Would You Know What To Do?
You get the phone call that your 79-year-old grandmother has just been admitted to the hospital and when you get there, you discover that she is confused and thinks she is at a hotel instead of a hospital, and is complaining about all the rats that only she can see running across the tiled floors.
Your grandmother is suffering from delirium, the most common complication that occurs with hospitalization for individuals over the age of 65. It’s dangerous and can increase the chances she will die within the year after she leaves the hospital…
Would you know what to do to help her?
Delirium: What It Is
Delirium is a medical emergency but often can go unnoticed amongst the hustle and bustle of a busy hospital or ICU environment. A person developing delirium becomes confused, unable to perceive time correctly, experiences changes in their sleep cycles, may be agitated or have other changes in personality, memory is impaired, with possible hallucinations or delusions.
Delirium is caused when something interrupts normal brain functioning. Having a urinary tract infection, becoming dehydrated, or having a negative reaction to prescription medication or surgery anesthesia are all potential triggers that can set this syndrome off.
Delirium is NOT Dementia
Delirium is NOT dementia… anyone can experience it. Delirium comes on suddenly and fluctuates in severity, and eventually clears up while dementia comes on gradually, is progressive, and is generally permanent. But dementia patients who develop delirium while in the hospital are at higher risk for poorer outcomes.
A brand new study conducted at the Massachusetts Alzheimer’s Disease Research Center found that of the dementia patients who experienced delirium, 43% had to be discharged to a nursing home and 15% died within a year, whether they had been sent to a nursing home or discharged to their homes.
Delirium Affects Non-dementia Patients
Even non-dementia patients who experience delirium after cardiac or hip surgery have been found to be twice as likely to show a decline in their ability to perform normal activities of daily living and an increased risk of dementia in the coming years.
According to Dr. Sharon K. Inouye, a professor of medicine at Harvard Medical School, not only do patients with delirium have a 25% to 70% higher chance of dying during their hospital stay, they also have a 62% higher risk of mortality in the following year. If the delirium occurs in the ICU, the mortality risk within the next year triples for the patient.
Hospital Prevention of Delirium
It’s important to know that steps can be taken to prevent delirium from occurring in the first place, in at least 40% of cases. Beginning with admission to the hospital, there are steps that hospital staff can take to reduce the likelihood that a patient will develop delirium, including screening for risk factors, reducing or stopping all medications that cause drowsiness, preventing sleep deprivation and dehydration, and helping to orient patients to the hospital via staff introductions and charts.
What Can Family Members Do?
1. Have someone with the patient at all times. Family members can take shifts to ensure round-the-clock attention.
2. Be present especially at mealtimes to ensure the patient is getting adequate food and fluids. Remind the patient to drink water frequently throughout the day.
3. Provide cues to help orient the patient. Put a big clock on the wall if there isn’t one in sight. Put up some family photos. Make a sign that says “You are in the hospital” and tape it to the wall across from the patient’s bed if they are unsure of their surroundings.
4. Make sure the patient has their eyeglasses, dentures, or hearing aids to help them remain oriented to the environment.
5. Stimulate the patient with conversation. If safe and approved by their physician, get them up and walk with them 3 times a day.
6. Keep lighting and noise patient-friendly. Bring in a small table lamp instead of using the overhead fluorescent lights. Bring in a CD player that plays soft, familiar music.
What We Can Save
Not only will hospital staff and family members’ efforts to prevent delirium in patients help to save the lives of those individuals, since developing delirium leads to much longer hospital stays (usually up to 10 days longer), preventing delirium could save up to $60,000 to $64,000 per hospital stay per patient. That’s not a small change!
It has been estimated that it costs up to $152 billion in post-hospital expenses for delirium treatment each year, also a 40% preventable expense. Regardless, the one thing we can never do is put a price tag on your loved one’s health. It’s why helping to prevent a case of delirium could be one of the greatest gifts you could ever give to him or her.
It could truly be the gift of life. 🙂
Dr. Anita Sanz, PhD, Psychologist
Learn more about Delirium Prevention here.
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