Going to the hospital, however, is not always the best (or only) alternative across a spectrum of treatment scenarios. Hospitalization itself can be an intensely disorienting process, especially for patients with advanced dementia. Little surprise, then, that more than half of all elderly patients with dementia who are transferred from the nursing home to a hospital and back will pass away within the following 18 months. Accordingly, hospitalization can be an unfortunate step in the care continuum.
In fact, hospitalization is oftentimes unnecessary. For example, most nursing home patients are sent to the hospital for respiratory infections, which is both avoidable and treatable in a nursing home setting without much trouble. On the other hand, the “do not hospitalize” directive can still provide that a broken bone or the replacement of a medical device can still trigger a hospital visit if you so stipulate.
While advanced directives do some important work, according to some the “do not hospitalize” directive can help assure more peaceful late-in-life care.
