Unnecessary Transitions Linked to Medication Errors, Readmissions, Risk of Death

Unnecessary Transitions Linked to Medication Errors, Readmissions, Risk of Death

Having coordinated care and a long-term care plan in place that considers the needs of a person with dementia may reduce unnecessary transitions, say the authors of a study published in the Journal of the American Geriatrics Society. For older adults, especially those with dementia, some transitions may be unavoidable and necessary. However, unnecessary transitions are linked to problems such as medication errors, hospital readmissions, and increased risk of death. Good dementia care emphasizes the need for familiar people and familiar environments. This can be more difficult to support when too many transitions take place.

In their study, researchers from the UBC Centre for Health Services and Policy Research in Vancouver, British Columbia, followed 6,876 people aged 65 and older and found a spike in the number of transitions during the first year of dementia diagnosis. Sixty-five percent of the study participants experienced at least one transition during the year of their diagnosis; 17 percent experienced three or more transitions, most of which were hospitalizations. More than 60 percent of people were hospitalized in the year of their diagnosis, and these hospital stays generally lasted for a month or longer.

People experienced a higher number of transitions the year prior to and the year of their death. Receiving a prescription for an anti-psychotic medication as well as living in more rural areas increased risk too.

Receiving ongoing care from a known primary care physician and receiving care consistent with dementia guidelines were linked to fewer transitions.

The year of diagnosis is often overwhelmingly stressful. Still, steps can be taken to lessen transitions and improve care. These include:

  • Connection to an ongoing primary care provider
  • Early, advanced care planning consistent with one’s wishes
  • Having a patient advocate who can help with care coordination
  • Increasing caregiver and provider awareness of community support systems