Become a Delirium Detective and Save Lives!
As he opened his eyes to survey his surroundings, nothing seemed normal. The sounds of beeping alarms of varying decibels and the glare of bright lights were constant, as faceless figures rushed by him. A barely restrained sense of imminent crisis was welling up all around him. As he sat up, his body banged against cold tall rails on either side of him and his sense of dread gave rise to full panic – he was penned in – trapped! His brain screamed at him “You’ve got to get out of here – your life depends on it.”
Welcome to the terrifying world of delirium. According to the National Academy of Medicine, up to 50% of all Americans age 65 or older will develop delirium during the course of a hospital stay. Delirium is an acute reversible condition. This differs from dementia which is a chronic progressive deterioration of cognitive function. Research shows that older adults who experience delirium in the hospital are more likely to have injuries, delayed recoveries and develop other medical complications. Understanding the common signs of delirium, reporting concerns promptly and knowing how to handle the symptoms of delirium can avoid catastrophic outcomes.
Signs of delirium:
- Sudden onset of confusion
- Fluctuating levels of alertness
- Poor concentration
- Easily distracted
- Disorientation to time and place
- Rambling speech
- Disturbed patterns of sleep
- Rapid mood swings
- Hallucinations or paranoid beliefs
Here are some simple ways to reduce the odds of your older loved one developing delirium in the hospital:
Provide companionship – Have family members stay with your loved one during an ER visit or hospitalization or pay a trained private caregiver familiar with the conditions of dementia and delirium to stay or rotate in your place. A comforting and familiar presence will reduce fears and anxiety associated with being in an unknown chaotic environment. It will also provide much-needed advocacy in the event that the sick older adult is unable to give an accurate medical history or express their health care wishes.
Create a peaceful and calming environment – Whether it be requesting a private room or a bed by the window – creating a quieter sense of space calms nerves. Inquire if monitor alarm volumes can be reduced or set to more accurate parameters to reduce constant noise. Bring some family photos to decorate the room and supply a familiar pillow or blanket from home to increase a sense of familiarity and comfort. Offer fluids and comfort food from home as allowed by the staff. Consider bringing a small bluetooth speaker or radio to play calm music.
Supply orientation and sensory aides – Provide the room with a clock and calendar that is easily visualized. Ensure your older loved one has their eyeglasses, hearing aids and dentures when needed.
Delirium can often be reversed by treating common causes which can include:
- Medication side effects
- Substance abuse or withdrawal
- Uncontrolled pain
- Low oxygen levels
- Trauma to the head
- Acute medical conditions affecting brain functioning
- Sleep deprivation
- Electrolyte imbalances
Provide hospital staff with an accurate medical history. Have available a printed list of your loved one’s medical conditions, allergies, current medication list and insurance information to supply to the hospital staff. Report any recent signs of infection, trauma, pain, vomiting, or change in bowel or sleep patterns. Alert the staff if a new medication was recently started.
Written by Anne Sansevero