(P06) A Patient’s Account of her Experience with Hospital Acquired Delirium

Introduction: This is a description of a patient with hyperactive delirium after a prolonged hospital stay who was able to share her account of what she was experiencing at that time.

Case Description: An 81-year-old female, who was previously independent in the community, was admitted to the hospital for a Trans Urethral Resection of Bladder Tumour (TURBT) for bladder cancer. She had a prolonged hospital stay requiring two trips to the ICU and had multiple episodes of hyperactive and hypoactive delirium while admitted. She was discharged to skilled care and upon arrival was altered and non-participatory in care. She was agitated and combative at times. When her delirium improved, she was able to describe her hospital experience in detail including the fear and anxiety she felt as well as complete confusion of her whereabouts. She described “being held and feeling like she had to fight her way out” as well as “the fighting got too hard, and I decided I was going to die”. Any mention of the hospital increased her anxiety significantly and she was suspicious of medical care. This led to difficulty with her care and recurrence of delirium symptoms.

Discussion: Patient delirium experience is a poorly explored area to aid in prevention and treatment. Patient fear, anxiety, and helplessness is commonly described in patients who experienced delirium. These emotions are in response to a misinterpretation of their environment, which is what our patient also described. A study also noted that patients fear and anxiety with delirium followed them after the delirium course, which we also observed in our patient. Better understanding of a patients experience with delirium can clarify what medical actions increase delirium risk and work on ways to change patient care to prevent this.