Heal­ing daze

The Walrus - - LETTERS -

Syd­ney Loney’s ar­ti­cle on hospi­tal-ac­quired delir­ium (“The Delir­ium Di­ag­no­sis,” No­vem­ber) ap­peared dur­ing a dif­fi­cult time for my fam­ily. Two weeks ear­lier, an el­derly fam­ily mem­ber had been ad­mit­ted to hospi­tal after a fall. Soon after, this rel­a­tive — who, pre­vi­ously, reg­u­larly won at Scrab­ble and could talk at length about cur­rent events — be­gan to ex­hibit the symp­toms of delir­ium, in­clud­ing deep con­fu­sion and dis­tress.

Break­ing the si­lence on this lit­tle­known health prob­lem is an im­por­tant first step to­ward im­prov­ing care for Canada’s most vul­ner­a­ble cit­i­zens. As baby boomers age, cre­at­ing uni­ver­sal guide­lines to pre­vent hospi­tal-ac­quired delir­ium may save the health care sys­tem mil­lions of dol­lars — and save count­less fam­i­lies the grief of watch­ing their loved ones suf­fer.

Meaghan Thurston

Mon­treal, QC

Pa­tients, fam­i­lies, and doc­tors could im­ple­ment sev­eral mea­sures to­day to pre­vent or mit­i­gate the symp­toms of the com­mon men­tal dis­or­der that Loney de­scribes in her ar­ti­cle. But alone, they are not enough: the next step is to de­velop pol­icy that em­pow­ers pa­tients to make de­ci­sions about their own treat­ment.

Doris Wrench Eisler

St. Al­bert, AB

While hos­pi­tals try their best, there’s no sub­sti­tute for the home en­vi­ron­ment, par­tic­u­larly dur­ing a highly stress­ful time. Don’t be too hard on the hos­pi­tals and their staff. They’re try­ing their best. El­iz­a­beth Wordsworth

Christina Lake, BC

I agreed to be in­ter­viewed for Loney’s ar­ti­cle be­cause, as a prac­tis­ing neu­rol­o­gist and crit­i­cal-care doc­tor, delir­ium and its longterm con­se­quences are passionate re­search in­ter­ests of mine. Peo­ple need to un­der­stand the dis­or­der and how to deal with it. But I was dis­ap­pointed in how my opin­ion was rep­re­sented; by as­so­ci­a­tion, the ar­ti­cle im­plied that I shared many views I dis­agree with. For ex­am­ple, delir­ium and post-icu cog­ni­tive im­pair­ment are con­se­quences of ill­ness, not of in­ad­e­quate care by doc­tors. De­spite a hospi­tal’s best ef­forts, pa­tients may ex­pe­ri­ence com­pli­ca­tions. Loney’s ar­ti­cle spec­i­fied that delir­ium is caused “in large part” by in­ad­e­quate care, but these three words do not con­vey how lit­tle blame should be as­signed to doc­tors. This was re­it­er­ated to the fact-checker, ver­bally and in writ­ing.

At­tribut­ing delir­ium to “in­ad­e­quate care” sen­sa­tion­al­izes the is­sue and un­der­mines the hard work of those car­ing for the sick­est pa­tients and their fam­i­lies. I am dis­ap­pointed The Wal­rus chose this ex­pla­na­tion. Gor­don Boyd

Kingston, ON

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