A new article on Medpage regarding delirium (acute confusional state is a common and severe neuropsychiatric syndrome with core features of  acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior - From Wikipedia) that is important to any elder facing cardiac surgery or potentially any other surgery.  We often see our elder clients, when hospitalized, have a severe exacerbation of their dementia or new onset of a confusion and disorientation during the hospitalization and after returning home. Often a delirium is misdiagnosed in the hospital as a dementia and so it is important that a psychiatrist or neurologist test a person who is suspected to have either a rapid onset delirium or a dementia to determine the correct diagnosis.  The link to the Medpage article is here.

As reported in last evening's news, Dick Cheney received a heart transplant.  He is expected to remain in the hospital for 1-2 weeks and then be in rehab for more weeks to get back on his feet.

This article reminded me of a recent study that showed that hospitalizations have a significant impact on those over the age of 65.  Many people may not realize that hospitalizations can lead to a decline in cognition for elders, whether they have a pre-existing cognitive decline or not.  And the longer the hospitalization, the severity of the illness and greater age all contribute to a greater cognitive decline.  The authors noted that the medical community needs to figure out how to minimze hospitalizations for the elderly, especially for minor illnesses/injuries. 

A daily assessment of elders when residing in their homes, assisted living, or skilled nursing and immediate action taken to have them visit their primary care physician (PCP) when caregivers note anything out of the ordinary would go a long way to avoiding emergency room visits and hospitalizations.  A minor cold, flu, or infection if caught early and treated early by the PCP would often times reduce hospitalization days later.  Caregivers should note any change in cognition, temperature, or behavior and notifiy the family, fiduciary or physician, rather than waiting until the illness becomes a medical crisis.    The link to the article is:
http://www.neurology.org/content/early/2012/03/21/WNL.0b013e31824d5894.abstract