Archive for the ‘Hospital Delirium’ Category

“Hospital Delirium” – a true concern for our society!

Friday, June 25th, 2010

There is a concerning report posted today by JusticeNewsFlash.com regarding “hospital delirium” in elderly patients. While it has long been recognized that elderly patients in hospitals are many times confused during their hospital stays, “contemporary resarch has indicated that such episodes may be accompanied by significant negative consequences” – longer hospitalizations, delayed procedures, increasing health costs, dementia later in life and a sginifciant rise inpremature death.

The American Geriatrics Society estimated that approximately one-third of patients over the age of 70, experience hospital delirium. Intensive-care and post-surgical patients also have an increased tendency to endure such cognitive lapses.

Though the cause of hospital delirium, more often reported as “confusion,” remains unknown, doctors have become more aware of its potential triggers. These included infections, surgery, pneumonia, medical procedures such as catheter insertions, among others.

All of these cases and procedures have a tendency to incite apprehension in many elderly patients. Certain medications have also been linked to hospital delirium.

McKnight’s, an online source for long-term care and assisted living, reports in a posting on June 24th:

A study has been underway by researchers at Indiana University. The report’s author, Dr. Malaz A. Boustani, referred to delirium among elderly patients as “more dangerous than a fall.”

On June 20, 2010, Pam Belluck, a reporter for the New York Times wrote a piece entitled “Hallucinations in Hospital Pose Risk to Elderly.” She recounts a chilling story of exactly how an 84 year old patient, Justin Kaplan, a Pulitzer Prize-winning historian with a razor intellect … became profoundly delirious while hospitalized for pneumonia last year. For hours in the hospital, he said, he imagined despotic aliens, and he struck a nurse and threatened to kill his wife and daughter.”

Doctors once dismissed it as a “reversible transient phenomenon,” thinking “it’s O.K. for someone, if they’re elderly, to become confused in the hospital,” said Dr. Sharon Inouye, a Harvard Medical School professor.

This thinking is now becoming significantly modified.

Some hospitals are adopting delirium-prevention programs, including one developed by Dr. Inouye, which adjusts schedules, light and noise to help patients sleep, ensures that patients have their eyeglasses and hearing aids, and has them walk, exercise and do cognitive activities like word games.

On a personal note, a very close relative of mine had undergone a knee replacement operation. Within a day of surgery, this elderly woman became so disoriented that she was convinced that she was being attacked by a strange man entering her room in the middle of the night. Fearing for her life, she picked up the nearest ‘weapon’ she could find – the bedside telephone – and struck the ‘intruder’ with the phone. It turned out that this ‘intruder’ was a male nurse coming to take her vitals. Hearing of this incident and shocked that this woman – my mother – would ever do such a thing (since she was the embodiment of the description -”wouldn’t hurt a fly”), my sister and I asked the hospital to check her electrolytes. It turned out that they were wildly abnormal. She was administered the necessary replacement therapy and returned to her normal, sweet self – having absolutely no memory of this incident whatsoever.

It is no secret that as the Baby Boomer population ages, the number of people in our country over the age of 70 will soon be very significant. We can only hope that physicians such as Dr. Sharon Inouye and Dr. Malaz Boustani will continue their research and efforts to learn what can be done to minimize the incidence rate of “hospital delirium.” It is good to see recognition of this problem now exists and that the concept of “it’s OK – it will pass; they’re just confused” is becoming a thinking process of the past.