Spending time as a hospital patient is challenging for anyone, but it is especially hazardous for older adults. Hospitals are bright, noisy, fast-moving places where sleep is often disrupted, and patients may be on new or altered medication. Even those who are mentally alert, may experience periods of disorientation in a hospital environment. Such was the case with Anna, a woman in her seventies, who had fallen at home and found herself in the hospital emergency room with cracked ribs and a broken wrist. Anna also appeared dehydrated, so the doctors decided to keep her overnight for observation.
Alone in her dark, unfamiliar hospital room, Anna became frightened and confused. She was in pain and on new medication. When a nurse arrived and startled her, Anna struck out in her confusion. She was suffering from hospital delirium. In response, the hospital staff ordered medication to calm Anna and to help her sleep. The heavy medication made Anna listless and unresponsive. Her family was shocked by her condition, and called us for help.
The following day, hospital staff advised Anna’s family that she should be transferred to an assisted living facility due to her level of confusion and inability to care for herself. Unaware that she was on new medication, Anna’s family members were heartbroken.
That is when we stepped in. We reviewed Anna’s chart and discussed her new medication with the doctor. Anna had been living independently prior to the hospitalization - not listless and unresponsive. While the doctor was hesitant to immediately remove all of Anna’s new medications, a plan was made to wean her off the medication over a period of two weeks. Anna was sent home with an aide to help provide care while she recovered. Within a short time, Anna was alert and feeling strong. An event that could have marked the beginning of a slow decline, turned out to just be a small setback in Anna’s long and fruitful life.