Saturday, November 05, 2011

Hospital Delerium a Hazard for the Elderly

20 percent of the 11.8 million elderly patients in hospitals develop delirium.
Distinguishing between delirium and dementia, which even medical professionals often mix up, is critical. Delirium signals that something in the body is seriously wrong and needs attention, fast. Dementia, not so; it’s chronic confusion and memory loss that comes on gradually and gets worse. Delirium is confusion that comes on suddenly, often within hours, brought on by such triggers as infection, the stress of a disease or operation, not getting enough food or water or sleep, or medications often administered in the hospital.
How to know if your family member is suffering delirium? Caregivers who know the patient in normal times are the best judges of when things are not right. Look for any of these four signs:
Acute change of mental status: Not making sense when he or she talks? Disoriented, illogical, unable to focus? Trust your instincts. Let the staff know this is not normal behavior.
Inattention: As you hold the patient’s hand, ask him or her squeeze every time you say the letter A, as you clearly spell out “save a heart.” “If they miss two, or squeeze on the wrong letter, that is a sign of delirium,” said Dr. Michele Balas, assistant professor in the College of Nursing at the University of Nebraska Medical Center.
Altered level of consciousness: You’re looking for two possible extremes. In hyperactive delirium, patients are anxious, agitated, aggressive, picking at clothes or IVs. In hypoactive delirium, they’re lethargic, sleepy and not making eye contact.
Confusion and disorganized thinking: Can the patient track a conversation? “Ask simple questions, like, ‘Does one pound weigh more than two pounds?,’ or ‘Will a stone float on water?’” .
Another Hospital Hazard for the Elderly - NYTimes.com

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