Storytelling May Help Elderly Patients

For years, doctors have known that hospital stays can lead to severe, temporary cognitive dysfunction in elderly patients, who are at risk of developing delirium once hospitalized. A patient with delirium is often incoherent, confused and disoriented, but symptoms come and go making this condition hard to diagnose. The risk is higher for patients with dementia, but even elderly patients with healthy cognitive function could develop short-term delirium during their hospital stays. This risk is compounded if a patient has hearing loss, visual impairment, or depression.

It was once thought that it was only natural for older patients to become confused while hospitalized, but doctors now know that this condition is far from normal. Medication often worsens the condition, but there is a promising new treatment in the wings that has nothing to do with drugs: storytelling.

A study from the University of Alabama at Birmingham has opened up the possibility that storytelling and poetry programs could have significant cognitive benefits for elderly patients, even reducing delirium rates.

Delirium and its effects on elderly hospital patients 

Hospital-acquired delirium is a temporary but severe form of mental impairment that commonly affects elderly patients in hospitals. It is estimated that up to one third of patients 70 or older experience delirium, and the rate is even higher for those undergoing surgery or in intensive care. Though this condition may be common, it is often undiagnosed and the danger is underestimated. The negative effects of hospital-acquired delirium can range from long-term hospital stays to permanent cognitive damage, and an increased risk of pneumonia or blood clots.

Once in hospital, delirium can be caused by the confluence of multiple factors, including surgery, infection, isolation, dehydration, poor nutrition and over-medication.

How can storytelling help?  

There is something special about listening to a poem or a story being read aloud: the act of listening seems to simultaneously calm and activate our brains. And the cognitive stimulation that these unique arts-based experiences provide has great potential for healing, says Katrina Booth, M.D., a physician and medical director in the UAB Acute Care for Elders unit and a study co-author.

“There are no proven medication options to prevent delirium, so the only prevention is to optimize the patient’s physical and mental health with non-medications,” Booth explained. “For each prevented case of delirium, the health care system saves $2,500. Services like UAB’s Arts in Medicine program should be available in all health care systems and are truly a complement to traditional medical care.”

A pilot study with promising results

An experiment on whether bedside storytelling intervention could reduce cognitive dysfunction in older hospital patients has been completed, with promising results. The study, which was published in Innovation in Aging, is the first of its kind, though it may be the first of many. Research is one of the Arts in Medicine programs primary goals, and more investigations into the benefits of arts inventions is expected.

The participants of the study were 50 patients age 65 or older, who stayed in the UAB Highlands Hospital in 2016. Two artists-in-residence from UAB’s Institute for Arts in Medicine visited each patient once for 15 minutes of bedside storytelling or poetry during their time in the hospital. Patients were given the choice of hearing a story or poem, and could also say whether they preferred to hear something religious, funny, a folk or fairy tale, or a legend or myth. The session was intentionally interactive, and patients also had a chance to speak, whether it be to reflect on the poem or story, or to share personal stories of their own.

And these brief moments of storytelling and sharing did seem to have an effect on patients’ cognitive well-being. The effect of the experience was examined and a lower delirium score at discharge was observed in those patients who participated in the program. The research team adjusted for age, baseline cognitive impairment, and general well-being, and still found the result of the storytelling significant. Patients who were severely agitated or delirious, or who did not wish to participate, were excluded from the study.

A patient-centered approach

Arts in medicine programs have come to the forefront because they provide uniquely patient-centered care which can improve quality of life for hospital patients. Though there have been advances in treating delirium, pain, discomfort and anxiety in elderly patients in hospitals, there is still much progress to be made, according to lead study author Maria Danila, M.D., associate professor of medicine in the Division of Clinical Immunology and Rheumatology.

“Arts in medicine programs have opened doors to different ways to promote a healing environment,” Ms. Danila commented. “The results of our study suggest that the arts in medicine program was well-received and may assist patients with their recovery. Such arts in medicine programs may be beneficial to patients across the health system, and are an exciting addition to the UAB’s healing opportunities.”

Get on the path towards better hearing today

Living life to the fullest means being able to hear your friends and loved ones, their voices and their stories. If you have been dealing with untreated hearing loss, our team at Comprehensive Ear and Hearing wants to help. From start to finish, we will answer all of your questions and provide the personalized care you need to hear better. Contact us to schedule an appointment today!