Foundation grants target hospital delirium
Marsha Atkind said delirium prevention “has the potential for changing the culture of caring for elderly patients.”
January 16, 2013
The Healthcare Foundation of New Jersey is moving forward with a $900,000 grant to prevent and treat delirium in hospitalized patients.
The funds enable area hospitals to hire elder-life specialists who help reduce risk factors for the sudden and severe confusion that often afflicts elderly patients.
Since launching the grants program in 2011, the foundation — created with funds from the sale of Newark Beth Israel Medical Center — has given seed money to anti-delirium programs at seven hospitals.
The grants have “the potential for changing the culture of caring for elderly patients in our hospitals and improving their quality of life post-discharge,” said Marsha Atkind, foundation executive director. “Many of us have relatives who have gone to the hospital in a perfectly fine mental state, but when they are in the hospital, they develop confusion.”
Symptoms of delirium can range from mild confusion to hallucinations. Delirium can be caused by anything that disrupts normal brain function, including sleeplessness, infection, medications, and unfamiliar surroundings.
A local woman told NJJN about the dismay of watching a parent suffer with hallucinations while in an intensive care unit after undergoing heart surgery.
“It is horrible,” said the woman, who requested anonymity. “When my father was in the ICU he said I had to get him out of there because the nurses were killing old people at night. He was delirious. He was pulling out his IVs,” she said. “I didn’t know what to say. I didn’t know what to do.”
Her father “went back to being perfectly normal” after being taken off some of his medication and leaving intensive care.
“He was lucky,” she said. “With many people it has lasting effects. If nurses don’t take the time to tell patients what is going on and make them feel more comfortable, this can continue.
“We are not sure how to cure cancer,” she added. “But we damn sure can make hospitals better places for elderly people to be in.”
Four hospitals — Newark Beth Israel Medical Center, University Hospital in Newark, Morristown Medical Center, and Overlook Hospital in Summit — received the foundation funding in 2011.
A year later, the foundation gave seed money to anti-delirium programs at three other institutions: Saint Barnabas Medical Center in Livingston, Trinitas Hospital in Elizabeth, and Clara Maas Hospital in Belleville.
Some of the hospitals have set up “activity rooms” which persuade patients out of bed for card games, current events discussions, “and all kinds of things to keep their minds engaged so they don’t lose contact with reality,” Atkind said.
Other simple measures — such as ensuring that patients have hearing aids and glasses and are aware of the time and date — can make a big difference in the way they relate to each other and to themselves.
Medical specialists are being asked to “institute medication protocols so that all the nurses and doctors are trained to recognize which medicines are most harmful,” said Atkind.
Delirium prevention is also a cost-effective strategy.
“It’s a win-win situation,” said Ellen Wagenberg, a Livingston resident and Healthcare Foundation board member. “For the nurses and nurses’ aides, a patient requires a lot of extra care. If the staff is aware early on of who the patients are and how to treat them, they could prevent a lot of problems. It is also cost-effective for both the patients and the hospitals.”