Community Service as Patientsʼ Tutor to Avoid DeliriumArticle in several languages: English | deutsch
25 September 2019 (online)
Background Today, nearly two thirds of inpatients in trauma surgery hospitals are over 70 years old and at significant risk for comorbidities. These patients frequently suffer delirium. Delirium occurs in 15 – 30% of these trauma patients and increases the risk of mortality in up to 15 – 25% of cases. Conversation, attention, and activity significantly reduce this risk.
Objectives Thus, the Centre for Geriatric Traumatology and the District Seniors Council have initiated a new project of a visiting service, to prevent delirium and anxiety conditions in elderly inpatients. Volunteers from the welfare program offer daily care for selected patients.
Methods They care for and interact with the patients for approximately one hour per day. They accompany the patients in the hospital and during mobilization, explain, read aloud, converse, or simply listen, and thus provide calm, support, and company. The attendants are volunteers who have been previously trained by the clinic, who regularly attend team meetings and draw up reports from each admission. All patients and relatives are informed prior to these visits and are notified with an accompanying letter. There are structured visiting plans for each week.
Results From July 17 to May 19, 4031 patients in our clinic and in three other hospitals have been accompanied in the program. None of the patients suffered delirium. The patients and attendants found the care very good and personally satisfying. Evaluations of the volunteers for the success of their work, using the German school-grading system, was an average 1.3. Noticeable was the markedly reduced frequency of patient calls to nursing, who were thus relieved. Travel expenses and insurance costs for the volunteers were reimbursed.
Conclusion In times of skilled labour shortages, patient support provided by volunteer patient attendants enables innovative care for patients at risk for delirium. The assistance of the attendants alone reduced the workload on the nursing staff.
- 1 Bringemeier J, Thomas C, Gura M. et al. HELP zur Vermeidung von Deliren. Psychup2date 2015; 9: 137-148
- 2 Bubolz-Lutz E, Cosack A, Grote S, Wattad D. Patientenbegleitung. Lengerich: Pabst; 2015
- 3 Frühwald T, Weissenberger-Leduc M, Jagsch C. et al. Delir – eine interdisziplinäre Herausforderung. Z Gerontol Geriatr 2014; 47: 425-438
- 4 Prokop A, Reinauer KM, Chmielnicki M. Knapp 10 Jahre Altertraumatologiezentrum – eine kritische Bewertung. Z Orthop Unfall 2018; 156: 140-144
- 5 Mulligan O, Muresan L, Murray O. et al. Mortality at one year post delirium in general medical inpatients. Eur Psychiatry 2015; 30: 28-31
- 6 Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet 2014; 383: 911-922
- 7 Leslie DL, Inouye SK. The importance of delirium: economic and social costs. J Am Geriatr Soc 2011; 59 (Suppl. 02) S241-S243
- 8 Baron R, Binder A, Biniek R. et al. Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Ger Med Sci 2015; 13: Doc19 doi:10.3205/000223
- 9 Weinrebe W, Johannsdottir E, Karaman M. et al. What does delirium cost? An economic evaluation of hyperactive delirium. Z Gerontol Geriatr 2016; 49: 52-58
- 10 Statista Research Department. Statistiken zum Eherenamt in Deutschland. Im Internet: https://de.statista.com/themen/71/ehrenamt/ Stand: 27.03.2019
- 11 Braun T, Thiel C, Schulz RJ. et al. Diagnostik und Behandlung physischer Frailty. Dtsch Med Wochenschr 2017; 142: 117-122
- 12 Gurlit S, Möllmann M. How to prevent perioperative delirium in the elderly. Z Gerontol Geriatr 2008; 41: 447-452