September 23, 2015
Two of the many things that people fear will happen to their loved ones as they age are dementia and delirium. Dementia is the term used for a gradual decline in mental ability and is usually not reversible. Delirium, on the other hand, is usually a temporary state of confusion that can result from an illness or a treatment for illness, including a hospitalization. Illness and treatment don’t cause dementia.
Affecting as many as 7 million Americans hospitalized each year, the triggers for developing delirium seem to be related to heavy sedation and the use of ventilators in intensive care units, as well as longer hospital stays; but delirium is occurring among those recovering from routine and easily treated conditions as well. Other potential causes include use of anti-anxiety medications, and perhaps even the hospital environment itself. And, it can linger on for months after a patient is discharged.
Coined “ICU psychosis” 30 years ago by Sharon Inouye, a geriatrician and professor of medicine at Harvard Medical School, studies focused on hospitalization delirium prevention are now underway, since it’s estimated that as many as 40% of cases are preventable, and, according to Inouye, “There still aren’t good treatments for it once it occurs.”
Effects from the delirium can be severe, in both memory and cognitive issues but also commonly displaying as symptoms of post-traumatic stress disorder, with flashbacks and hallucinations. For the elderly, these symptoms are particularly troubling, as they may not have the capacity to describe what happened to them or how they’re feeling, and can result in a misdiagnosis of psychosis or dementia.
The good news is that hospitals are recognizing and taking steps to reduce the potential for delirium, by more carefully prescribing certain anti-anxiety medications and tranquilizers, limiting use of restraints, and creating a more soothing environment with less light and quieter alarms to ensure more normalcy in patients’ sleep-wake cycles. Nursing and medical schools nationwide are also including delirium training as part of their curriculum, and a number of hospitals have implemented the HELP program (Hospital Elder Life Program) for their senior patients, offering visits from trained volunteers to provide companionship and help with staying oriented.
If your loved one is showing signs of delirium or dementia, we at Continuum can help. Our in-home care staff is trained in Alzheimer’s and dementia care services, as well as safety supervision, companionship, and respite care. Our experienced eldercare managers will conduct a thorough assessment to see which in-home care services you and your loved one require.