We’re happy to share the following superb article by Dr. Edward L. Schneider, which appeared in a publication of the Los Angeles Jewish Home and is reprinted with their permission.
For most of us, it is an inescapable result of aging: Faced with conditions that require treatment or repair, we are admitted into the hospital, whether for an outpatient procedure or a longer-term stay. No matter the duration, hospitalization can present a variety of physical and emotional challenges for anyone – and for seniors, those challenges are particularly acute. One of the most pernicious, says Dr. Edward Schneider, a senior advisor for special projects at the Jewish Home and a professor at the Keck School of Medicine of USC, is a condition known as delirium.
Characterized by a short-term onset of problems with memory, disorientation and judgment, delirium, Schneider says, “does not last; this is not dementia, although people with early to moderate Alzheimer’s disease are more susceptible.” Delirium has a broad range of contributing factors, Schneider continues. “People are in a new environment, and are often receiving powerful drugs they haven’t taken before.” In addition, they experience changes in electrolyte balance and metabolism that can also serve as a trigger.
Fortunately, delirium usually passes within several days or weeks of leaving the hospital – the time horizon is different for everyone – and patients make a full recovery. However, while the prognosis is excellent, it does not necessarily translate to the return of robust mental health. Once they are discharged, Schneider says, “patients typically go back to their baseline.” In other words, the delirium recedes, but any preexisting cognitive impairment remains.
Whether someone is fighting delirium or trying to prevent it in the first place, Schneider points out that the prescription is the same. “You are much less likely to develop delirium, and are much more likely to recover from it, if you have a family member or friend present in the hospital.” The reason, Schneider says: “Being surrounded by people you know offers a sense of continuity and reassurance.” To that end, many hospitals send volunteers to sit with elderly patients; they become acquainted, and the patients feel more at ease.
If delirium does set in, it is important to alert the patient’s doctor to the change in behavior. And to the greatest extent possible, caregivers should avoid taking steps that can make the condition worse, such as the use of wrist or ankle restraints. “If a patient is already confused and feeling like he is in a foreign place, you can imagine how much more threatened he will become if he finds his movement restricted,” Schneider says.
The bottom line, according to Schneider, is that heightened awareness and compassionate treatment can go a long way toward staving off the condition. For countless seniors and their loved ones, that is good news, indeed.
Dr. Edward L. Schneider headed the largest private center for research and education on aging, the Andrus Gerontology Center of the University of Southern California, from 1986 to 2004. He is now Dean Emeritus of the Leonard Davis School of Gerontology and Professor of Medicine at the USC Keck School of Medicine. Dr. Schneider has written or co-written 14 books, including Ageless: Take Control of Your Age & Stay Youthful for Life, and published more than 180 scientific articles on topics related to aging.
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