After Hospitalization, Mental Trouble for Elderly Patients
When working as a hospitalist on Vancouver Island, the majority of my patients are elderly. They sometimes come from complex care facilities, sometimes from their own home where they have been functioning independently until they slipped in the garden at age 95 and broke a hip.
Medications, pain, infections, metabolic abnormalities, and new surroundings all wreak havoc on a brain that has underlying structural changes (dementia). Even the sharpest 88 year old retiree can get muddled by the physical changes that come with the reason for hospitalization or the process of being there. Delirium, an acute state of confusion, results.
We joke about it sometimes – the guy who thought he was on a ship and tried to stab me with his IV tubing, or the patient who streaked through the ER “uh oh, that’s my Code White*! Better leave the building for the night eh!?” – but it is a very serious issue.
Delirium can be devastating. Not only is it linked with increased mortality, but it is very hard for loved ones to watch an elderly person who is not behaving like them-self. Even when the physical illness resolves and delirium clears, family members often comment that their grandpa was just never the same after being in hospital. And below is more proof of this.
*the overhead code for agitated or aggressive patient requiring security personnel assistance
After Hospitalization, Mental Trouble for Elderly Patients – NYTimes.com
“Many older people fear that a hospital stay could leave them even more disabled than they were before. Unfortunately, there’s new reason to believe this fear is justified. Elderly patients who are hospitalized are at much higher risk of cognitive problems afterward, according to a study published on Wednesday in the journal Neurology. . .”