We’re all familiar with hospital-acquired infections such as MRSA or staph infections. But what about hospital-acquired delirium? Many people have never heard of this condition and yet research shows it is becoming more common in America. My hospital recently hired two part-time nurses for the specific purpose of studying and planning care for patients with hospital-acquired (or hospital-induced) delirium. What is this condition? And how can you prevent your loved one from developing hospital-acquired delirium?
Defining hospital-acquired delirium
Simply put, it is delirium that develops during a hospital stay. Delirium itself is defined as an acute disturbance in mental status. The patient may become disoriented, confused, and even combative. Hallucinations are also possible. This condition can last a few hours or a few days. While it may be temporary, studies show that people who suffer hospital-acquired delirium:
- Increase their chances for developing Alzheimer’s disease
- Double their risk of dying within 30 days
- Are more likely to be placed in a nursing home
Thus hospital-acquired delirium is a very serious medical condition not to be taken lightly.
Who gets hospital-acquired delirium?
The elderly are most vulnerable since family and even hospital staff are more likely to chalk up their behavior to old age. But other people at risk for hospital-acquired delirium include those with infections, intensive care patients, the hearing and vision impaired, and drug/alcohol users. Dehydration and poor nutrition are also risk factors in developing induced delirium.
Preventing hospital-acquired delirium
The best way to treat hospital-acquired delirium is to prevent it from happening in the first place.
Know your loved one’s medications: Taking multiple medications (known as polypharmacy) is another risk factor for developing hospital-induced delirium. Have a written record of medications, doses, routes (for example by mouth or injection), frequency of dosages, and if possible, when last taken.
Bring familiar items to the hospital: Things your family member recognizes will help lessen the chances of induced delirium. These can be a favorite blanket, pictures of family, or a spiritual item like a personal Bible.
Don’t change rooms: This is not always possible, especially if your loved one needs to be transferred to a new unit based on level of care. Tell hospital staff an unnecessary room change may confuse your loved one and insist he/she keep the same room for the entire length of stay. A room close to the nurse’s station would be ideal so any changes in mental status could be more readily noticed.
Ask to stay overnight: If your family member is becoming anxious and upset as you try to leave, ask if you can stay overnight in the room or in a waiting area near the room. Staying in the room overnight could be an issue if hospital rooms are not private.
Keep ’em busy: An active patient is less likely to develop delirium during their hospital stay. Talk to members of your loved one’s health care team about participation in such things as physical therapy (if needed), church services (if available), or programs where hospital volunteers visit patients for conversation and friendship. Also consider bringing your family member’s favorite activities to the hospital, for example crossword puzzles, books, laptop/tablet, or crafts.
The Advisory Board Company, Hospital acquired delirium growing problem among patients, January 12, 2011
WNDU.com, Tips for tackling hospital-induced delirium, March 26. 2012
US National Library of Medicine, MRSA, last reviewed April 9, 2012
US National Library of Medicine, Hospital-induced delirium hits hard, January 10, 2012 (article courtesy of Canadian Medical Association)