Hospital Delirium and the Elderly

Hospitalization, Hallucinations and the Elderly

“Thousands of tiny little creatures,” he said, “some on horseback, waving arms, carrying weapons like some grand Renaissance battle,” were trying to turn people “into zombies.” Their leader was a woman “with no mouth but a very precisely cut hole in her throat.”

No one who knows Justin Kaplan would ever have expected this. A Pulitzer Prize-winning historian with a razor intellect, Mr. Kaplan, 84, became profoundly delirious while hospitalized for pneumonia last year. For hours in the hospital, he said, he imagined despotic aliens, and he struck a nurse and threatened to kill his wife and daughter.

“It’s terrible, more dangerous than a fall,” said Dr. Malaz A. Boustani, a professor at the Indiana University Center for Aging Research, who found that elderly patients experiencing delirium were hospitalized six days longer, and placed in nursing homes 75 percent of the time, five times as often as those without delirium.

Hospital delirium is a phenomenon that affects older patients disproportionately, and it’s characterized by disorientation, hallucinations, and other psychotic symptoms. It can be triggered by a variety of factors, such as infections, surgeries, and medications, and it poses significant risks to patients’ health and recovery.

Hospital delirium is a growing issue that affects a large number of older patients, and it’s often underreported and undertreated. Delirious patients may experience sheer terror and other negative effects, hindering their recovery from their initial conditions, delaying procedures, requiring more staff attention, and escalating healthcare costs. They’re also more likely to be placed in nursing homes or rehabilitation centers or to develop dementia later.

Although the cause of hospital delirium is unclear, doctors are increasingly trying to prevent or treat it. Preventive measures include managing patients’ pain, anxiety, and discomfort, promoting mobility and social interaction, and avoiding unnecessary interventions. Treatment options include stopping medications that trigger delirium, using non-pharmacological interventions, and, in some cases, administering antipsychotic drugs with caution.

A serious problem, hospital delirium affects older patients and poses significant risks to their health and recovery. Doctors are increasingly trying to prevent or treat it by addressing its underlying causes, using non-pharmacological interventions, and administering antipsychotic drugs with caution. It’s essential to raise awareness of this phenomenon and develop effective strategies to manage and prevent it.

Hallucinations in Hospital Pose Risk to Elderly, Pam Belluck, New York Times

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