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I am seeking collective wisdom. If your loved one has moderate to severe dementia and develops a fever or other symptoms consistent with COVID-19, would you take them to the hospital? If they cannot understand the questions or explanations, or follow instructions, what good is that?


Would you keep your loved one at home?

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The instructions we are getting in NYC (for anyone, not just elders) are to speak with your health care provider via phone if you have symptoms and follow their advice.

Only go to the hospital if the patient develops breathing problems and only after consulting your provider.

At this point, no one is allowed to accompany a patient into the hospital.

Is your husband receiving hospice services? Are you both isolating at home so that he is not exposed?
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BarbBrooklyn: that’s the same guidance everyone receives, but my question (which I admit I did not make clear in my post) is what to do if your loved one with dementia has covid-19? You wouldn’t be in quarantine with them in the hospital room, so how will they respond to treatment if they do not understand questions, explanations, or instructions?
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Judysai422 Apr 2020
If your husband is on hospice, as my parents are, I would do as for any illness...provide comfort care only. My parents both have DNRs, so they would not go to hospital or be intubated. They have made their choice clear and I would respect that.
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We are fine (knock on wood), and yes, he is receiving hospice care at home. And we are isolating in the house. But I was still going to the office until 2 weeks ago and was out buying groceries last week. Caregivers were taking care of him until last Thurs when I decided to cancel all caregiving and totally isolate ourselves.
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Worried, if your spouse starts to run a fever, you don't send him to the hospital (even in normal times). You would talk to his doctor or hospice provider.

If he develops breathing problems (the only indication for hospitalization) you would need to talk to hospice first and have him dis-enrolled from hospice, right?

I would not send someone with severe dementia to the hospital alone. I would use the comfort pack meds to keep him comfortable and unaware.
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From everything I've read a frail elder has no better chance in a hospital, if the illness is mild they can be cared for and recover at home (wherever that home may be). I personally would never consider sending someone to the hospital for this no matter how ill they become.
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These are hard times & there are hard issues to have to think about.

The name Covid-19 strikes more fear due to this being a new disease but if your LO developed influenza or pneumonia what would the plan be for those? Is an advance care directive or similar health care plan in place?

If active treatment is chosen, if unable to manage at home, transfer to hospital would then be required.

If comfort care is chosen, what supports will be available in the home? Family may be unable to come to help as planned & services may be reduced due to the pandemic?

If very end stage of life I would personally want to stay at home but I would need a lot of support.

Is your LO's Doctor someone you could ask this hard question to?
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Any symptoms I would first call my primary physician and follow their advice.
And the advice may greatly depend on where you live.
Frankly the LAST place I would want to be is in the hospital. IF things can be managed at home you are better off there. If however the conditions worsen or on the advice of the physician then it would be a necessity.

Big question is does this person have a POLST or DNR that indicates no intervention? If so then putting them on a Vent is against the directives of the POLST or DNR making the trip to the hospital unnecessary for the most part.
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