In-Home X-ray Improves Experience for Dementia Patients

Providers who have imaged patients with dementia know that the process can be delicate and complicated as many of these individuals can experience fear, anxiety, and even anger when they find themselves in an unfamiliar environment. But, new research out of Denmark indicates at-home X-ray can help solve this problem.

Investigators, led by J.M. Jensen, from the Health Sciences Research Center at the University College Lillebelt, launched an initiative in an nursing home in 2018. Their goal was to determine whether patients with dementia could respond better to X-ray services provided in their normal living space.

Their determination? Providing these imaging services in a familiar environment significantly improved the experience both for the patient and the provider. The team published their results recently in Radiography.

“Mobile X-ray examinations for patients with dementia living in nursing homes had a positive impact on patients’ reactions towards the X-ray examination,” the team said. “The patients appeared calm and relaxed during the examination in their usual environments where there are less stimuli.”

By shifting these services to the patient’s home, there was no longer a need to transport the patient, potentially putting them in a position to wait for a long time in an unfamiliar place. Consequently, the team determined, the entire X-ray experience was truncated from roughly five hours to 25 minutes overall. Streamlining the process also distinctly lowered the likelihood that patients would become verbally or physically aggressive as is frequently the case when they feel frightened, threatened, or confused if their normal routine is changed.

To reach this conclusion, Jensen’s team conducted in-home X-ray exams between October 2018 and November 2018 on 23 nursing home patients living with dementia. Caregivers were present, and two observers were also on-hand during the exam. After the images were captured, the observers conducted six 10-minute-to-20-minute interviews with caregivers. Based on these conversations, the team identified four over-arching themes.

• In their normal environments, patients continue to feel safe and calm – some even joked about the experience.
• Good first impressions were important to the quality of the overall exam. If the experience started off well, it was apt to continue in the same fashion. Most patients smiled and remained happy, and even those who were in pain navigated the experience in a positive way.
• Involving the patient makes the experience more successful. Radiographers who communicated with the patient during the exam – listening to them and talking with them – were able to finish the studies faster.
• Communication is still likely to be difficult. Offering slow, clear instructions helps patients understand what is going on and can decreased the chance of confrontation and difficulty.

Ultimately, the team concluded, their results – and use of a mobile X-ray unit – could change clinical practice for patients with dementia.

“Knowing that unfamiliar environments can trigger distress and be overwhelming for a patient [living with] dementia,” the team said, “the findings indicate that mobile X-ray examinations are beneficial for patients living in nursing homes.”