Delirium in Hospital: Violence, Vulnerability and Humanity

Article Summary by Victoria Hume

In the UK, hospitalisations from Covid have been increasing steadily since the summer. On 18 November, 923 covid patients were mechanically ventilated in hospital – this represents about a quarter of all mechanically ventilated patients.1 The Nuffield Trust tells us that covid patients typically stay longer in ICU than surgical patients.2 Given that mechanical ventilation is a risk factor for delirium, and that at any time in ICU around 80% of people may be delirious, all this means a massive increase in the numbers of people in this country alone going through this experience. Delirium can be a deeply disturbing, often traumatic experience, known to slow down our recovery (keeping people in ICU longer), and to negatively impact our health in the short and long term. It also places strain on relationships with already pressured healthcare professionals, as well as families.

There is some urgency then in tackling people’s experience of and recovery from delirium. This article is one of relatively few qualitative studies attempting to understand the detail of the experience. It suggests that by listening to what people go through inside delirium, we can also learn about how intensive care impacts us. It concludes by making recommendations for building on the humane instincts of healthcare professionals to improve the working cultures and environments.

The research process was guided by composing 45 minutes of music about delirium, structured around audio clips from interviews and from the hospital itself. Composing music was a way of analysing data, but the music has also been an effective way to communicate information and catalyse much-needed discussion about delirium.

Listen to the author discuss the article:

 

Read the full article on the Medical Humanities journal website.

 

[1] https://coronavirus.data.gov.uk/details/healthcare

[2] “Covid patients typically require longer stays in intensive care than surgical patients”

Scobie S (2021) “Will the third Covid-19 wave overwhelm the NHS?”, Nuffield Trust comment. https://www.nuffieldtrust.org.uk/news-item/will-the-third-covid-19-wave-overwhelm-the-nhs

 

Victoria Hume is Executive Director of the Culture, Health & Wellbeing Alliance. She was an arts manager for the NHS for 15 years, before working establishing a module in hospital-based performance for the University of the Witwatersrand (South Africa). She is also a composer, with a Masters in Music and Health Communication, and is a Research Associate in the Medical Humanities at WiSER (Wits Institute for Social & Economic Research), working with the Medical & Health Humanities Africa Network. She writes and releases music, through Lost Map Records, based on Eigg.

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