Delirium afflicts one-third to two-thirds of elderly hospital patients, who can suffer abrupt and intense mood changes as a result of medications, invasive treatments, or just confusion about their surroundings.
Hospitals have long known that the panic of delirium is preventable, but prevention isn’t easy, as it often requires staff who can spend time with patients beyond what doctors and nurses provide for treatment and recovery.
Methodist Hospital in St. Louis Park is now reporting the benefits of this commitment, though, and the payoff has been so good that its approach is spreading to other HealthPartners hospitals, including Regions in St. Paul.
Starting in one unit in 2010, Methodist staff checked twice daily on patients 70 and older, and ordered support for any showing signs of delirium. The support includes visits three times daily from any of 150 trained volunteers.
Of patients receiving support, 98 percent are discharged with no symptoms of the disorder, according to a HealthPartners analysis released last month. Methodist expanded the service to 10 units this year.
“Delirium is very frightening for patients … and this analysis adds to growing evidence that it can and should be prevented,” said Mary Brainerd, HealthPartners’ president and chief executive.
Research has found that patients with delirium suffer higher rates of death within six months of hospitalization, longer hospital stays, and more discharges to long-term care.
Delirium can get mixed up with dementia, but delirium typically produces rapid and unstable mood changes and confusion, while the path of dementia isn’t quite as helter skelter.
Minnesota hospitals have been leaders in addressing delirium; Unity Hospital in Fridley was lauded several years ago for its progress.
A key is knowing the risk factors, which include urinary-tract infections, dehydration, poor sleep and medications (including sleeping pills).
Methodist’s approach was created at the Yale University School of Medicine and is elegant in its simplicity.
Hospital staff manage hydration and physical needs. Volunteers read newspapers or cards to keep patients aware; clean their glasses and make sure they can hear; and keep patients’ brains churning with crosswords and puzzles.