Unspecified Disorientation: Ways to Avoid Hospital Delirium
An unplanned hospital visit can lead to many complications in the lives of the patient and their caregiver(s). There is never a good time for an extended hospital (and often skilled nursing) stay. It is helpful to understand risk factors that may affect those hospitalized, to create a strong network of support both in and out of the hospital, and not be afraid to ask for clarification from the extended care team at the hospital and/or facility.
One major problem that I am often asked from family members who have loved-ones in the hospital is related to increased confusion by the patient once placed in the hospital. Recovering from an infection, broken bones or other serious illness is hard for anyone; as we enter our older years it can prove to be even more challenging. There is something called “Hospital Delirium” that affects a great deal of patients in hospital and skilled facility settings. This change of condition can be interrelated to other problems with a patient but it also present independent of the current diagnosis. “Unspecified disorientation” which is the common reference made by hospital staff should not be ignored and can lead to even further complications if not properly addressed. It is OK to speak up, ask the questions of medical professionals and make sure the care plan in place is the right one for your loved one.
Some ways to help decrease the likelihood of delirium in the hospital setting are:
Make sure the patient gets up and moves around daily (if possible).
Bring familiar items from home to help make the environment more “livable.”
Monitor what medications are being given. Certain sedatives, and pain medications can greatly increase the risk of confusion.
Make sure secondary pain symptoms are treated properly; yet safely. Hidden pain can often trigger other icky side-effects for patients.
Make sure the patient is having regular bowel movements, obtaining enough fluids/calories, and sleeping in regular intervals.
Finally, interact with the patient! Keep them updated on their health status. Involve them in the recovery process as much as possible. Talk to them about life outside of the hospital. Make sure they have access to a calendar and are reminded of their surroundings.
Something else to be mindful of are the changes associated with a long stay in bed (bed bound). From what was likely a very active life prior to the hospitalization can quickly change to endless hours in bed for the patient. Don’t settle for this as a normal and safe change in the patient’s status. Unless required for safety reasons or their current medical diagnosis; it is important for a patient to get up and move often. Even if that is changing positions in bed, sitting in a chair or wheelchair or simply getting up to walk to the restroom.
Make sure the hospital staff are regularly checking for skin breakdown on the patient.
Ask for elimination records from the nursing team or better yet keep a personal log for peace of mind. Further, watch for any signs of incontinence or the inability to urinate. Sometimes this can be a sign of a new developing infection.
Make sure the patient is eating enough calories and getting enough fluids.
Many of these problems can lead to lengthened hospital stays and more issues. It can be hard to navigate the medical system and have a good understanding of hospitalization complications.
One way to allow family member’s and caregiver's to focus on their loved one; is to hire a Life Care Manager aka Geriatric Care Manager as an expert resource to guide the family within the hospital system, between care settings and during the discharge process.
Our extensive knowledge in this area can prove to eliminate many of the challenges and concerns listed above. We are there as a professional resource, patient advocate, and in many ways extended “family” member. What may seem like a high price to pay for a professional serve can quickly prove to pay-off in a smooth recovery of the elderly patient.
Reach out to Hope Aging Care today for more information on how we can help you in your time of need!