How Do You Rebuild Trust

by DavalosMcCormack on June 22, 2010

Faith and trust are such delicate things. Once broken or damaged they are not easily repaired. Just as a dog that bites you is always going to be suspect, when an organization that you turn to for help lets you down you will have a hard time trusting it ever again.

I was thinking about that today when I read an article in the New York Times about something called “hospital delirium”, where patients experience episodes of disorientation, even hallucination, during their time in the hospital. It mirrored a couple of recent personal experiences and left me wondering just how widespread the problem is.

Scared and Confused

Elderly patients in hospital often suffer delirium

Delirium can be deadly for elderly patients

In one incident my aunt in Ireland, a feisty 94 year old, was in a care facility for a few days and became – as they called it – confused. She fell out of bed. Three times. Fortunately she’s in great shape for her age and although she suffered some pretty bad bruises and some cuts she didn’t break anything. A few days later she went back home and is now fine – no confusion. Coincidence!

The second incident was when the mother of a friend had to undergo surgery for a hernia. Afterwards the mother, who is in her mid-80’s, was hooked up to all sorts of monitors and devices in the Intensive Care Unit for days. She also had a tube down her throat to help her breathe, which caused her a lot of discomfort and anxiety. My friend was eager to get her mother out of the Intensive Care Unit and back to her own home as quickly as possible and was working hard to get the doctors to remove the tube so her mother could breathe on her own. Things were progressing nicely until one night when her mother became “disoriented” and fell out of bed, breaking her hip.

She had to undergo surgery the next day to repair the break, further complicating her already complex recovery.

Word Play Hides Problem

Note the words used in both cases. “Confusion.” “Disoriented.” Words that effectively absolve the hospital of blame. But the piece in the NY Times on delirium shows how often times the care that people get in the hospital, and in particular the cocktail of medications they are placed on and the changes in their routine – waking them up to do tests, moving them from one room to another, being in shared room with another patient, being in a room that is rarely dark or quiet – can lead to delirium. In fact the article quotes one study showing that one third of elderly people in the hospital suffer from the problem and that it can greatly increase their risk of dying.

So substitute the words that absolve the hospital of responsibility, and replace them with “delirium” which is often a direct result of the care they receive and all of a sudden you begin to get a completely different view of hospitals. And it’s not a very reassuring one.

If I were elderly – and I’m no spring chicken – it would make me think twice about going into the hospital.

Need for Open and Honest Approach

Prescription drugs can be a cause of delirium

Medications can be a cause of delirium in patients

Hospitals don’t like to talk about these kinds of things because it doesn’t reflect well on the level of care they give. That’s why they like to use terms that deflect attention away from the cause, to make it appear as if the problem just arose out of thin air. I can understand that. I work for a hospital – and a darn good one at that – and know just how dedicated and hard working the staff are, and how committed they are to doing their best for all their patients. But sometimes things go wrong and when they do we need to face up to it.

If we don’t, we risk losing two precious things. A patient. And trust

10 Tips to Avoid Confusion in the Hospital

If you have an elderly friend in the hospital,  Dr. Sharon Inouye’s website, “The Hospital Elder Life Program” (HELP) has some great advice and useful information for you, including, 10 tips to avoid confusion in the hospital.

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