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Elder Care: Hospital Delirium Prevention

Delirium is a mental illness that can be brought upon by external stress and is often due to hospitalization. It is serious enough that people with delirium are often twice as likely to die in the next year as those without delirium. As well as due to it being an invisible illness, it is much harder to catch in hospitals by medical staff. The internal struggle and external confusion may not be perceived as delirium and can go unnoticed. However, due to the severity of its consequences, it is important to prevent delirium before it happens or catch it early and begin the necessary treatment promptly. Fortunately, there are a variety of ways you can work to prevent delirium, especially as a primary caregiver.

Primary caregivers can be armed with the knowledge that hospitalization can be a key trigger that leads to delirium and use that foresight to prevent it. Delirium is a multifactorial mental illness and therefore requires a multidisciplinary prevention strategy to address the condition. A few beginning strategies to consider are the following:

  • Become knowledgeable about delirium prevention
  • Look for clues in behavior that indicate worsening mental health
  • Advocate for your loved one so they receive early prevention from the hospital staff

 

With these beginning strategies in mind, it is important to know that not all delirium can be prevented. Some seniors are prone to delirium or may even be delirious before they are hospitalized. However just because delirium cannot be entirely prevented does not mean that the effects cannot be minimized. Approximately half of all delirium cases can be either prevented or the symptoms can be minimized, so do not lose hope even if your loved one is showing signs of delirium.

As a caregiver, you want to consider not only the internal world of your loved one and how to minimize mental and emotional stress but also the external factors that may lead to that stress. Hospitals can be a very jarring and stressful experience and so if there are hospitals that cater specifically to seniors or minimize stressors by creating a calm and comforting environment then that may be a great option if your senior is prone to delirium.

However often those programs are very specialized and may not always be available to you in a pinch so here are some things you can do even if your elderly loved one is being stressed out by the external factors of the hospital.

Similar to the comforting nature of the hospitals that cater to seniors you can also cater to your seniors’ need for safety and comfort by bringing items that make them feel at home. If they have a favorite pillow, blanket, or any other item that brings them comfort it may be beneficial to bring that with you as a source of comfort during the difficult hospital stay. As well as comforting items, you must bring any sensory aids that your elderly loved ones may need such as their reading glasses or their hearing aids to ensure a more comfortable and confident stay.

While in the hospital your senior may be overstimulated by all the new sights, sounds, and changes. Consider creating a calm soothing environment that is conducive to a peaceful mental state. Try bringing items that allow your senior a sense of calm, for example, an old favorite book or a confident hobby like knitting or crocheting. While in the hospital consider clothes that they can wear that are also comfortable and adaptive to the temperature. If they are staying in a room with other patients consider getting them noise-canceling headphones or headphones that they can use to listen to relaxing music. Being in the hospital requires many decisions to be made and it can feel overwhelming, so it is important to keep your instructions very simple when discussing treatment options with your senior loved one.

Sleep is one of the best methods for getting better however it is important to consider how your elderly loved one can get to sleep while staying in the hospital. It may seem like a good idea if your elderly loved one having trouble sleeping to prescribe them sleeping pills or drugs. However, these drugs increase the chances of delirium and are therefore concerning in the long term. While they may be necessary in some cases, try pursuing different strategies first to see if they will work instead. Of course, you can request a quiet room, however, there are also other calming strategies that your elderly loved one can do no matter where they are. Soothing music, meditation, and a massage from a familiar companion can all be great ways for them to calm their mind and body so they can sleep soundly in the hospital. A full night’s rest will help them feel better and minimizing the number of sleeping pills they need to take and can also reduce the chances of delirium.

Pain management can also be a deciding factor in whether the senior develops delirium because pain is incredibly stressful for their mind and body. Often pain with seniors can go unnoticed if it is not advocated for and so if your elderly loved one is complaining of discomfort and pain it is valuable to get that looked at and addressed to minimize the stress that the pain is causing this can then minimize the amount of mental strain and potential to develop to delirium.

Exercise is an excellent daily habit to get into and it is good for the mind and body. Often in a hospital stay, seniors do not get the adequate physical exercise that they need. This can lead to them becoming weak as well as increasing chronic pain and difficulty sleeping. Physical therapy in the hospital can be a great way to continue their exercise routine. Or have a familiar or loved companion visit the senior often and invite them to go on walks around the hospital grounds. Companionship is an excellent mood booster for seniors and increases cognitive function while the exercise keeps them in tiptop physical shape.

While delirium is not one hundred percent preventable there are many different strategies you can implement that will minimize the chances of getting delirium. Minimizing the chances of getting delirium can be your best shot at avoiding it during the hospital stay. As well, minimizing stressors that lead to mental strain can also de-escalate any delirium symptoms and prevent them long-term. If your senior develops delirium, it will be time for hospital intervention so ensure that you are connecting with your doctor as soon as possible once you notice any symptoms of delirium.

For more information, check the following articles in our home care blog on hospital stay: