Delirium Lingers for Elderly

Elderly and hospitals rarely mix well together.  

Whether the hospital stay is for a minor procedure or something more serious, some elderly can exhibit a state of confusion, or even aggression, otherwise referred to as delirium, while in hospital and even after returning home. 

Originally perceived as something temporary, a recent study conducted By the Hebrew Senior Life Group of Boston followed a group of Alzheimer's patients up to 3.2 yrs after their original hospital stay. They were able to determine that up to 56% of elderly patients had delirium during their hospital stay. These same elderly, deteriorated 
to a greater degree in the year after their hospital stay, than those in the study group that did not have any delirium.

This study, published in the Archives of Internal Medicine, found that delirium severely affected Alzheimer's patients who entered hospitals for other medial reasons, such as falls, infections,etc. In fact, effects of that delirium were followed by significant cognitive changes even five years after the initial hospital stay. In a manner of speaking then, it became a more permanent state than temporary, although some improvement in the intensity of the original delirium, is also common.

Our family can attest to that with Dad's first hospital stay, in 2004 for a spinal infection. Although he had been a Parkinson's patient for 7 years prior to that point, he had never shown any effects of dementia or cognitive issues. Seemingly overnight, he went from being a lucid, engaging and funny person, to an aggressive, paranoid, delusional stranger who even had a psychotic break. If we had been advised as a family that this can occur to Parkinsons patients during hospital stays in advance, we would have handled everything 
differently.

With dementia now in overdrive throughout the 11 week stay, we had to adjust to a new normal.  Although it did get somewhat better, several months after we brought him home, he was never the same cognitively.  And as the study noted, he deteriorated from that point forward. 

For those family members who have elderly parents or relatives or even friends that are admitted to hospitals, make their rooms as comfortable and 'safe' as possible. Some suggestions include:  bringing in familiar items from home to make them as comfortable as possible by making their hospital room as similar as possible to their usual bedroom; making sure they either have the bed closest to the window in their semi-private or ward rooms; ensuring their rooms are well-lit at all times, and as much as possible, keep their environments quiet, even if that means giving them ear plugs.  

The more comfortable they feel, the greater the chance that they will suffer less effects or none at all, of delirium. If you come across any resistance from the hospital staff, enlist the aid of a Patient's Advocate to give your loved one the health care and attention he/she requires.

Hospitals are disconcerting for most of us, let alone the elderly.