to Mothers' degree of understanding and ability of reasoning, she has little. We found out that if a patient can not do everything for them selves, brushing teeth, shower, go to the restroom, choose selection of meals, operate call button, etc., the staff has no clue. My wife had to dump her bed pan, change her depends, give her a shower, clean her up after a BM because no one showed up. Mother had no breakfast because she was served pancakes. No one bothered to asked her if she liked them or not.
Yes we were on call 24/7 for any questions. Yes the staff assured us they understood about her condition. Is this common for most hospitals? This incident has driven our confidence down to nil in hospital competence.
I hate to think it could be the reason, but I wonder how much hospitals budget for income from Medicare. There seems to be no logic or concern for quality of life when these procedures and tests are ordered. Obviously, any person over the age of 80 has a LOT of symptoms for which tests could be ordered and procedures done. When did doctors stop caring about the patient as a person who wants a life, not just to continue breathing while cognitively deteriorating. And, you're exactly right, loved ones are easily bullied because, even though their head tells them they should not give consent, their heart is listening to the doctor talking about "doing everything you can." The information the doctor doesn't share is the enormous, prolonged suffering that can result from some of these procedures, pacemakers in particular. I think that, before a pacemaker is installed or replaced in a person who is in the advanced stages of terminal dementia, that the doctor's order should have to pass an ethics review. Sadly, I'm sure that would just stir the pot among the 'death panel' crowd.
Colonoscopies seem to be a favorite. One of the many doctors treating my father-in-law during his final hospitalization ordered one while he was actively dying! We were able to put a stop to it, but couldn't stop the replacement of his pacemaker.
I've told my family that if I'm one of the unlucky ones and am diagnosed with dementia of any kind, I don't want any medical intervention that's non-palliative; no BP meds, no aspirin a day, no cholesterol meds, nothing. I'm not a religious person, but if I'm fortunate enough to live to a ripe old age, God's will is how I want to go out. Not being kept alive as a cash cow for a perverse health care system.
We had the same situation with a family member. Though he was experiencing hallucinations and was completely disoriented, a doctor had him give consent to an invasive procedure even though it clearly stated on his chart that his daughter had medical POA. That procedure bought him an additional month of suffering.
Even at the adult day care where she was, when I complained about the verbal and physical abuse I had witnessed, I was told that "even" if that was true, the clients would forget about it anyway. And these were professionals!
You have to be very vigilant, & don't assume that medical personnel know what dementia means.
Each time my husband is hospitalized I make sure there is family with him 24/7. I did this myself one stay, and don't recommend it as a one-person job! The next time our children and I rotated shifts.
My advice? Explain the condition to the head nurse and also have family present 24/7.
As our population ages and dementia becomes even more common, I think the hospital profession will learn to deal with this. They are not there yet!