Seniors at Highest Risk of Hospitilization-Related Delirium
Approximately seven million Americans, many of them seniors, develop delirium during hospital stays annually. Although Delirium has no age restriction, those 65 or older are at the highest risk.
Delirium can cause lack of focus, delusions, and frightening hallucinations. These symptoms frequently are misdiagnosed and treated as Dementia, which results in incorrect treatment and, in some cases, admission into nursing homes where treatment continues but never actually addresses the Delirium.
Patients with Delirium are also subject to further risks: falls, longer-than-expected hospital stays, development of Dementia, and elevated death rate.
How does Delirium differ from Dementia?
Although Delirium patients’ symptoms may be similar to some symptoms of Dementia, they are two distinct conditions. Delirium occurs suddenly, usually changing as the day wears on. Symptoms may include agitation, inability to pay attention, lethargy and sleepiness, or combative behavior.
Delirium patients suffer memory and cognitive issues, frightful hallucinations, and some symptoms of PTSD such as anxiety, paranoia, or anger.
Symptoms of Delirium
Hallucinations are quite common in patients with Delirium -- such as mistaking an MRI machine for an oven which will burn them alive. Sometimes patients distort things that actually happened into horrible things that seem connected in their delirious mind. For instance, a catheter insertion might be mistaken as a sexual assault.
Causes of hospital-related Delirium
Seniors have as great as an 85% chance of developing Delirium while heavily sedated, in ICU (intensive care unit), in surgical recovery, and/or on ventilators. Other simple problems, such as a bladder infection, can be exacerbated by hospitalization and can lead to development of Delirium. It is important that you make known to your loved one’s hospital care team or treating physician any altered mental status exhibited by the patient. While your senior may recover as expected from the initial condition that led to hospitalization, Delirium, once begun, can take months to abate.
Prevention is critical
Almost half of Delirium occurrences are preventable. Prevention, however, is often thwarted by a lack of proper recognition and diagnosis Delirium prevention is critical because of a dearth of good treatment protocols after onset.
Older adults are particularly sensitive to some treatments. Many Delirium cases are caused by such treatments as meds for anxiety and narcotics. Environmental triggers can also cause delirium. These include the noise from busy staff going about their tasks, overly bright rooms, and frequent interruption of sleep.
Some hospitals try prevention
Some hospitals try to prevent Delirium by striving to shorten the length of time ICU patients spend on ventilators, limiting the use of restraints, and getting patients out of bed more quickly. They are also taking more precautions with medication, especially benzodiazepines.
Environmental precautions taken by some hospitals include installing large, easily read clocks; keeping audible alarms to a minimum; and turning off room lights at night.
The bottom line
Delirium is serious and adds suffering to the recovery of a hospitalized patient’s initial medical condition. And sometimes, recovering from that initial condition takes far less time than recovering from Delirium.
If your senior suddenly starts showing symptoms of an altered mental status during or after hospitalization, then don’t jump, or let your senior’s doctor jump, to the conclusion that it’s Dementia. Make sure to have your loved one evaluated for Delirium. The sooner Delirium is diagnosed, the better your senior’s chance of recovery and survival.
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