Doctors have long known that patients who have pre-existing medical conditions that affect the brain, such as early signs of dementia, are at an elevated risk of developing delirium while in hospital. But a growing body of research has also pinpointed certain medical practices that can propel patients towards delirium. They include:
- Inadequate hydration and nutrition: Patients who arrive in an emergency department are often told not to drink or eat anything – just in case they might need to have surgery. Yet dehydration and insufficient nourishment can start a patient on the path to delirium. Once the treatment plan becomes clear – and if surgery is not in the cards – the patient should be permitted to eat and drink.
- Lack of mobility: Confinement on an emergency-department stretcher for a prolonged time can lead to muscle weakness and cause disorientation. Patients quickly lose track of whether it’s day or night. If patients are able to walk, they should be helped to get up and move around at least once every eight hours.
- Medication interactions: Many elderly patients are on multiple medications. Adding another pill to the mix can lead to potentially harmful drug interactions. The medical team must take special care to review the existing medications before prescribing new drugs – such as sedatives – that could contribute to a mental fog. In cases involving a broken or fractured bone, for example, a local anesthetic may be a better way to control pain than an oral medication that makes the patient drowsy.
Full article at: Globe and Mail