Dementia: Delirium is not only triggered by alcohol

Dementia: Delirium is not only triggered by alcohol

Delirium in dementia patients possible consequence of operations

After surgery, dementia patients often show a state of massive confusion, the so-called delirium. Too often, the population, but also among experts, is still too vague about the term “delirium”, reports “Der Tagesspiegel”, citing Albert Diefenbacher, chief physician of psychiatry, psychotherapy and psychosomatics at the Queen Elisabeth Herzberge Evangelical Hospital (KEH). .

The delirium is usually equated with alcohol and alcohol withdrawal, although this is only a special form of delirium - namely the "delirium tremens" - Albert Diefenbacher told the "Tagesspiegel". Eckehard Schlauß, gerontologist at the Queen Elisabeth Herzberge Evangelical Hospital (KEH), adds that surgery and the subsequent complex treatment in the hospital often lead to delirium in dementia patients. If this is misinterpreted, it can quickly end in a vicious circle of measures and result in a severe deterioration in the patient's condition. After surgery, up to 30 percent of people over the age of 70 suffer from postoperative delirium, reports Der Tagesspiegel, referring to a study at KEH.

Informing the nursing staff According to the experts, the acute state of confusion after an operation can be reflected, for example, in a massive lack of orientation, which in turn may lead to strange behavior such as urinating in the corridor. Those affected often end up in psychiatry as a result of the behavioral problems, "these patients are not mentally ill," quotes "Der Tagesspiegel" the chief physician Albert Diefenbacher. Dementia delirium management has been in place at KEH for a year and a half to educate staff. Nursing experts are trained and trained here. The experts also present the program at conferences and congresses. For the project "Establishing a clinical pathway through liaison care as part of the prevention and treatment of elderly patients with delirium in surgical wards in the general hospital - a health care research study on liaison care", the KEH doctors were awarded the 2014 Innovation Prize by the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) awarded.

Delirium risk significantly reduced With the help of dementia-delirium management, the overall risk of delirium after surgery was significantly reduced, reports Eckehard Schlauß. Overall, the most difficult task was to change the awareness and attitude of the staff, Diefenbacher adds. Today, the doctors and nursing staff at the KEH would be equipped with a so-called "Delir Pocket Card", on which, among other things, the symptoms of a delirium were described and starting points for review were explained, reports "Der Tagesspiegel". Although the delirium is reversible, dementia, which can progress rapidly under it, is not why prevention is of particular importance here.

The mattress can be decisive According to the experts, the mattress can also be a sticking point. So-called anti-decubitus mattresses, which are used to avoid pressure sores, would remove the feeling of lying on a firm surface. As a result, the patients "then no longer know where you are in the room," quotes "Der Tagesspiegel" the chief physician Diefenbacher. For this reason, according to the expert, the anti-decubitus mattresses should not be used in dementia patients. According to Diefenbacher, it can also help to adjust the headboard of the bed from time to time in order to give patients better orientation. Furthermore, the nursing staff should be careful not to move the patients from one room to the other too often because the increasing disorientation increases the risk of delirium. (fp)

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Video: What is delirium? Mental health. NCLEX-RN. Khan Academy