Can Your Home Care Agency Help Prevent Delirium?

Delirium is likely to be the most costly and debilitating disease afflicting the elderly that you never heard of.  We focus lots of attention on dementia, alzheimers and fall-related issues, and we should, but at the same time delirium is hurting the quality of life for elderly people and costing Medicare over $143 Billion per year according to a study this year in The Journal of American Geriatric Society.  The November 2, 2011 New York Times article "Another Hospital Hazard for the Elderly" by Susan Seliger tells a chilling story about the onset of delirium and just how common it is:

Hours before she fell and broke her hip, my mother, 85, lucid and whip-smart, was doing what she always did in the morning: drinking an entire pot of coffee and digesting both The New York Times and The Baltimore Sun.

The next day she came out of the hip surgery just fine. But within 24 hours, a totally different woman seemed to have taken over her capable mind and body.

She was disoriented. “This isn’t a very nice hotel,” she told us in the hospital room. “They haven’t even served cocktails. Let’s go.” My father, sister and I laughed, thinking it was just grogginess from the anesthesia. But then she developed trouble breathing, and the nurses clapped on an oxygen mask and whisked her off to another ward for more intensive monitoring.

Things quickly spiraled out of control. She tried to rip off her oxygen mask and IV tubes. She frantically tugged at the sheets and her skimpy hospital gown. Like the aged Lady Macbeth, she kept saying: “We have to clean this up! Clean this mess!”

They tied her hands to the bed. The medications to calm her down didn’t work. The doctors upped the sedation. Later, the physical therapist could barely rouse her to do the critical rehab on her brand-new hip.

What my family didn’t know at the time, because the doctors did not tell us, was that this frightening transformation was a classic case of hospital delirium — a brain dysfunction characterized by sudden confusion and inattention. It’s one of the most common, dangerous and costly complications of hospital stays for the elderly.

This two part story in the New York times continues by teaching us the signs of delirium and how it can be prevented.  The following items in particular caught my attention:

1. Once delirium occurs, the patient has a 62% chance of dying in the next year
2. Delirium can be prevented in 30 - 40% of cases
3. The best people to detect and counteract delirium are caregivers who know the person well and are able to detect when they're not normal
4. Home Care Caregivers can greatly assist in the prevention and recovery from Delirium with steps as simple as getting the person up to walk a little bit each day

This topic is too important to stop here, so here are the next steps:

• You should all read the two part series right now by clicking on the titles.  The first part is entitled "Another Hospital Hazard for the Elderly" and the second (published November 11, 2011) is entitled "Preventing Hospital Delirium"
• Ankota will do a deeper dive into the prevention and cure in the coming weeks.

Can your agency put an awareness and education program in place to help prevent and recover from delirium?  Can you offer hospital companion services with caregivers who can advocate for your clients, alert hospital staff when something's not right, and make sure that the hospital is doing the right things?

Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota