I don't know which forum is most appropriate for this post, so I picked this one.
Yesterday I heard a segment of NPR's Morning Edition about preventing delirium in older hospital patients. This is important not just in the short term but for the long-term health of the patient, because people who develop delirium in the hospital are more likely to develop Alzheimer's later on.
I told my Dad about this segment. He is both an anesthesiologist and a man in his seventies. He told me that when treating older patients preventing confusion is his greatest priority (after keeping them alive, of course!)
I'll post some of the things he told me, and that I heard on the show, for those of you who are either caring for a geriatric relative or who are older yourselves. I don't have the link to the show, but if you go to http://www.npr.org and click on "Morning Edition" you should be able to find the program.
Pharmacologically, my Dad told me two things: First, in the OR he likes to use short-acting drugs, so that geriatric patients do not wake up under the influence of drugs that make them sleepy, confused or disoriented. Even when they are "wide awake" they may be confused and need several reminders that they have just had surgery. This is also something he teaches his residents to keep in mind for test, like the kind we have prior to heart surgery. For example, while I received versed for several tests, he would use a different agent on an older patient.
Second, he strongly disagrees with doctors who automatically dose patients who awake confused in their hospital rooms with anti-anxiety medications. He says that this makes the situation much worse, not better.
The program talked about policies about letting geriatric patients sleep through the night, and not waking them for such things that are not essential. My Dad says that at Ford there are "quiet wards" with these kinds of policies. There a patient would not be awakened just to change sheets, for example. The entire hospital tries not to awaken patients for blood draws between midnight and 6am. (Unfortunately, there is nothing that can be done about 6am blood draws because the doctors need that info each morning.)
The program also talked about the great importance of glasses and hearing aids to geriatric patients. Someone like me can get along without my glasses for a while, even if I can hardly see anything. The worst that would happen to me is that I would be bored. (Can't read anything!) However, with older patients, great care should be taken to prevent confusion, which means that should clearly see and hear as much as possible.
I asked my Dad if it would be helpful to be sure that there is always a light on in the hospital room, so that upon awakening the patient can see that he or she is not at home. He said he didn't know; as we all know, one of the bad things about hospitals is that sometimes you want the room to be dark so you can sleep, and it isn't!
I hope this has been helpful to others!
Yesterday I heard a segment of NPR's Morning Edition about preventing delirium in older hospital patients. This is important not just in the short term but for the long-term health of the patient, because people who develop delirium in the hospital are more likely to develop Alzheimer's later on.
I told my Dad about this segment. He is both an anesthesiologist and a man in his seventies. He told me that when treating older patients preventing confusion is his greatest priority (after keeping them alive, of course!)
I'll post some of the things he told me, and that I heard on the show, for those of you who are either caring for a geriatric relative or who are older yourselves. I don't have the link to the show, but if you go to http://www.npr.org and click on "Morning Edition" you should be able to find the program.
Pharmacologically, my Dad told me two things: First, in the OR he likes to use short-acting drugs, so that geriatric patients do not wake up under the influence of drugs that make them sleepy, confused or disoriented. Even when they are "wide awake" they may be confused and need several reminders that they have just had surgery. This is also something he teaches his residents to keep in mind for test, like the kind we have prior to heart surgery. For example, while I received versed for several tests, he would use a different agent on an older patient.
Second, he strongly disagrees with doctors who automatically dose patients who awake confused in their hospital rooms with anti-anxiety medications. He says that this makes the situation much worse, not better.
The program talked about policies about letting geriatric patients sleep through the night, and not waking them for such things that are not essential. My Dad says that at Ford there are "quiet wards" with these kinds of policies. There a patient would not be awakened just to change sheets, for example. The entire hospital tries not to awaken patients for blood draws between midnight and 6am. (Unfortunately, there is nothing that can be done about 6am blood draws because the doctors need that info each morning.)
The program also talked about the great importance of glasses and hearing aids to geriatric patients. Someone like me can get along without my glasses for a while, even if I can hardly see anything. The worst that would happen to me is that I would be bored. (Can't read anything!) However, with older patients, great care should be taken to prevent confusion, which means that should clearly see and hear as much as possible.
I asked my Dad if it would be helpful to be sure that there is always a light on in the hospital room, so that upon awakening the patient can see that he or she is not at home. He said he didn't know; as we all know, one of the bad things about hospitals is that sometimes you want the room to be dark so you can sleep, and it isn't!
I hope this has been helpful to others!
but I will share an experience that I have only just had (today in fact).
