May 10, 2018

WAKE UP Strategies for Reducing Hospital-Acquired Delirium

The condition, once known as "ICU psychosis," disproportionately affects seniors and those who have been heavily sedated-and the delusions can last long after the patient is discharged. Delirium is a sudden disruption of consciousness and cognition marked by vivid hallucinations, delusions and an inability to focus. The disorder can occur at any age, but more often affects people older than 65 and is frequently misdiagnosed as dementia. While delirium and dementia can coexist, they are distinctly different illnesses. Dementia develops gradually and worsens progressively, while delirium occurs suddenly and typically fluctuates during the course of a day. Some patients with delirium are agitated and combative, while others are lethargic and inattentive. Patients treated in intensive care units who are heavily sedated and on ventilators are particularly likely to become delirious; some studies place the rate as high as 85 percent. The condition is also common among patients recovering from surgery and in those with something as easily treated as a urinary tract infection. Regardless of its cause, delirium can persist for months after discharge. Read the patient story that led to the creation of the Hospital Elder Life Program (HELP) for prevention of delirium.

The FHA WAKE UP campaign promotes opioid and sedation management with the goal of reducing unnecessary sleepiness and sedation, which allows for early mobilization, reduction of delirium, decreased risk of respiratory compromise and shortened length of stay.  Free resources and tools are available on the FHA WAKE UP website.