In a perspective published in the New England Journal of Medicine, researchers from the Benson-Henry Institute (BHI) for Mind Body Medicine at Massachusetts General Hospital (MGH) call for broader use of mind-body practices.
What is delirium?
Delirium is a sudden state of confusion, inattention, and change in one’s ability to think clearly.
How common is delirium?
Delirium occurs in one in three patients 65 years and older who are hospitalized. It is most common in patients who are very sick – like those in the intensive care unit – or those with underlying medical problems, but can occur in any patient in any setting.
What are the effects of delirium?
People who develop delirium are more likely to stay in the hospital longer, be discharged to a rehab or nursing home rather than their own home and have trouble participating in their recovery. Because of this, delirious patients have a higher risk of death and permanent disability. Some patients with delirium will suffer with confusion for weeks to months after discharge and require ongoing support and care.
How is delirium different from dementia?
Delirium comes on suddenly (hours-days) and can often be reversed if addressed promptly. Some people with delirium are agitated while others are very sleepy. Some have periods of agitation mixed with times of sedation.
Dementia is a condition that comes on slowly - usually over years - and is not reversible. Patients with dementia often show memory problems and difficulty with daily tasks. Their ability to remember and do their daily tasks will gradually worsen over years.
Delirium can be prevented:
It’s important to recognize patients with delirium as soon as they show signs of the condition, and to target preventive strategies to those at the highest risk of developing delirium. Some proven strategies include staying hydrated and nourished, getting enough sleep, and keeping the body and mind active while avoiding unnecessary medications.
What is MGH Doing to Prevent, Assess, and Manage Delirium?
- In 2018, MGH formed a Delirium Steering Committee made up of experts in the field from all role groups and supported by hospital leadership.
- The Delirium Steering Committee and its workgroups are testing strategies focused on:Making systems changes to help providers identify, assess, document, prevent, manage, and monitor delirium using best-practice standards
- Promoting mobility – while also keeping patients safe from falling
- Maintaining activity carts and partnering with volunteers on inpatient units to keep patients engaged
- Educating clinicians and staff about changes and improvements as they occur
- Educating patients and family members about signs and symptoms so that if they notice delirium starting, they can alert the patient’s care team
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