Preventing Delirium at Home and in the Hospital
Delirium is a type of confusion that develops suddenly鈥攐ver the course of hours or days鈥攁nd most commonly affects older adults who are hospitalized or in a long-term care facility.
鈥淲e refer to delirium as an acute onset brain failure, because it comes on so quickly,鈥 says Roxanne Weiss, MD, a geriatrician and medical director of the Hospital Elder Life Program (HELP) at 麻豆学生精品版. 鈥淵our loved one may appear to be doing fine, and then the next moment they seem confused or are hallucinating. They may not be able to focus, they may go on tangents, or they may just seem lethargic and less engaged.鈥
While delirium is a temporary condition, and most episodes resolve within a few days, it should be treated as a medical emergency. Letting delirium go unaddressed can lead to longer hospital stays and other cognitive disorders in the future. Watching a loved one suffer from delirium can be upsetting, but it is preventable.
Understanding the Risk Factors
Preventing delirium from occurring in the first place is key for faster recovery times. Understanding and promptly addressing any risk factors can result in more positive long-term outcomes than if delirium is left untreated.
Some delirium risk factors are outside of your control, such as:
- Being over the age of 65
- Having dementia or another cognitive disorder
- Organ failure
- Serious infections
- Needing anesthesia for surgery
- Admission into the Intensive Care Unit (ICU)
- Being at the end of your life
However, risk factors that you can control to prevent delirium include:
- Poor nutrition or dehydration
- Not having access to sensory devices like hearing aids
- Some medications
- Sleep deprivation
- Unmanaged pain
- Being immobilized
- Lack of socialization
鈥淎ddressing those modifiable risk factors, especially in a hospital setting, is really important,鈥 says Chelsee Marshall, BSN, RN, a nurse specialist in HELP at 麻豆学生精品版. 鈥淚t may not be possible to prevent every infection, but we can treat delirium. We can make sure patients are eating and hydrated, and that they have their hearing aids or glasses, so they can communicate with the world around them.鈥
Preventing Delirium in the Hospital
Hospital-induced delirium affects nearly and of patients over age 70 that require a hospital stay. Not only is the patient enduring an illness or injury that may be contributing to the development of delirium, but they are in an unfamiliar environment staffed with care providers they may not know.
If your loved one is going to stay in a hospital or care facility, ensure it is a place that provides age-friendly care. These types of facilities are committed to preventing, identifying, and treating age-related issues like delirium by:
- Monitoring and treating other pre-existing conditions, like infections or chronic illnesses
- Avoiding medications that can cause delirium
- Ensuring the patient has their glasses or hearing aids at the hospital
- Encouraging the patient to get out of bed and move their bodies when it鈥檚 safe to do so
- Offering food at regular mealtimes and water throughout the day
- Providing proper pain management
- Opening curtains to allow plenty of natural light during the day
- Making sure nighttime hours are dark and quiet to promote sleep
- Having calendars and clocks around so the patient is aware of the day and time
- Keeping familiar objects around, such as family photos
- Encouraging visits from family and other socialization
- Providing mentally stimulating activities, like crossword puzzles or reading
Preventing Delirium at Home
If you are a caregiver for an older adult, you can aid in delirium prevention at home by continuing the same prevention strategies that are used in age-friendly care facilities.
鈥淏eing at home is helpful for patients who have experienced delirium because it鈥檚 a familiar environment, which is really great for them,鈥 Weiss says. 鈥淥nce they have been discharged, caregivers can continue those behavioral interventions that have been shown time and time again to prevent delirium.鈥
If you suspect your loved one may have delirium, contact their health care provider immediately. They will likely want to see the patient as soon as possible to determine and treat an underlying cause.
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