For seniors, the biggest danger in a hospital stay — especially if it involves surgery — isn’t what you might think.
Certainly, there are plenty of risks for anyone who lands in the hospital — but this side effect, one referred to by an expert as being “underrecognized and underdiagnosed,” can hit hard and fast.
I’m talking about hospital delirium, a reversible condition (if caught early enough) that is far too often thought of as being nothing more than the confusion or agitation you might expect from someone who’s a bit on the older side.
It’s such a common problem that researchers from all over the globe are trying to find ways to prevent and treat it, with the latest study looking at a sedative drug called Precedex as an answer.
But plenty of other research has found something else – that more drugs not only won’t alleviate this condition, but they can actually end up making it much, much worse.
A few ounces of prevention
Delirium is basically a state of confusion, one that can be “quiet,” with someone acting very withdrawn and having no interest in anything, or so violent that hospital staff need to restrain the patient.
You might think that everyone would notice such an obvious condition… but unfortunately, they don’t.
In fact, in a busy ER or hospital ward, doctors or nurses correctly identifying hospital-induced delirium is usually a hit-or-miss proposition. More often than not, it’s missed.
This new study out of Montreal looked at the med Precedex as a way to prevent hospital delirium from occurring in the first place — specifically in the ICU, where it’s most likely to occur.
The takeaway from the study is that the drug should be given to those with a high risk for delirium. But wait a minute – because one of the many factors that can disrupt normal brain functioning and cause delirium is drugs!
So, why in the world would researchers be considering even more medications as a treatment?
Nevertheless, the researchers seem quite pleased with their results, saying that they observed fewer cases of delirium in the study volunteers and calling it a “practice-altering study.”
Well, it’ll sure “alter” practices if doctors give yet another drug to patients in danger of delirium… on top of all the other risk factors (which include illness, unfamiliar surroundings, stress, and dehydration)!
Instead of drugging patients even further, there are a number of proven methods for nipping this potentially serious problem in the bud – and even preventing it in the first place.
In fact, studies have found that around 40 percent of all hospital delirium cases can be prevented!
Some of the best ways to do that include:
- Allow the patient to sleep through the night instead of waking them up for blood pressure checks at 3 a.m. (I know I’m not altogether “with it” if you wake me up in the middle of the night, even when I’m fit as a fiddle!)
- If a patient uses glasses or a hearing aid, make sure that those items are readily available.
- Get the patient out of bed for exercise or physical therapy ASAP, as either can help them to clear their head and focus on an immediate task.
- Avoid sleeping pills and any other drugs that are sedating. And this one is vital, as those kinds of drugs, even “mild” sedatives such as Benadryl, can significantly up the chances of delirium.
Other drugs likely to cause confusion and full-blown delirium are benzodiazepines (or “benzos”), a class of meds that I’ve told you quite a bit about lately. These include drugs that are given to sedate, such as Ativan and Xanax (which can actually slow down your ability to think), as well as the popular “calming” drug Valium.
In fact, Precedex, the very med used in that recent study, is also known to cause “agitation,” “confusional state,” “hallucination,” and guess what else? That’s right, “delirium.” And that’s along with side effects such as too-low blood pressure, an abnormally slow heart rate, acute respiratory distress syndrome (ARDS), and respiratory failure.
In other words, it can take you from the frying pan to the fire.
Some other proven ways to prevent hospital delirium are to be an active participant if a loved one is in the hospital.
Forget that big bouquet of flowers or the balloons that say “Get well soon!” The best gift you can give to anyone at risk for delirium is the time you spend with them talking, reading aloud, playing music they enjoy, or simply being a familiar face in a very confusing and unfamiliar place.
“An effective drug for preventing ICU delirium?” Nicole Lou, March 2, 2018, Medpage Today, medpagetoday.com