Iris Rinke-Hammer didn’t mind getting the call in the middle of the night. Her partner, Lewis White, suffered from advanced dementia and was in the hospital for a severe urinary tract infection. White, 82, would sometimes walk restlessly for hours, and the nurses often engaged him by asking him to sit with them at their station. “I was so impressed that they didn’t even consider restraining Lewis or sedating him, which would have clouded his mind even more,” says Rinke-Hammer. The nurses also knew that the best way to soothe an agitated patient with dementia and to prevent delirium was to have a loved one with him—which is why they had asked Rinke-Hammer to come to the hospital.
White was in an “acute care for elders” (ACE) unit at the University of Alabama Hospital in Birmingham, which provides specialized care to frail older adults. The primary goal of ACE is to preserve vulnerable patients’ physical and cognitive faculties, which are often jeopardized by a stay in the hospital, and to avoid what the majority of patients fear most—being discharged to a nursing facility instead of being able to go home. During White’s four admissions to the ACE unit, a geriatrician, a geriatrics nurse practitioner, a physical therapist, a pharmacist and a social worker consulted on his care every day, discussing not only his medical problems but also how to minimize the stress and dangers of his hospitalization. The team eliminated drugs that made him drowsy and carefully calibrated doses of others to account for his diminished ability to metabolize them. Staff members helped White walk to maintain muscle strength. While other patients worked on adult coloring books, did puzzles or played cards with volunteers to keep their minds active, White, a jazz aficionado, listened to music his nurses found for him.