Author: Caplan, Gideon

Source: Aging Health, Volume 4, Number 1, February 2008 , pp. 69-74(6)

Publisher: Future Medicine

Abstract:

Delirium is a common problem, mostly affecting older patients in hospital, which results in greater mortality, nursing-home placement and cognitive and functional impairment. Delirium can be triggered by a wide range of conditions, treatments and procedures, as well as by certain environments. Some hospital environments have been causally implicated, but until it was possible to compare treatment in-hospital with treatment in other places, the observation remained at the level of an association. However, the development of ``Hospital in the Home'' services has allowed clinicians to explore this question scientifically. Recently, a number of studies comparing treatment of acute conditions, both medical and surgical, and rehabilitation in hospital with treatment at home, have found a lower incidence of delirium with home treatment, as well as lower rates of the sequelae of delirium. Since delirium is an indicator of a wide range of subsequent poor outcomes, this information has broad implications for the delivery of hospital-level services to older patients, and means that health services should seek to provide Hospital in the Home services wherever older patients are treated.

Keywords: aged; delirium; dementia; Hospital in the Home; hospitalization; post-operative cognitive dysfunction

Document Type: Research article

DOI: http://dx.doi.org/10.2217/1745509X.4.1.69

Affiliations: 1: Prince of Wales Hospital, Randwick NSW 2031, Sydney, Australia and, School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia., Email: g.caplan@unsw.edu.au

Publication date: 2008-02-01

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• Aging Health leading coverage of current and emerging topics relating to the safe and effective management of therapy in the elderly, all subject to rigorous peer review. The journal focuses on the most important advances and highlights their relevance in the clinical setting. The journal has been designed to deliver essential concise information in an easily assimilable format - vital for the increasingly time-constrained professional.
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