Many people who have had to have their elderly relatives admitted to a hospital intensive care unit have little or no knowledge of how that environment’s impact can affect the patient. Even some medical staff are poorly trained in this aspect of care and begin to exhibit their ageist bias when they talk about the “dementia” or psychosis now manifesting itself. You see, if you’re over a certain age and your treating healthcare workers unconsciously subscribe to the notion that with age comes dementia, your goose is cooked.
Mightily trying to stave off the decline that they see, they may begin to administer drugs which are not suited to geriatric patients in the belief that it’s not dementia but a psychotic process that is only now making itself known. Time for a reality check, guys.
Are any of you familiar with the experiments that were done in the 50s where people were put into isolation water tanks with masks for breathing? The exact purpose of this work escapes me for the moment, but I do recall reading an entire book on it. Striped of their clothing, tethered to a breathing hose and mask, they floated freely in warm water in a completely black space. With time, some of the subjects began to experience incredible auditory, visual and even tactile hallucinations in the absence of all sound, vision or touch. One of them even thought someone was trying to pull at his leg to drown him.
If you’d care to see what an experiment like this might be like, get a copy of the Dirk Bogarde film “The Mind Benders
” (1963) and you’ll have a pretty good idea. Interestingly enough, after these experiments in sensory deprivation were concluded, someone got the bright idea that this might be marketable. Then came the era of the water isolation tank to help you ease your stress away while floating in warm water. The thing looked like a coffin and I can’t imagine relaxing in one.
Now put yourself into a hospital environment, perhaps in an intensive care unit. What do you know about them? For one thing, the lights never go off and the sounds never stop. Hour after hour, there is clanging, talking, yelling, carts crashing around and perhaps screams of patients. Ever think what it would be like not to be able to sleep or have some rest from this massive stimulation? Well, it has earned itself a name; Intensive Care Psychosis. Want to read more about it? Here’s a link to it:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2154033/
But it’s not only in the intensive care units (ICUs) that this subtle form of cognitive impairment has an opportunity to stretch its wings. Look in any hospital room and tell me what is missing. Can’t see anything? Sure, there’s a TV (or maybe not), a phone, all the tidy little bits of furniture patients need, but there’s one thing missing. How about a calendar and how about marking off the days so that the patient knows what day it actually is? No, you probably won’t find one. The simple isolation of any hospital room can produce a disconnect with reality and, in the elderly, it’s misperceived as pathology.
The effects of this isolation, medications, anxiety and sleeplessness, too, can add up to a misperception of “the patient is in denial” when they can’t remember why they’re there or what their diagnosis is. Please, give me a break here. Take heavy-duty meds, mix carefully with the aforementioned and what do you get? Disorientation and memory impairment.
Your task now, should you choose to accept it, is to be the vigilant one who will retain this information and use it wisely in the service of those you love who are hospitalized.