During the 8th edition of the Basic Certificate Course in Geriatric Medicine at the Chief Tony Anenih Geriatric Centre in Ibadan, Dr. Akin Ojagbemi emphasized the importance of elderly individuals consuming a diet rich in roughage and staying adequately hydrated to prevent temporary confusion, inattention, or altered mental states often triggered by factors like dehydration, constipation, and medication side effects.
Dr. Ojagbemi highlighted the link between transient confusion, a potential sign of delirium in seniors, and an increased risk of developing dementia.
The psychiatrist also pointed out that individuals with delirium are at four times greater risk of developing dementia and facing higher mortality rates within a year compared to those without delirium.
While the exact cause of delirium remains unclear, Dr. Ojagbemi noted that potential triggers of this condition may stem from various factors such as medical treatments, medications, electrolyte imbalances, surgeries, dehydration, constipation, and anesthesia.
“They might have a painful experience that they are unable to articulate. And because of that fact, they become agitated and delirious. But we often focus on the primary reason why the patient was admitted, without also looking at the possibility that some of our treatment, including antidepressants, could have triggered something like delirium in the patient,” he noted.
Dr. Ojagbemi recommends a multifaceted approach to prevent delirium in elderly individuals.
This includes ensuring their surroundings are well-lit, helping them stay oriented and aware of their environment, encouraging physical activity and social engagement, promoting adequate hydration and restful sleep, and avoiding potential triggers that may lead to delirium.
“For some patients, it might just be sensory impairments. Maybe they were wearing spectacles at home before they came to the hospital, and then they don’t have their glasses with them in the hospital, and then they become disorientated,” he stated.
According to Dr. Femi Olowokere, a family physician and geriatrician, delirium often goes undiagnosed in approximately 80% of cases due to a lack of knowledge among healthcare professionals on how to properly identify and diagnose the condition.
According to him, “If somebody has hypoactive delirium and is unrecognised, that patient can die. That is why older people are better treated in hospitals because many things can precipitate it, including constipation, pain, urinary tract infection, and dehydration.”
Dr. Lawrence Adebusoye, Director of the Chief Tony Anenih Geriatric Centre at the University College Hospital (UCH), explained that the training aimed to enhance the capabilities of healthcare professionals to effectively address the demands of Nigeria’s growing elderly population .
“There’s a difference between a normal ageing process and a disease process. As a healthcare practitioner, you should know if the particular change seen in an older person is due to the natural ageing process or if it is a disease process.
“Most often, about one-third of the problems in older people are caused by healthcare workers intervening wrongly, with the wrong measure at the wrong time. So knowledge is of paramount importance.”
Mr. Tunde Ajobo, a clinical dietitian and president of the Institute for Dietetics in Nigeria, Oyo State branch, advised older adults to consume more water, fruits, and vegetables and engage in regular exercise to prevent constipation and dehydration, promoting overall health and well-being.
“We encourage them to drink the water; it can be flavoured with Vitamin C; to take ewedu or okra with their food; they can drink it also. That way, it will boost the fibre intake. When they sit down too long on the seat, it can lead to constipation. So, mere walking within the compound can help to stimulate bowel movement, too.”
