For the elderly patient it is often difficult to adapt to significant changes such as hospitalization – explains Dr. Agnese Rossi, psychotherapist at Humanitas Gavazzeni – The disease itself is an obstacle that makes everyone more vulnerable, even more so the elderly. It often leads to a decline in cognitive functions, linked both to physiological processes and to psychological discomfort resulting from situations that lead to suffering and stress, both for patients and for family members. The disorientation can be spatio-temporal, it can involve psychomotor agitation, difficulties in the management of simple daily activities, it can alter the sleep-wake rhythm and sometimes it can reach delirium (or acute confusion state) in which the state of consciousness, perception, conception and thought become disorganized.
Can the disorientation be permanent?
Sometimes it is, but it depends on the patient’s clinical condition before hospitalization. If there are already physical disabilities, or a perceptual deficit such as hearing loss (deafness) or visual impairment, or cognitive disorders such as the onset of dementia, the situation usually gets worse. This is because removing the elderly person from their daily habits increases the risk of a generalized worsening, where the cognitive aspects are directly involved along with the emotional and physiological ones. Memory, attention, language, but also mood and autonomy can all suffer.
What can be done to help older people keep in touch with the reality in hospital?
First of all, the constant presence of loved ones alongside elderly patients serves to reassure and support them in a context that is chaotic and confusing for them. In fact, seeing familiar faces and hearing familiar voices make the hospital environment less aseptic. Moreover, to make the environment more livable and less anonymous for the elderly, it would be useful to personalize it as much as possible, or rather make objects known to the patients (their pyjamas, an object they are fond of on the bedside table) visible to the patient and stimulate them, where possible, to perform the usual activities (read the newspaper, watch the television program that interests them, offer food that they appreciate, reduce the prolonged enticement as much as possible). It is also important to promote rest at night, so as not to upset the sleep-wake rhythm and gradually accustom it to the novelties it has to face, with clear and understandable explanations.
Can involving them in the “things at home”, that is, in everyday life, help the elderly?
Of course, especially if they are stimulating and rewarding activities and in particular if they have been interesting activities for the patient in the past (cooking, flower care, etc.), together with the company of a loved one, which reassures him and guarantees him to suffer as little as possible from loneliness, which for the elderly can be a determining factor in the deterioration of the quality of life.
It is important to bear in mind that the elderly population today is constantly growing and requires more and more attention from a social and welfare point of view, especially in the case of chronic pathologies or disabilities. This implies rethinking the care of the elderly in their totality and complexity, not only for the specific pathology they present at the moment, but welcoming them in their fragility and vulnerability with the aim of ensuring dignity in this delicate phase of life, in which organic diseases and cognitive decay influence each other. Therefore, we will have to invest more and more in home care, providing good support to families in order to keep the elderly as much as possible in the home, which helps to maintain their sense of identity and reduces the risk of cognitive impairment.
