The impact of pandemic‐related measures on COVID‐negative dementia inpatients

Abstract

BackgroundDuring 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.MethodsThis 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).ResultsDemographics 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.ConclusionsWhile 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.