“During the day he is completely calm, but at night he becomes very agitated.”
“Tonight she kept calling for her mother, who died many years ago, but she had been sleeping all day and it was nearly impossible to wake her up.”
These testimonials will resonate with many relatives and carers of elderly people who have to be hospitalised.
They attest to a very common situation in which older people are hospitalized and experience a sudden deterioration in their health, characterized mainly by spatial and temporal disorientation and agitation.
It sounds like dementia, but is it some other disease?
Dementia or delirium?
dementia Dementia is not a specific disease, but a general term that describes a gradual decline in cognitive functions such as attention, concentration, orientation and problem-solving skills, ultimately impairing a person’s independence and ability to carry out daily activities.
Many of these symptoms overlap with those of older patients who suddenly become agitated, but dementia develops gradually over a long period of time.
In the above testimony, the patient Acute confusional state, also known as delirium.
This complex and common complication of hospitalization can directly impact patient morbidity and mortality, therefore, it is crucial to prevent it or, if this is not possible, diagnose it early and treat it appropriately.
According to some studies, it may have an impact 20% To 30% Of elderly hospitalized patients.
Patients suffering from delirium may experience the following symptoms: Symptoms:
- Changes in alertness and wakefulness. These can vary throughout the day. Often, affected people will feel very alert at night but very sleepy during the day.
- Cognitive changes, memory loss (not being able to remember what happened during the night), disorientation (thinking they are actually at home), and disorganized or incoherent speech.
- Other symptoms include altered perception, hallucinations, agitation, and sudden, unpredictable mood changes.
A variety of factors are at work
there are many factor These symptoms overlap in older patients, some of which are inherent to the aging process, such as polypharmacy (the simultaneous use of multiple medications) and sensory impairment.
Many are related to the process of hospitalization itself, such as the stress of acute illness, administration of certain medications, surgery, etc. Environmental factors also play a role, such as not getting a good night’s sleep due to constant interruptions from nursing staff and other patients.
Dementia and delirium are clinically quite distinct, despite some commonalities, but they can, and often do, occur together. In fact, patients diagnosed with dementia may: Delirium during hospitalization.
This may be due to a decline in cognitive reserve, meaning that fewer brain resources are available to deal with stressful situations.
Can it be treated?
The good news is that delirium is certainly treatable, and the earlier the better. It is important to keep in mind that one of the main risks is that it goes unnoticed and nothing is done. This risk is even higher in dementia patients, since dementia is accompanied by changes in attention levels.
If delirium is a reaction to a particular medication, the solution is simply to stop the medication. If the cause is an infection, treating the infection may relieve the symptoms.
In other cases, certain medications can help curb behavioral disorders. Of course, all of these options should only be considered after a thorough evaluation by a specialist.
There are also measures you can take to prevent delirium from developing in the first place. HELP (Hospital Senior Living Program) In the United States, these include non-pharmacological measures such as retraining, sleep management, early mobilization, and the use of sensory aids (e.g., glasses and hearing aids). AIDS), hydration and digestive health.
The implementation of such programs and the ongoing training of medical professionals is essential to prevent and rapidly diagnose what is fast becoming a silent crisis. Contagious diseases.
How caregivers can manage or prevent delirium
There are several important steps that can help older hospitalized patients avoid or manage the onset of delirium.
- Maintain a regular day-night schedule: Open curtains during the day to let in sunlight, and reduce noise and turn off lights at night to help you sleep.
- Keep the room quiet to make the patient as comfortable as possible.
- Carry out basic conversation using short, simple phrases and allow the patient enough time to respond.
- If the patient becomes confused or scared, remind them where they are and what is happening.
- If the patient becomes agitated or upset about something in particular, try to remain calm and avoid arguments. Changing the topic or situation can help a lot.
- If a patient is having hallucinations, you should not ignore them or argue with them. You should acknowledge their emotions and try to be gentle and calming.
In conclusion, delirium is a disorder that not only has a significant impact on a person’s physical and mental health, but can also have serious implications for the public health care system, making prevention and early detection essential for optimal treatment of delirium.
Laura Zaurin Paniaguaa study by the University of San Jorge, Grado Enfermeria, San Jorge University
This article is reprinted from conversation Published under a Creative Commons license. Original article.
