hosp delirium

[meerkat111]

Lately, we have a string of older demented people from memory care units getting hospitalized. There was one person who by the time I got called completely out of control on the floor though he/she was fine in ED. Turns out she/he had to pee and nursing did not understand why she/he was agitated. What do we do as doctors do when restraining is in full force with a pt kicking and screaming and then u get called in? I am finding out that the basic things such as urination and defecation are addressed most of these individuals would be less delirious and psychotic yet, the nursing is reluctant to address these basic things as these tasks are unpleasant. It seems to me everyone is too busy playing the doctor to do anything else...

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[ROBINHO]

Most delirium can be managed by re-directing patient. But as you have noted , it is not easy to managed delirium or dementia because you can spend every 5 minutes re-directing patients. A nurse who has 4 plus patients to take care off, cant spend all day re-directing one patient. They are paging you because they want chemical restraint (haldol, seroquel etc) which is not the solution in a perfect world. SOme hospitals make sitters available for such patients.