New study reveals best way to prevent ‘hospital delirium’
If you’ve never heard of “hospital delirium,” consider yourself lucky.
It’s a side effect of being hospitalized that experts believe can affect up to 50 percent of seniors who have surgery. For those in the ICU, the delirium rate hits 80 percent.
And hospital delirium can go way beyond a temporary condition. For those in their 70s and 80s, it can be the start of a downward spiral from which many never recover.
That’s why health experts were very excited to hear about the results of a new study that found a simple, common-sense way to cut cases of delirium by more than half.
The only problem is, the researchers didn’t go far enough in pinpointing what may be the biggest reason why being hospitalized is so dangerous for those over a certain age.
Dr. Angela Catic, a specialist in senior care at Harvard Medical School, knows all too well about hospital delirium.
Around a decade or so ago, she said, “people would say that it’s an old person and of course they are confused.” Everyone accepted delirium as “the norm,” she added. But while it may be common, it certainly is “not normal.”
Now, researchers out of Harvard and the Institute for Aging Research in Boston, along with scientists on the other side of the world in Taiwan, have found some ways to cut delirium rates by more than half.
This altered state of consciousness and confusion is believed to be caused by a disruption of normal brain activity triggered by a combination of unfamiliar surroundings, stress, dehydration, illness and drugs.
And what the researchers discovered is that if nurses spent simply 30 minutes with patients, talking to them, helping with tasks such as brushing their teeth, making sure they’re eating and assisting them to get moving and out of bed as soon as possible, delirium cases could be reduced by 56 percent.
Of course, that might sound like what should be the standard of care in any hospital! But you and I both know that’s no longer the case.
This study did shine a spotlight, however, on the enormous difference simple interventions can make in how fast you or a friend or family member recovers from a hospital stay.
But what the researchers failed to point out is the very big role drugs play in tipping the scales toward delirium.
There’s a long list of meds that can cause patients to become delirious, including sedatives (especially “benzos”), sleeping pills, anti-depression drugs, steroids, antihistamines, asthma therapies and painkillers.
And then there’s ketamine, a med frequently used during surgery to help reduce pain and keep patients off of opioids — but that might actually do more harm than good.
A recent study out of Washington University in St. Louis discovered that patients given low-dose ketamine have a bigger risk of experiencing delirium, hallucinations and nightmares during recovery. And it didn’t even seem to have an effect on lowering post-op pain!
Despite how “common” hospital delirium can be, it appears that many doctors still aren’t familiar with it. That’s why it’s vital for anyone entering a hospital to have a “coach,” someone who can help them get home in one piece!
Here are three important ways to start:
- Forget the cards and flowers! A better way to show you care is to duplicate as many findings in this new research as possible — things such as helping the patient brush their hair and teeth and get out of bed as soon as possible. At the very least, spend time talking with them about a subject that interests them or is timely.
- Monitor what drugs are being given and find out which ones can be reduced or skipped entirely.
- Before surgery, ask if ketamine will be used. The doctor who headed up that study on the drug advises clinicians to “reconsider the common practice” of using the med during an operation.
Taking those simple measures may make all the difference in the world between simply a stint in the hospital or crossing a point of no return.
“Anti-delirium strategy reduces after-surgery confusion in elderly” Reuters, May 27, 2017, The Washington Post, washingtonpost.com
