gms | German Medical Science

Background and Purpose: An increasing number of older persons with cognitive impairment (PwCI) use inpatient services for co-occurring acute illness. PwCI face more adverse health outcomes during hospitalization than their age counterparts without cognitive impairment. As hospitals tend to be ill equipped to meet the complex care needs of this population, various initiatives underscore the need to better utilize existing evidence to improve quality of care.

Methods: Using a scoping review methodology, electronic databases, reference lists, and websites of relevant organisations were searched. Publications were included if they targeted acute care issues relating to PwCI 65 years or older, their family members, or health professionals caring for them, and were published after 2000. Data were extracted using a predefined template, and analysed using thematic analysis.

Results: Of the 1445 identified publications, 62 were included. Experiences of care and best practice for acute inpatient services pertained to structural (such as staff capacity and knowledge) and process dimensions (such as assessment and interventions with PwCI), underpinned by principles of person-centredness and family engagement.

Conclusions: There is a discrepancy between a clearly defined best practice for PwCI utilising inpatient services, and the actual care experience of PwCI, family members, and staff. Research reveals a sobering picture of inadequate care and manifold challenges encountered by PwCI, family members and staff alike. Organisation-wide efforts to ensure best care for this patient group are urgently needed.