In This Episode:
Dr. K talks with geriatrician Sharon Inouye, MD MPH, a nationally-known expert on delirium who is Professor of Medicine at Harvard Medical School and Director of the Aging Brain Center at the Institute for Aging Research, Hebrew SeniorLife. They discuss:
- What is delirium and what are common symptoms of delirium
- What are common causes of delirium, and what can make it worse
- How Dr. Inouye became interested in studying delirium
- The difference between delirium and dementia, and how the two conditions are related
- The problem with using restraints and bed alarms, when someone is delirious
- How to treat delirium, and how to keep a person safe while delirious
- How the Hospital Elder Life Program helps reduce delirium (by 40-60% in some studies!)
- Why many hospitals still don’t have a HELP program
- The most effective ways to maintain brain health while aging
Related episodes:
039 – Interview: Creating Age-Friendly Health Systems
014 – Delirium & Hospital Confusion
Related Resources:
- Hospital Elder Life Program (HELP) for Prevention of Delirium
- 10 Things to Know About Delirium
- Hospital Delirium: What to know & do
- 7 Common Brain-Toxic Drugs Older Adults Should Use With Caution (about anticholinergics)
- Choosing Wisely: 5 More Treatments to Question in Older Adults
- National Academy of Medicine Report on Cognitive Aging
- 4 Types of Medication to Avoid if You’re Worried About Memory
- National Institute on Aging: Brain Health Resources
- The 2015 American Geriatrics Society Updated Beers Criteria: Medications that Older Adults Should Avoid or Use with Caution
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Fabulous resource – working through a situation with a parent currently and this was tremendously helpful and easy to listen to and digest.
Thank you!!
So glad you found it helpful, thank you for letting us know! Good luck to you, hope your parent improves soon.
MY MOM HAS BEEN IN HOSPITAL 5 TIMES IN 6 WEEKS HAS DELIRIUM NOW SO HARD TO DESL WITH THIS INFORMATION HAS HELPED
Thank you for the feedback, I’m so glad the information has been helpful!
My elderly parents currently dealing with hospital delirium. Not related to COVID. No visitors rules boost situation to more critical status when they cannot connect with family. Getting a doctor to treat the whole patient and finding resources for a care plan for an elderly parents is challenging.
Are both of your parents in hospital? That would be a challenge. You’re right that hospital care is often disease-focused and not very holistic. A consultation from a Geriatrician would probably be helpful, but given the pandemic, it might be hard to access that resource too.
This article from Dr. Kernisan might have some helpful tips. It’s about creating a Senior-Friendly Hospital system, a very hot topic right now.
My mom was recently admitted to the hospital for a sudden onset of confusion and delirium. The diagnosis was alcohol withdrawl and once the severity of treatments were done she became even more delirious she was fine at home and then within a few hours she couldn’t walk on her own and she has incontinence, the hospital also just found a urinary tract infection after about 10 days of being there. Its just very scary and I understand that her type of delirium is a bit different and much more severe. What are some things I can do to help her and to speed up her recovery.
I’m so sorry to hear about your mom’s experience with delirium. You’re right, the delirium of alcohol withdrawal can be very complex and dangerous period the treatment for alcohol withdrawal delirium usually involves giving benzodiazepine’s which are sedative hypnotic medications. Although these medications can prevent some of the risks of alcohol withdrawal, they can also cause sedation.
You also note that your mom’s alertness and function tended to fluctuate. This is very typical of delirium, as I mentioned in my YouTube video here.
In general it’s always easier to prevent a delirium than to cure one but most of the measures that we take to prevent delirium seem reasonable to try in order to try to speed up the recovery. This includes things like getting a person back into a familiar environment and routine as quickly as possible, encouraging the person to do physical activity , avoiding dehydration, taking medications that are prescribed and trying to avoid any medications that could further cloud thinking or alertness.