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| Home > Healthy People > April 2004 |
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Spring 2004
Away from the comforts of home:
How visitors can help their loved ones in the hospital
Last summer, Ben Hayes* of Springfield visited his 74-year-old
grandfather in the hospital after routine back surgery to repair a
protruding disc.
What he saw disturbed him.
“My grandfather is the patriarch of our family, whom everyone goes to for
advice. You would never guess that he and my grandmother are in their
70’s. Both of them are in great health, both mentally and physically. The
evening my grandfather came out of surgery, he was hallucinating,
confused, agitated and aggressive. It was like he was a different person,”
Hayes, who is in his early 30’s, says. “Thankfully, his dementia was only
temporary. Once some of the medicine wore off, and he switched to a
private room, he was back to his normal self.”
Hollis Bell, M.D.,
medical director of St. John’s Hospital’s
Rehabilitation Unit, says confusion is common for the elderly and even the
non-elderly when they are in the hospital. A hospital stay may also
aggravate already-existing dementia.
Being away from home
 “Many people may function fairly well in their home setting when not under
close supervision but when their situation is changed we may notice
cognitive deficits,” Bell says. “This is not necessarily new dementia but
perhaps an unmasking of what the family previously didn’t see or didn’t
want to see. This is the type of situation that causes the most anguish
with staff because the family often refuses to acknowledge that there may
well have been a problem before hospitalization.”
Being away from the comforts of home, waking in a strange room with a
roommate and other people that they do not recognize, medications, sleep
deprivation,“sundown syndrome,” which is brought on by being in an
intensive care unit where there are no windows to determine day from
night, and interaction with too many people at one time can all contribute
to a hospital patient’s confusion, especially if they have a head injury.
“In our Neuro Units, we see patients display behavioral changes regardless
of age, but depending on the location of their injury,” says Eddie Spain,
R.N., nursing director for St. John’s Hospital’s Neuro Units. “Healing
requires time with quiet and rest. We try to find one or two family
members that the patient is close to and have them as the main visitors,
which is a comfort. If there are too many faces, too many voices, too many
noises, the patient cannot process it all, which can harm the healing
process. We try to be as consistent with their environment as possible and
consider things like, ‘do they need bright lighting or do they need a
dimly lit room? Are their medications working properly?’ Every patient
responds to their environment differently and we strive to find what works
best for them.”
The role of family members
Family members can play a pivotal role in helping the hospital patient
adjust to the hospital environment. While it might be disturbing to see
their family member in an altered state, such as in Ben Hayes’ case, it
helps to remember that the change in the patient’s attitude, behavior and
personality is most likely temporary.
What can families do to help keep their relative oriented and comfortable
during a hospital stay?
“There are times when it is appropriate for a family member to spend the
night, especially if the patient has the tendency to get up without
calling for help and has a chance of falling from disorientation. Family
members can assist by letting us know any additional health problems the
patient had before the onset of the newly diagnosed illness. That lets the
nursing staff be aware of other things to look for in providing care. When
visitors leave for the day it is good to let the staff know. They should
also leave the call button within reach of the patient with a reminder to
call for help if they need assistance such as help to the bathroom,” says
Jeff Hawkins, R.N., nursing director for St. John’s Hospital’s
Rehabilitation Unit.
Following visiting hours and limiting the number of visitors to a room at
one time can also help keep the patient oriented and calm. Visitors can
utilize waiting areas to rotate in and out of the room so the patient will
not have so many faces to recognize and focus on at one time. Family may
want to alternate visitation times. This gives the patient an opportunity
to have visitors throughout the day and evening on a limited basis, so
they don’t feel obligated to try to hold a conversation when they really
feel like resting.
Family members should also encourage their relative to eat and drink
plenty of fluids.
“Hydration is very important for everyone and especially the ill. Family
can be an encouragement for patients to increase fluids and food intake,”
says Judy Moomau, R.N., nursing director for St. John’s Hospital’s
Transitional Care Unit, which typically cares for patients who may have
already had a long illness that required previous hospitalization. “More
often than not, family members are valuable partners for us as health care
providers to ensure the best outcome for our patients.”
* Not his real name. |
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