Word Puzzles to reverse Cognitive Decline in Dementia and Alzheimer’s
Recently one of our clients inspired us to launch an exceptional service specifically designed to reverse cognitive decline. It is a…
The surgery went smoothly, the doctor told Gail’s son Will. But when Will arrived in the recovery room, Mom didn’t recognize him. She tried to pull out her IV, and moaned in distress. The nurse who was trying to change Mom’s dressing asked Will if Mom had Alzheimer’s disease! Will wondered—had something gone wrong during the surgery? Did Mom have brain damage? When the doctor arrived, she explained that Mom was suffering from delirium. By the next morning, Mom was tired, but pretty much back to her normal self.
There’s been a national movement to cut back on unnecessary hospitalizations in older adults (see “Post-Surgical Care in Boca Raton“), and that might be a healthy thing for more than a senior’s bank account or the Medicare bottom line. Hospitals, say experts, aren’t necessarily a healthy place for seniors! University of Michigan researchers recently reported that 25 percent of hospitalized seniors may pick up a so-called superbug—an organism that is resistant to common antibiotics. Seniors are also at high risk of falling while they’re in the hospital. Beeping monitors, pagers going off, squeaking carts in the hall, bright lights and perhaps a roommate’s TV often deprive them of nourishing sleep. Studies have found that the hospital environment can raise a patient’s blood pressure, impede healing, and lead to an often overlooked and underdiagnosed condition: hospitalization delirium.
Delirium can occur in patients of any age, but it is especially common in older adults. More than half of all hospitalized seniors will develop the problem—more than 2.5 million patients annually. More than $150 billion per year is spent on delirium-related healthcare costs, including re-hospitalization, rehabilitation and nursing home care.
Not so long ago, hospitals believed it was almost impossible to prevent delirium. But experts now say that much can be done. The U.S. Department of Health and Human Services is urging care professionals to take steps to prevent and manage delirium, and many hospitals have already put new protocols into place to lower the risk. The first step is to train personnel to recognize the signs of delirium; a research team from Indiana University School of Medicine recently found that emergency room staff, for instance, failed to recognize two-thirds of cases of delirium, and the team is working on an improved screening tool.
Meanwhile, patients and family caregivers are also urged to be aware of this often preventable complication. Here are some questions they often ask:
Q: What is delirium?
Delirium is a sudden, temporary change in brain function that causes confusion, hallucinations and memory problems. Patients with delirium may be lethargic or agitated. They may exhibit distressing personality changes, such as anger, paranoia and agitation.
Q: What causes hospital delirium?
Delirium in the hospital can be the result of sedatives and other medications, sleep deprivation due to strange surroundings, pain, excess light and noise, the effects of anesthesia, dehydration, infection, inactivity and the use of physical restraints, bladder catheters, the side effects of a patient’s underlying health problems or—most likely—a combination of these factors.
Q: Does delirium have long-term effects?
Though most patients recover from delirium after a short time, there can be serious complications. In an earlier Indiana School of Medicine study, Dr. Malaz Boustani said, “Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home, doubles the risk of death, and may lead to permanent brain damage.” Researchers also suspect that delirium raises the risk of developing dementia, and may cause a decline in thinking skills and memory from which a patient doesn’t bounce back.
Q: Can delirium be prevented?
Dr. Sharon K. Inouye of Harvard Medical School reported that up to 40 percent of delirium episodes are preventable. She described precautionary measures that include a careful evaluation of the patient’s medications, treating infection if present, ensuring adequate oxygen levels and prompt identification of delirium when it does occur. The American Delirium Society’s Dr. James Rudolph recommended that hospitals create a less stressful healing environment that does not overload the brains of patients, and that patients receive sedative medications only when necessary. He said, “Most importantly, we need to make sure we are alert to signs of delirium and address it as soon as possible.” And a Brown University research team recently urged hospitals to bring in a geriatrics specialist when older patients are hospitalized for surgeries or for injuries such as hip fracture.
Here are four things to keep in mind if an elderly loved one is hospitalized:
Research is underway to improve the prevention, diagnosis and management of hospital delirium. Better management of this condition will be more and more important as our population ages.
Source: Assisting Hands Home Care in association with IlluminAge. Copyright © IlluminAge, 2016.
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