- Email: [email protected]
Delirium
European Geriatric Medicine 1 (2010) 373
Introducing the case
Delirium A.J. Cruz-Jentoft Servicio de Geriatria, Hospital Universitario Ramon Y Cajal, Ctra. Colmenar km 9100, 28034 Madrid, Spain
Mrs. D. is a 84-year-old woman, who has recently been admitted to the hospital for an elective surgery of a colon cancer. She suffers from type 2 diabetes, obesity, chronic obstructive lung disease, osteoarthritis, and moderate deafness. She is usually on seven different drugs for these conditions. She lives alone, and has only one daughter who lives in a town 100 km away from her and visits her monthly. She is independent for her basic ADL, although she reports recent urge incontinence. She performs most of her instrumental ADL, but needs some help for complex finances and transportation. Recently, she has subjective memory complaints, which have never been assessed. Nine months later she suffered a mild delirium after an uncomplicated urinary tract infection; she recovered uneventfully. On the second day after successful colon surgery (non-invasive adenocarcinoma), the surgeon calls the geriatrician to assess acute mental changes, with fluctuating level of consciousness, memory loss, disorientation, and visual hallucinations. Expert geriatricians from three different countries will be asked to explain how this patient will be cared for, what would be considered standard care in the country. Questions that may be interesting for readers will be:
Is delirium systematically assessed on hospital admission? If so, what instruments are used for detection and who makes the assessment? If not, how are cases of delirium detected and who is called to care for them? Are standard diagnosis instruments used? Are standard assessment protocols used by geriatric departments? What are usual diagnostic procedures? What kind of supportive treatment is offered? Are drugs used for symptom control? What is the usual attitude of health care providers (physicians, nurses, aides) and caregivers/family members towards delirious patients? What is the follow-up after hospital discharge? Who cares for these patients? Is there any program on prevention on delirium at work in the country?
Conflicts of interest statement None.
DOI of original article: 10.1016/j.eurger.2010.09.011 Adresse e-mail : [email protected]. 1878-7649/$ – see front matter ß 2010 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. doi:10.1016/j.eurger.2010.09.009
Introducing the case
Delirium A.J. Cruz-Jentoft Servicio de Geriatria, Hospital Universitario Ramon Y Cajal, Ctra. Colmenar km 9100, 28034 Madrid, Spain
Mrs. D. is a 84-year-old woman, who has recently been admitted to the hospital for an elective surgery of a colon cancer. She suffers from type 2 diabetes, obesity, chronic obstructive lung disease, osteoarthritis, and moderate deafness. She is usually on seven different drugs for these conditions. She lives alone, and has only one daughter who lives in a town 100 km away from her and visits her monthly. She is independent for her basic ADL, although she reports recent urge incontinence. She performs most of her instrumental ADL, but needs some help for complex finances and transportation. Recently, she has subjective memory complaints, which have never been assessed. Nine months later she suffered a mild delirium after an uncomplicated urinary tract infection; she recovered uneventfully. On the second day after successful colon surgery (non-invasive adenocarcinoma), the surgeon calls the geriatrician to assess acute mental changes, with fluctuating level of consciousness, memory loss, disorientation, and visual hallucinations. Expert geriatricians from three different countries will be asked to explain how this patient will be cared for, what would be considered standard care in the country. Questions that may be interesting for readers will be:
Is delirium systematically assessed on hospital admission? If so, what instruments are used for detection and who makes the assessment? If not, how are cases of delirium detected and who is called to care for them? Are standard diagnosis instruments used? Are standard assessment protocols used by geriatric departments? What are usual diagnostic procedures? What kind of supportive treatment is offered? Are drugs used for symptom control? What is the usual attitude of health care providers (physicians, nurses, aides) and caregivers/family members towards delirious patients? What is the follow-up after hospital discharge? Who cares for these patients? Is there any program on prevention on delirium at work in the country?
Conflicts of interest statement None.
DOI of original article: 10.1016/j.eurger.2010.09.011 Adresse e-mail : [email protected]. 1878-7649/$ – see front matter ß 2010 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. doi:10.1016/j.eurger.2010.09.009