For aging patients, delirium can be a frightening and potentially dangerous condition. But it often goes undetected in hospitals, nursing homes, home health care and adult day centers.
Margaret Bull, Ph.D., a leader in elder health care, wants to change that. Bull is researching the prevalence of delirium in elders attending adult day centers. “Delirium is marked by a sudden change in cognitive status. If delirium is detected and treated early, it can usually be reversed,” says Bull, a professor of nursing. “But if left untreated, it can lead to quicker decline in functioning or even death.”
Previous research has shown that health care providers are often “not tuned in to assessing for delirium,” says Bull. Hospitals frequently discharged patients without detecting their delirium, which further deteriorated the patients’ health and created confusion and worry for their caregivers. To prevent that, Bull is using a four-minute screening that could lead to early detection of delirium. She is the first researcher to use the screening in community settings.
Why is delirium so often missed? The nationwide nursing shortage means that often the same nurse does not interact with the patient for long enough to recognize the sudden onset of confusion or disorientation that marks delirium. Family members often dismiss the symptoms as part of the aging process. Shorter hospital stays also mean that providers might not notice a change in cognitive status.
Bull hopes her research will lead to improved understanding of care for elders in community settings. “As adult day care and similar arrangements become part of long-term care plans for those living at home or with relatives, this information is important,” she says. “People in contact with elders on a regular basis are key to recognizing symptoms of a condition that can be readily treated.”
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