IngentaConnect Does Hospital in the Home treatment prevent delirium?

Author: Caplan, Gideon¹

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

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: 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

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Does `Hospital in the Home' treatment prevent delirium?