This semester, I am going to be volunteering in a hospital-based program that specializes in preventing delirium within our local population of geriatric patients. Delirium is an acute onset of confusion and disorientation. This term can be confused with dementia, as they both share the same aspect of confusion. However, Dementia is a progressive disease that cannot be prevented or solved, and delirium is an abrupt change in orientation. Delirium can be caused by fluctuations in a patient’s health and/or care. This includes hydration status, fever, stress, certain medications, and lack of proper sleep. Confusion puts the patient at risk for injury which lengthens their stay at the facility. To prevent delirium, we need to create a safe and stimulating environment. We also need to look for signs and symptoms of risk factors that could lead to delirium. For example, you notice that your 86-year-old patient is dehydrated and is under airborne precautions. Therefore, they are placed in a private room with no visitors allowed for 10 days. That patient is going to be more likely to experience delirium over another patient that is well hydrated, and goes to regular activities at the facility. It is our job as hospital elder life program (HELP) volunteers to look for these preluding events and prevent delirium from occurring.

I have not directly worked with delirium patients within my practice of the healthcare field. However, I have worked on a dementia unit during my previous summer break as a certified nursing assistant (CNA). I did not get to see the acute aspect of confusion in my patient population, but I was able to observe the firsthand effects of “sun-downing” on my patients during evenings. The effects of dementia varied immensely on all of my patients based on what stage they were at. Some patients were fully independent, yet sometimes forgetful, some wandered around unoriented in terms of their location, and others were not able to move or support themselves entirely. I could imagine that if I were to observe signs of delirium while volunteering, it would be a similar situation in which their orientation levels differ depending on the individual. Therefore, it is important to utilize our cognitive functioning exams and compare with original baselines in all geriatric patients.

One of my goals for this experience is to learn how to enter a patient’s room without a specific objective. In the past, I would visit my patients based on whatever duty I would have, and I would converse with them as I was performing my task. In this situation, I am primarily there to converse with the patient and assess their orientation statuses. Therefore, I will need to teach myself how to hold a conversation without having a specific agenda in mind. I am a little nervous to enter patients’ rooms without tasks on hand. If I were that patient, I personally would want privacy whenever possible in busy settings like the hospital. Therefore, I am worried that patients are not going to want my company during my volunteer hours. I don’t particularly feel ready quite yet to perform my volunteer skills, as I feel I am in a gray area about what my duties will be when I get there. I am hoping that my job will become clearer when I arrive for my first shift.

My second goal is to become more oriented to the our local hospital. I personally live in a rather rural area, so our technologies are not as advanced as those in my assigned hospital. Therefore, I want to be able to learn how to utilize my resources properly within a large healthcare setting.

I am currently only aware of one type of support that is provided from some healthcare facilities for geriatric patients and that is an activities board. Over the summer, I noticed that each unit of my facility had two different types of activities that differed daily to stimulate the patients. One particular activity that comes to mind is one where facilitator states a broad topic, and asks the residents to say what first comes to mind when they think of that topic. This helps jog the resident’s memory and can sometimes orient them to person, place, and time as well.

Overall, I am hopeful for this opportunity to improve my communication skills with patients and use my nursing skills to see early signs of complications, and stop them before it is too late. I am thankful for the HELP program for allowing us to take part in this program, and look forward to working with them.

“Inpatient Services.” Inpatient Services | Maine Medical Center | Portland, ME, https://www.mainehealth.org/maine-medical-center/services/geriatric-care/inpatient-services.