According to a recent New York Times article entitled “Vigilance About the Dangers of Delirium,” hospital patients need not be elderly to beat risk for developing delirium. This condition is characterized by disorientation and hallucinations. According to experts, small but important changes in patient care, as well as knowledge about the causes of delirium, could help prevent its occurrence in up to 40 percent of cases and reduce healthcare costs. Additionally, if doctors, nurses, and families are able to recognize the symptoms of delirium quickly, then proper management can take place. This can help to alleviate the occurrence.
“Given the reality that nobody is absolutely certain how potent anesthetics work, it should come of no surprise that how they impact patients may vary depending on a multitude of factors,” said Marc Koch, MD, MBA, president and CEO of Somnia Anesthesia. “The most important thing is for patients, regardless of their age and medical problems, to have a discussion with their anesthesia providers and learn more about techniques that are less likely to result in post operative cognitive issues.”
Certain conditions such as urinary tract infections, thyroid or kidney dysfunction, and malnutrition can work to trigger the onset of a delirium episode. Also, some medications like antihistamines, muscle relaxants, narcotic painkillers, and even some antibiotics have been linked to the condition. In the hospital, the chances of an episode are greater when older patients have surgery or receive treatment in an Intensive Care Unit. According to the article, about one-third of patients over 70 go through a delirium episode when they are hospitalized.
“We used to think of delirium as inevitable, almost normal,” said Dr. Dale Needham, a critical care specialist at Johns Hopkins. “We now know there are things we can do to reduce the risk.”
Needham advises that healthcare professionals use little or no sedation when dealing with a patient in delirium, as this may worsen and extend the length of the episode. Also, start occupational and physical therapy early for the patient. Have family and friends regularly orient them about what day it is and why they are in the hospital, as well as bring familiar items to the room to calm and reassure the patient.