Being in the hospital isn’t supposed to be fun, but it shouldn’t have to be a nightmare either. It isn’t unusual for older patients to enter into a state of disorientation that can hardly be called anything else This nightmare state is labeled “cognitive impairment” but the fact that it has a name doesn’t make it any less frightening. If it seems to you, the onlooker, that your loved one has literally “lost his or her mind,” how do you think it feels to them?
The stress of hospitalization, drugs, pain, sleep deprivation and mental confusion are hard to handle at any age but even more profound in older people. In the past nobody knew what was happening. All they knew is that grandma was screaming, biting, hitting out, pulling out drainage tubes, taking off oxygen masks, and scaring everyone to death. Needless to say these behaviors were frightening to family members and frustrating to care givers.
The good news is that the experts have identified why older patients behave the way they do when faced with multiple stressors. It isn’t their fault, and it isn’t the fault of the care givers or the family members who love them.
Cognitive impairment associated with critical illness and hospitalization is real, and it can seriously affect a person’s ability to recover. Fortunately, methods have now been identified to address the problem. Prevention and treatment involves family members as well as understanding caregivers.
You may be thinking that having your loved one in a place with 24/7 supervision is enough; it isn’t. Family members need to be actively involved, even if it means taking turns staying with grandma.
- Spend time with the patient. Offer reassurance and frequently remind them where they are. Hand holding is the treatment of choice.
- Have clocks, calendars, and pictures of loved ones in the room. Engage in meaningful conversations and read the newspapers to them.
- Make sure that they have their glasses and hearings aids so that they can see and hear everything.
- Allow as much uninterrupted sleep as possible, especially at night.
- Getting hospitalized patients out of bed and walking as soon as possible is part of the treatment. Recognize that caregivers are not being cruel and unfeeling; you are not doing the patient a favor by being overly sympathetic.
- Avoid the use of unnecessary medications. Do not beg for additional pain medication because you can’t stand to see them this way.
Understand the wisdom of day surgery for minor procedures and don’t fuss when the ER doctor recommends home care instead of hospitalization. Make arrangements for someone to stay with your favorite patient at home. If hospitalization is necessary for surgery or extreme illnesses stay with them as much as hospital policy allows. Many hospitals will provide comfortable chairs or beds so that relatives can stay in the room. Family intervention will do more to prevent cognitive impairment in older adults than all the medicine in the world.