Dementia Delir not just triggered by alcohol

Delirium in dementia patients possible consequence of operations

01/16/2015

After surgery, dementia patients often show a state of massive confusion, the so-called delirium. It prevail in the population, but also among professionals too often uncertainty about the term „delirium“, reported „The daily level“ citing Albert Diefenbacher, chief physician of psychiatry, psychotherapy and psychosomatics at the Protestant Hospital Queen Elisabeth Herzberge (KEH).

The delirium is usually equated with alcohol and alcohol withdrawal, although this is only a special form of delirium - namely „Delirium tremens“ - form, so Albert Diefenbacher opposite the „Tagesspiegel“. Eckehard Schlauß, gerontologist at the Protestant Hospital Queen Elisabeth Herzberge (KEH), adds that surgery and subsequent complex treatment often lead to delirium in dementia patients. If this is misinterpreted, it could quickly end in a vicious circle of measures and bring about a severe deterioration in the condition of the patients. After surgery, up to 30 percent of over-70s suffer from postoperative delirium, reports „The daily level“ citing a study at KEH.

Education of the nursing staff
According to the experts, the acute state of confusion after an operation can, for example, be reflected in a massive disorientation, which in turn may cause strange behavior such as urinating in the corridor. The affected people often end up in psychiatry as a result of their behavioral problems, „These patients are not mentally ill“, cited „The daily level“ the chief physician Albert Diefenbacher. To educate the staff there has been a dementia-delir management at KEH for one and a half years. Nursing experts are trained and trained here. The experts also present the program at conferences and congresses. For the project „Establishment of a clinical pathway through liaison care as part of the prevention and treatment of elderly patients with delirium at surgical wards in the General Hospital - a care research study on liaison care“ The KEH physicians were awarded the Innovation Prize 2014 of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN).

Delir risk significantly lowered
With the help of the dementia-delir management, the risk of delirium could be significantly reduced after surgery, Eckehard Schlauß reports. All in all, the most difficult task was to change the consciousness and attitude of the staff, adds Diefenbacher. Today, the doctors and nurses in the KEH with a so-called „Delir Pocketcard“ which describes, inter alia, the symptoms of a delirium and points of departure for the review are explained „The daily level“. Although the delirium is reversible, but the dementia, which can progress rapidly, it is not, why prevention is of particular importance here.

The mattress can be crucial
A sticking point here, according to the experts, the mattress. So-called anti-decubitus mattresses, which are used to prevent pressure ulcers, would relieve the sensation of lying on a firm surface. As a result, the patients know „then no longer where you are in the room“, cited „The daily level“ the chief physician Diefenbacher. For this reason, the anti-decubitus mattresses in dementia patients should not be used, according to the expert. 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. In addition, nurses should be careful not to move patients too often from one room to another because increasing disorientation increases the risk of delirium. (Fp)