The coronavirus pandemic has created conditions that cause delirium.
Early data from peer-reviewed studies suggest that one-third of hospitalized COVID-19 patients of all ages, and two-thirds of those with severe disease, show signs of delirium, an acute state of confusion that raises the risk of serious health complications and death.
That’s unacceptable to Sharon Inouye, professor of medicine at Harvard Medical School. Inouye is widely known for proving that delirium among older hospital patients is preventable. She created the world’s most widely used checklist to identify delirium and developed a program that hundreds of hospitals have used to reduce delirium cases by 40%.
The coronavirus pandemic has created conditions that are almost perfectly designed to cause delirium, says Inouye, who directs the Aging Brain Center in the Marcus Institute for Aging Research at Hebrew SeniorLife, a LeadingAge member in Boston. Patients who experience delirium in the hospital:
- Remain hospitalized longer than their peers.
- Have more complications.
- Are more likely to die during their hospital stay or in the following year.
- Are more likely to need long-term care or develop cognitive impairment, including dementia.
“We’re seeing an epidemic of delirium in COVID-19 patients globally,” says Inouye, who suggests there’s “a lot you can do” to help patients—even those on ventilators—avoid the condition, including:
- Walking patients around to raise oxygen saturation.
- Preserving the sleep/wake cycle by making the room dark and quiet at night and providing earplugs and eye masks.
- Playing soothing music.
- Minimizing drugs associated with confusion.
- Cycling medications, when medications are available.
- Lightening the sedation periodically for those who are sedated.
- Using orientation boards to help patients remember where they are.
- Facilitating remote visits with family members.
- Avoiding physical restraints.
- Providing vision and hearing aids as needed.
- Attending to nutrition and hydration.