Advanced Care Research Centre

Blog - PPI Network – Delirium Call

Last month, Multimorbidity PhD student Rose Penfold hosted a PPI group call to help her with her delirium research.

Delirium is a form of confusion which starts suddenly in people with multiple long-term conditions admitted to hospital. The aim of the call was to find out why some people have delirium when they are admitted to hospital and why some people have problems after they have been in hospital. Rose,  and PPI Network member, Stella Findlay have reflected on their experiences.

Rose said: Last month, I had the privilege of meeting members of the ACRC PPI network to discuss my PhD research looking at delirium in people with multiple long-term conditions admitted to hospital.

Delirium is a form of confusion which starts suddenly, often as a result of another medical problem such as an infection, surgery, or certain medications. It is a common and serious condition, affecting up to one in four older people admitted to hospital in an emergency. It is more common in people with multiple long-term conditions and people who are frail

During my PhD, I am trying to find out why some people have delirium when they come to hospital, and why some people have ongoing problems after delirium. This research will help to understand the causes of delirium, so that healthcare practitioners can spot the condition earlier and try to reduce bad outcomes after being in hospital with delirium. I am very grateful to the public contributors who joined the discussion to share their personal experiences of delirium – direct personal experiences, or as a caregiver, relative, or friend. Involving public contributors early in my PhD is very important, to guide the questions I will ask and to ensure that the research focuses on the outcomes which are most important to people.

During the meeting, we explored possible causes of delirium – for example, medications, infection, dehydration and surgery. I heard about the impact of delirium on the experience of being in hospital – including the distress for patients and carers, differences in the ways that healthcare professionals interacted with patients with delirium, and the frustrations of a protracted hospital stay whilst waiting for care arrangements to be put in place for discharge. We talked about differences between dementia and delirium, and the importance of distinguishing between these and the important role that carers and relatives play in helping healthcare professionals to understand what someone was like before delirium, and what is different now.

Through our discussion, I gained a deep appreciation of the importance of “returning to [a new] normal” following an episode of delirium. This normality encompassed returning home again following the hospital admission, regaining independence in day-to-day living, and being able to think with the same clarity as before the hospital admission. Public contributors highlighted the important role of healthcare professionals, caregivers and others involved in the hospital journey in facilitating this, by giving patients and carers the hope and confidence that recovery from delirium was possible.

The experiences of patients in hospital with delirium and the factors which facilitate a return to normal will be key areas of focus in my analysis going forward. The insights that public contributors shared are important not only to guide my PhD research, but for my future work as a geriatrician looking after patients with multiple long-term conditions and delirium in hospital

Stella Findlay added: The Zoom call on delirium in hospital was well organised, giving everyone a chance to describe their experiences either personally or witnessing delirium in others. The PPI members had varied views to offer on the subject and this seemed to make a fully comprehensive overview of suffering from or witnessing delirium in others. Effects upon others were also discussed and appeared to be wide and varied. After effects of delirium in patients could be lasting and disturbing. However, it’s comforting to know that a return to normal is likely.

To find out more about Multimorbidity PhDs through the Wellcome Trust, click here. Recruitment for the next intake takes place in July.