Undiagnosed delirium may pose costs to seniors, health care system

Clinical experience reveals that family members can play a part in detection

Vancouver, Sept. 3, 2013 – Delirium, a health issue which is surprisingly underdiagnosed and undertreated, is the subject of the first of a free, three-part Dialogue on Aging series kicking off tomorrow and presented by the Tapestry Foundation for Health Care.

We are pleased to be bringing forward this important but often overlooked topic to our popular public presentation series. It is yet another positive outcome of our ongoing efforts to raise funds toward improved treatment of and education about issues that affect seniors,” said Ann Adams, Tapestry Foundation for Health Care CEO.

According to a recent study out of Harvard Medical School and Pennsylvania State University, total health care costs attributable to delirium reach up to $152 billion annually – almost twice the cost of diabetes at $91.8 billion. A 2012 McMaster University study found that 10 per cent of patients in non-critical care areas are delirious on any given day which has significant implications for patients and the health care system, including increased hospital stays with associated costs to hospital care as well as rehabilitation, institutionalization and home care. 

Valerie Krause, clinical nurse leader at the geriatric psychiatric unit at Mount Saint Joseph Hospital (MSJ), says many of these costs may be reduced through improved education about the condition.

Seniors are at higher risk for delirium because of age-related changes, chronic illnesses and polypharmacy (taking multiple medications). Delirium complicates hospital stays and increases hospital costs. Mortality rates for hospitalized older adults who experience delirium are much higher. However, delirium is often preventable if recognized promptly and treated appropriately, and there are many ways family members and friends can support a senior with delirium,” said Krause.

A wide variety of factors can cause and/or contribute to delirium – sometimes referred to as a “cognitive superbug” — such as untreated pain, infection, dehydration, medication reaction, general anesthetic (especially common after hip surgery), acute medical illness (stroke or heart disease), alcohol or substance misuse, sleep deprivation, hospitalization, and psychological factors such as grief and relocation stress. The risk increases as a senior grows older and becomes frail.

A senior may have delirium if he or she:

  • is disoriented and cannot maintain focus and attention;
  • is distractible, anxious and oversensitive to stimulation;
  • has altered language and thought processes;
  • is quiet, sleepy, withdrawn, lethargic (hypoactive delirium).

Even in a health care setting, delirium is easily missed or misdiagnosed. This is where family knowledge is critical and can serve to educate the health care provider about the senior’s health information, personality, routines and preferences, and cultural considerations.

When faced with a senior showing signs of delirium, we often recommend constant care as their disorganization and/or anxiety can put them at risk of harm. Delirium can be very frightening. If appropriate, a family member can stay with the patient day and night,” added Krause.

The Dialogue on Aging presentation, Dodging Delirium:  Recognition, Prevention and Treatment, takes place at 2 p.m. on Wednesday, Sept. 4 at VanDusen Botanical Garden, 5251 Oak Street (at West 37th Avenue) in the BMO Great Hall. Doors open at 1:15 p.m. Free onsite and street parking is available. To register, call 604.877.8335 or visit www.tapestryfoundation.ca.

MSJ is the proud home of an extremely busy, 16-bed geriatric psychiatry unit. As the population ages, more geriatric psychiatry beds are needed to meet the demand. To find out how you can make a donation to the Tapestry Foundation for Health Care toward services and equipment for MSJ’s geriatric psychiatry unit, call 604.877.8335 or visit www.tapestryfoundation.ca.

About Tapestry Foundation for Health Care
Tapestry Foundation for Health Care raises funds for eight hospitals and residences in Metro Vancouver operated by Providence Health Care. Sites supported include Mount Saint Joseph Hospital, Holy Family Hospital, Marion Hospice, St. Michael’s Centre, St. Vincent’s: Brock Fahrni, Honoria Conway-Heather, Langara, and Youville Residence. Donations support purchases of medical equipment, funding to support quality of life programs for the elderly, education programs, and geriatric research projects.

Michele Penz,
Calico Communications for Tapestry Foundation for Health Care
Tel: 778.888.2249
Email: calicocomm@telus.net