By Susan Chaityn Lebovits

When an elderly loved one is hospitalized, the experience can be overwhelming for everyone. One distressing complication that can arise during a hospital stay is delirium, a sudden confusion that affects a patient’s ability to think clearly, stay focused, and remain aware of their surroundings. Understanding hospital delirium, knowing how to prevent it, and being prepared to manage it if it occurs can make a significant difference in care and recovery.

What is Hospital Delirium?

Hospital delirium can be characterized by sudden changes in attention, cognition, and consciousness. It can be incredibly frightening, both for the patient and their family.

Imagine your normally sharp and independent parent suddenly becoming disoriented, agitated, or excessively drowsy and withdrawn. Delirium can present in various forms—some patients might become restless and agitated, while others may become unusually quiet and sleepy.

Elderly patients can be particularly vulnerable to delirium due to numerous factors such as preexisting cognitive impairment, severe illnesses, the use of multiple medications, infection, dehydration/electrolyte imbalances and sensory deficits like poor vision or hearing. The unfamiliar hospital environment, disrupted sleep patterns, and invasive medical procedures can further contribute to the onset of delirium.

How to Avoid Hospital Delirium

Preventing hospital delirium requires a proactive and compassionate approach. Here are some strategies to help reduce the risk:

Medication Management: Work closely with healthcare providers to review and manage medications. When possible, reduce the use of high-risk drugs like sedatives and anticholinergics. This can help minimize adverse side effects that could trigger delirium.

Sight and Sound: If your loved one uses eyeglasses or hearing aids, make sure they have them in the hospital and are using them correctly. Clear vision and hearing can greatly reduce confusion and help them stay oriented.

Create a Comforting Environment: Personalize the patient’s space with familiar items such as family photos, a favorite blanket, or a familiar clock. These touches of home can provide comfort and reassurance. We love this large clock for seniors that displays date, time, and day of the week as morning, afternoon, evening and night.

Restful Sleep: Sleep is crucial for cognitive health, especially when convalescing. Encourage a regular sleep schedule by minimizing nighttime disruptions. Request that hospital staff do not wake your loved one for unnecessary check ins. 

Nutrition and Hydration: Dehydration and malnutrition can significantly increase the risk of delirium. Encourage the use of a bedside tumbler with soft, flexible straw.

Pain Management: Uncontrolled pain can contribute to delirium. Ensure that pain is adequately managed using the least invasive methods possible.

Early Mobilization: Gentle physical activity can help maintain cognitive function and reduce the risk of delirium.

Cognitive Stimulation and Social Interaction: Engage your loved one in activities that stimulate their mind. Puzzles, reading, and conversation can keep their brain active. Encourage regular visits from family and friends to provide social interaction and emotional support.

What to Do if Your Loved One Develops Hospital Delirium?
Despite the best preventive measures, delirium can still occur. Here’s how to support your loved one if they develop this condition:
Alert Hospital Staff: If you notice signs of delirium, inform the healthcare team right away. Early intervention can help mitigate the severity and duration of symptoms.

Provide Reassurance and Orientation: Be a calming presence. Use simple and clear communication, and gently remind your loved one of their location, the date, and the reason for their hospitalization. Frequent reassurance can help ease their confusion. 

Ensure the Use of Sensory Aids: Continually check that your loved one is using their eyeglasses and hearing aids. Correcting sensory deficits can significantly reduce the severity of delirium symptoms.

Monitor and Adjust Medications: Work with healthcare providers to review and adjust medications as needed. Some medications may need to be discontinued or dosages adjusted to reduce delirium symptoms.

Encourage Mobility and Hydration: Help your loved one stay mobile and ensure they are drinking enough fluids. Physical activity and proper hydration can aid in recovery.

Create a Calm Environment: Maintain a serene and quiet environment. Attempt to reduce noise, and minimize unnecessary stimulation.

Involve Family and Friends: Familiar faces can be incredibly comforting. Encourage short visits from family and friends to provide emotional support and help your loved one feel more secure.

Research has shown that a proactive, compassionate approach can make a significant difference in preventing and managing hospital delirium. One study, “The Effect of a Multicomponent Intervention on Reducing the Incidence of Delirium in Hospitalized Older Patients,” published in the New England Journal of Medicine, found that a comprehensive approach significantly reduced the incidence of delirium. Another insightful study, “Delirium in Elderly Patients: An Overview of Diagnostic Approaches and Strategies for Management,” published in the Journal of Clinical Medicine, offers valuable strategies for managing this challenging condition.