Hospital puts spotlight on patient experience of delirium
Ten per cent of all patients admitted to hospital will experience delirium at some stage; this can increase to up to 40% in patients living with dementia and up to 80% of patients within an Intensive Care Unit (ICU). With World Delirium Awareness Day (13 March) approaching, staff at Princess Alexandra Hospital Trust are building on their recent success in promoting recognition of the condition by supporting the day with a range of activities.
Delirium is a state of mental confusion that can happen if you become medically unwell. It is also known as an 'acute confusional state'. Medical problems, surgery and medications can all cause delirium. It often starts suddenly and usually lifts when the condition causing it gets better. It can be frightening - not only for the person who is unwell, but also for those around him or her. (Royal college of psychiatry 2015)
Staff at the Harlow hospital have been working hard to ensure that everyone recognises the condition, and healthcare workers and family/carers can work in partnership to speedily respond to it.
What patients who experience delirium all say is how frightening it is. It causes confusion and patients often have unreal experiences and describe worrying visions. Seeing the distress the episodes cause prompted Caroline Ashton, the Dementia Clinical Nurse Specialist at PAHT, to bring together health professionals from across the community for a conference looking at causes and effective responses.
Such was the interest in the subject, that the conference attracted 150 healthcare professionals from Essex and Hertfordshire, ranging from doctors, nurses to healthcare assistants, mental health specialists, as well as patients, families and carers. It was also an opportunity to showcase collaborative work with partner organisations, such as the Alzheimer's Society and other charities. Feedback from the event was hugely positive.
Patients and carers shared their experiences in an open panel discussion.
Barbara, a nurse, had delirium following surgery; she knew what she was experiencing wasn't real but the things she saw were vivid - she saw an ocean outside her house and told her family and the GP they would need a boat to be able to get to her. Those memories have remained with her until now.
Sue, a dementia volunteer at PAH and carer spoke about her husband's delirium. He was living with dementia and she spoke about her distress at the sudden increase in confusion and change in her husband which was not his normal behaviour;
Matron for quality improvement at PAHT, Andy Dixon, spoke about his experience of delirium after being prescribed a strong painkiller. One thing that sticks in his mind is how scared he was. He didn't know whether he was awake or asleep and will never take that medication again.
Caroline explained her own commitment to raising awareness: "My dad, who died of cancer at the age of 60, had delirium leading up to end of his life. No-one had prepared me that this may indicate he was nearing end of life. This is why I have focused my career on dementia and palliative care."
The conference ended by raising the importance of interventions to help minimise the impact of deconditioning and raising the awareness of the role of the delirium champions which PAH will launch in 2019; while Julia Jones, the founder of John's Campaign, spoke about her efforts to extend the right of relatives to stay with patients in hospital who may need to be supported by familiar carers. This has already been in practice at PAHT since 2017.
You will be able to catch Caroline and her team on World Delirium Awareness Day, with a mobile "delirium trolley", if you would like advice or information. Look out for her from 3pm to 4pm at the patient information centre, at the front entrance to the hospital, Hamstel Road, Harlow CM20 1QX.
Royal College of Psychiatrists: