DEMENTIA PERIOPERATIVE ADVOCACY

Dementia Perioperative Advocacy

Information for Families and Supporters

Hospital admissions, surgery, and procedures can be confusing and frightening for people living with dementia. Dementia Perioperative Advocacy provides a skilled, dementia‑informed advocate to support the person and their family before, during and after hospital care.

What is Dementia Perioperative Advocacy?

It is independent, private advocacy and companionship focused on safety, communication, dignity, and emotional regulation throughout:

• Pre‑operative assessments and consent processes

• Day surgery, theatre waiting areas, ICU, or ward admissions.

• Transfers (including Emergency Department presentations)

• Post‑operative recovery and discharge planning.

The advocate works with families and clinical teams to reduce risk and improve outcomes.

Why is this support important?

People with dementia are at higher risk of:

• Delirium, distress, and behavioural escalation

• Missed history or misunderstood needs.

• Falls, dehydration, pain under‑recognition

• Early discharge without adequate planning

A familiar, skilled presence helps:

• Reduce anxiety and agitation.

• Improve communication between family and clinicians.

• Support informed consent and best‑interest decision‑making.

• Maintain dignity and personhood.

What does a Dementia Perioperative Advocate do?

Before admission or surgery

• Gathers a clear life story, routines, triggers, and calming strategies.

• Clarifies substitute decision‑makers and consent pathways.

• Prepares a dementia‑specific hospital plan for clinicians.

• Liaises with the hospital to flag risks and reasonable adjustments.

During hospital care

• Provides continuous or targeted bedside presence (as agreed)

• Interprets behaviour as communication and de‑escalates distress.

• Supports pain, hunger, toileting, and sensory needs.

• Assists families to ask the right questions at the right time.

• Advocates respectfully with staff if risks emerge.

After surgery or admission

• Supports discharge planning and safe transitions.

• Links families with community, aged care, or rehabilitation services

• Documents concerns or follow‑up actions if needed.

Is this allowed in hospitals?

Yes. Private hospitals and many public settings allow private advocates or companions, particularly where patients are vulnerable.

Advocates:

• Do not replace clinical staff.

• Do not give medical advice.

• Work collaboratively and professionally.

Their role is to support communication, safety, and dignity.

Ambulance and Emergency Department support

Where appropriate, advocacy can extend to:

• Planning for Emergency Department presentations

• Supporting handover information for SA Ambulance Service (SAAS)

• Assisting families during long ED waits or transfers.

(This is arranged case‑by‑case.)

Costs and private health insurance

 

Dementia Perioperative Advocacy is a private service.

• Fees are usually paid by the patient or family.

• Some private insurers may consider rebates for approved support services, but this varies.

• Advocates can provide clear invoices and service descriptions for insurer enquiries.

When should families consider engaging an advocate?

Consider early referral if:

• The person has moderate to advanced dementia.

• There is a history of delirium or hospital distress.

• Family cannot be present consistently.

• Surgery, ICU, ED, or complex discharge planning is expected.

Early involvement often prevents crises later.

How to engage Aged Care Counselling and Advocacy SA (ACCAASA)

ACCAASA provides specialised Dementia Perioperative Advocacy across South Australia.

Referrals can be made by:

• Families or substitute decision‑makers

• Aged care providers

• Private hospitals or specialists

Contact ACCAASA early to discuss needs, scope of support and availability.

Dementia care is not just about procedures — it is about people, safety, and dignity at every step.