Delirium often affects hospitalized seniors
People with delirium often have terrifying hallucinations, delusions, and are unable to think or focus. In older hospital patients, delirium is often misdiagnosed as dementia. If that happens, they won’t get the right treatment and could even be sent to a nursing home.
In an article in Kaiser Health News, it’s said that delirium affects 7 million hospitalized Americans each year Delirium can happen at any age, but it’s more common in hospitalized people older than 65.
As if the delirium itself wasn’t bad enough, research has also linked it to longer hospital stays, greater risk of falls, increased risk of developing dementia, and an increased death rate.
We explain how delirium is different from dementia, what happens when someone has it, what causes it to happen, and how to prevent it.
Delirium is different from dementia
Delirium and dementia are two different conditions. Dementia develops gradually and gets progressively worse.
Delirium happens suddenly and usually changes during the course of a day. Some patients with delirium are agitated and combative and others are sleepy and can’t pay attention.
What happens when someone has delirium?
People with delirium have cognitive and memory problems, hallucinations, and symptoms of post-traumatic stress disorder (PTSD).
Some people talked about horrific hallucinations like being on stage covered in blood or being burned alive.
Psychologist James C. Jackson of Vanderbilt’s ICU Recovery Center says these horrible experiences are typical. Some delusional memories are distortions of things that have actually happened – like patients who got catheterized thinking they were sexually assaulted or people getting MRIs thinking they were being put into a giant oven.
What causes delirium in hospitals?
Delirium is more likely to develop when patients are in intensive care, heavily sedated, and on ventilators – up to an 85% chance! It’s also common when patients are recovering from surgery and with something as simple as a urinary tract infection.
Once the delirium starts, it can last for months.
Delirium is preventable
Dr. Sharon Inouye, a geriatrician and professor of medicine at Harvard Medical School says, “Delirium is very underrecognized and underdiagnosed…physicians and nurses often don’t know about it.” She also says that preventing delirium is crucial, because “there still aren’t good treatments for it once it occurs.”
Researchers say that about 40% of delirium cases are preventable.
Many cases are triggered by treatments that older adults are especially sensitive to, like large doses of anti-anxiety drugs and narcotics. Other cases are caused by the busy, noisy, brightly lit environments where sleep is constantly interrupted and the staff keeps changing.
What are hospitals doing to prevent delirium?
Some hospitals are trying to prevent delirium by being more careful about medication, especially benzodiazepines. They’re trying to get ICU patients off breathing machines sooner, to limit the use of restraints, and to get patients out of bed and moving sooner.
And, they’re also making the environment more pleasant by turning off room lights at night, installing large clocks, and keeping noisy machine alarms to a minimum.
Delirium is a serious condition that causes seniors a great deal of suffering on top of the medical condition that landed them in the hospital. And sometimes, recovering from delirium takes far longer than recovering from the medical condition.
If your senior suddenly starts showing signs of cognitive issues during or after a hospitalization, don’t assume it’s dementia – it could be delirium.