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An Under-Recognized Danger for the Elderly: Delirium
Conversation Continues | November 22, 2011
Conversation Continues feature ongoing discussions or news on current health topics with links to related materials.' They are part of the Center for Advancing Health's portfolio of free, evidence-based coverage of what it takes to find good care and make the most of it.' By Kelly Malcom, Editor, CFAH's Health Behavior News Service.
In Another Hospital Hazard for the Elderly on the New York Times New Old Age blog, Susan Seliger details the frightening experience of her elderly mother's hospitalization for a broken hip.' Over the course of treatment, her once lucid mother becomes disoriented and agitated due to hospital delirium. ' Seliger notes that each year, 20 percent of the 11.8 million elderly patients in hospitals develop delirium ' characterized by a sudden change in mental status associated with physical illness and related medications. ' It can be scary, she says, 'Delirium signals that something in the body is seriously wrong and needs attention, fast."
Prepared Patient guest blogger Nora O'Brien-Suric recounted a similar experience with her 80-year-old father following his triple bypass surgery. While her family and her father's physicians attributed his startling mental changes to possible dementia, Suric's training as a geriatric social worker led her to suspect delirium. ' But, she argues, you shouldn't need to have professional training to deal with this situation effectively: 'It seems to me that older patients and their caregivers should be better informed about post-operative confusion and how to deal with it,' she writes. Clearing up this confusion can help family members recognize a change in mental status as possible delirium and not sudden dementia -and quickly notify clinicians.
Delirium is also associated with higher rates of mortality in elderly patients. ' New research in the journal General Hospital Psychiatry has shown that elderly patients who received a psychiatric consultation and were diagnosed with delirium were more likely to die within the first year following the diagnosis than patients without delirium. ' Delirium symptoms typically fall into three categories: hyperactive'with symptoms such as agitation and disturbed behavior; hypoactive'with symptoms such as confusion or inattention; a mix of hyperactive and hypoactive.' The study authors note that elderly patients are more likely to display the quieter symptoms of delirium, which can be confused with dementia, depression or illness. ' This difference, combined with the subsequent delay of treatment, may contribute to higher death rates.
A Wall Street Journal article details recent changes to ICU protocols in a growing number of hospitals designed to help reduce delirium and other risks associated with this type of care. But, notes columnist Laura Landro, caregivers still play an important role. 'Since ICU patients generally can't monitor their treatment, it's important for friends and family to make sure the critically ill are getting the most attentive care.'
- Talking About Symptoms With Your Health Care Team ' Prepared Patient
- Listening to My Mother - Corinne H. Rieder, EdD
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Conversation Continues feature ongoing discussions or news on current health topics with links to related materials. They are part of the Center for Advancing Health’s portfolio of free, evidence-based coverage of what it takes to find good care and make the most of it.
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