A Patient with Delirium. Don’t Say: “You’re Confused!”

Dr. Inouye has been discussing delirium. By coincidence I recently cared for a patient with acute and distressing delirium. Sue is an 80-year-old woman who has mild Alzheimer’s Disease. Recently she fell and fractured a small bone in her hand. She was seen in the emergency room and a cast was put on. She was given a narcotic, hydrocodone, to relieve the pain. That night, at 1:30 in the morning, she walked over to her neighbor’s house in her nightgown. Her husband was sleeping next to her but didn’t wake up. The neighbors brought her […]

Delirium, prevention and long-term outcomes

For more than 30 years, Dr. Sharon K. Inouye has dedicated herself to the identification and prevention of delirium in the hospital. She created the Confusion Assessment Method (CAM), the most widely used method for identification of delirium worldwide. In her last video, Dr. Inouye described the features of delirium. She now discusses preventative strategies and long-term outcomes.

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Dr. Sharon K. Inouye explains delirium in older patients

Acute confusion is extremely common in hospitalized older adults. One third of general medical patients who are 70 years of age or older have delirium. For more than 30 years, Dr. Sharon K. Inouye has dedicated herself to the identification and prevention of delirium in the hospital. She created the Confusion Assessment Method (CAM), the most widely used method for identification of delirium worldwide. In addition, she is the champion of the Hospital Elder Life Program (HELP). In this video, Dr. Inouye explains delirium.

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The Life of a Caregiver: Ojay

I wanted feedback on GeriatricswithAloha.com. A caregiver named Ojay provided that. In the process, I immediately felt that caregivers like Ojay, and patients like his parents,  are the reason I’m working on GeriatricswithAloha. This is the first of a two part video about Ojay. This video talks about how he came to be a caregiver and his daily routine. It was a privilege to get a glimpse of his life.

3 Important No-no’s | Talking to a Person with Dementia /Alzheimer’s Disease

Dad has Alzheimer’s disease. You are a loyal daughter (Jill) who visits often and brings his favorite foods. On one visit, Dad has a big smile when he sees you. “Hi Mary” “Dad, I’m NOT Mary. (Mary is your older sister.)  What’s my name?” “Oh, gosh. Where’s Mary?” “Dad, I’m Jill!! Why do you always ask about Mary? Are you trying to get on my nerves?”

What’s the Most Likely Outcome in Your Case?

Mom Has Been Misplacing Things Your 84-year-old mother has Alzheimer’s disease. She has always tended to be anxious. Now that she has Alzheimer’s disease, the anxiety is much worse. She has been misplacing things such as her glasses and medicines. This happens frequently and she quickly becomes upset. She will claim that somebody took them. The hired caregiver becomes so fed up with the constant accusations that she leaves. “I didn’t want her here anyway,” says Mom. “She kept stealing my things!” The caregiver is gone but things continue to disappear: “Where did you put […]

Agitation – A Clear Description Leads to the Best Action Plan

A nurse working at night in the hospital calls the doctor asking for help: “I have a patient, Mrs Jones. She’s very agitated. Can you order some Imagine being the doctor in the above situation. The request can have multiple outcomes. The night doctor does not know the patient well. In addition, the doctor is busy and does not want more phone calls about the patient. In the worst-case scenario, a high dose of the medicine is ordered. The patient subsequently becomes over sedated and the next day she chokes on her food leading to […]

She Doesn’t Want to Do Anything? Is that Depression? Maybe Not

“Mom used to enjoy shopping, seeing friends, and going out to eat. After she was diagnosed with mild Alzheimer’s Disease, she’s changed. Now she just wants to stay at home and sit there.” It’s logical to think that a person with Alzheimer’s Disease might be depressed. After all, isn’t it a depressing disease? Depression IS commonly seen in Alzheimer’s Disease and other types of dementia. Loss of interest is a key feature. However, there is another possibility that is frequently overlooked. That person may have apathy, a loss of interest in doing things. Let’s take […]

The Brain is Like a Computer | Is It just Getting Older, or Is It Getting Dementia?

What is dementia? Here are some simple concepts to start with: The brain does three very important things. Each of these is impacted when a person develops dementia. The brain can be thought of as an amazing, living super computer. Dementia is a general term for diseases that injure the brain over time. An old brain is not the same as an injured brain. Three Important Things a Brain Does The first moments of life are unforgettable. A baby is born and starts crying. From that moment forward, the brain will experience a lifetime of […]