hospital-induced delirium

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I want to describe my mother’s experience of delirium, which culminated in her death nine days after she was admitted to the hospital. My mother died at the end of 2019. Since that time, I’ve read dozens of articles about hospital-induced delirium. Although the dangers of this condition have been known for decades, hospitals still lack adequate safeguards to protect elderly patients from delirium.

I want to share my mother’s story. I am curious to know if other people had similar experiences when their elderly relatives were hospitalized.

Delirium is often indicative of poor care in the hospital. It can result from excessive medication, immobilization of the patient, dehydration or malnutrition. It is indicative of hospitals failing their elderly patients.

At the time of her hospital admission, my mother was 88, frail and had heart disease. But she had a strong mind and had lived independently for the past decade. She didn’t believe herself to be seriously ill when she was admitted to the hospital with diarrhea and rectal bleeding.

My mother swiftly declined in the hospital. Two days after she was admitted, she told me she didn’t know where she was; this was shocking as my mother had never before become confused. Over the next few days, my mother’s speech became garbled. Then she could no longer speak. During her final days, her mouth hung constantly open. She recoiled from the least physical contact and gagged on the tiniest ice chip. She was increasingly less aware of her surroundings. She was malnourished; she did not eat at all during her last days. Repeated scans indicated she had not suffered a stroke.

My mother suffered a great deal in her altered mental state. She thrashed and screamed; her eyes darted uncontrollably. Hospital staff reacted to my mother’s worsening delirium with bland complacency. “It happens all the time,” a pulmonologist told me.

Doctors’ notes in my mother’s medical records suggest that anesthesia from an upper endoscopy (EGD) may have accelerated her delirium. Yet this possibility worried the doctors very little.

After my mother’s death, I wrote to the hospital with my concerns. The hospital informed me that an “administrative review” would examine my mother’s care. Weeks later, I received a letter documenting the “review.” The letter I received was a template response to a complaint with empty phrases apologizing that my “experience was unsatisfactory.” I still have no explanation for my mother’s very rapid decline.

I believe that my mother’s experience was sadly not unusual. There is simply no accountability; hospitals do not report the prevalence of delirium among their patients. Hospitals are failing older patients; medical studies show that doctors spend less time with patients who have advance directives for “do not resuscitate” (DNR). Doctors owe all their patients attentive care, even those with DNR directives. Patients and their families must demand better care.

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    @Elizabeth17941, I am so sorry for the loss of your dear mother. I too lost my mother just three years ago. She put up a valiant fight battling kidney disease for fifteen years and when she could no longer do the physical work of her job, fighting for her life became her job. My mother had about twenty hospital stays during her last fifteen years. I would estimate that delirium was a factor in at least half of those hospital stays. The delirium always eventually resolved, usually with extra dialysis treatments to remove residual anesthesia; or by getting Mom back home into comfortable surroundings and familiar routines. The one exception was her final hospital stay, and in that case the delirium actually began before she was admitted and never completely resolved. When i read the words of your mom's pulmonologist what i heard was, "It happens all the time at the end of life."

    I read a good book by doctor Atul Gawande called "Being Mortal" that i would like to recommend to you. It helped me come to an understanding of death as a normal part of the circle of life. It also helped me feel honored that my mom chose me to be the person to help her through her final transition.

    My mother passed away at the young age of 69. She was young and strong, and she lived independently up until her final hospital stay. Today, at the age of 79 my Dad too is approaching end of life. He has different underlying conditions he deals with and i hope to again be the best advocate and comforter that i can be.

    God bless. Ecclesiastes 3

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