Older people in hospital - Mind and mood

Being unwell can impact on your mind and your mood. No matter how old you are, a hospital stay, ill health and changes in medication can impact on your mood and mental health. Problems with memory, thinking and your mood are not a normal part of ageing or illness.

Health issues affect your mind and mood in hospital

Being in hospital can impact on your mood. Worrying about your health, feeling anxious or overwhelmed can be a common issue for many people in hospital, regardless of age. Some of this is normal. However, having problems such as feeling confused or very sad may be symptoms of other health issues.

Some mind and mood problems that can be identified during your hospital stay may be short-term health issues, which are a result of your stay in hospital, while others may be long-term problems that need to be managed after you leave hospital. Three common problems seen in people in hospital, especially those who are older, are delirium, dementia and depression.

Delirium in hospital

Delirium is a common and serious problem. It can affect people, especially some older people, during their stay in hospital. Delirium is confusion that develops suddenly. It can be caused by dehydration, or an illness, such as a urinary tract infection or medication.

Delirium can cause sudden and fluctuating changes in behaviour and mood. People can see things that are not there, become agitated or experience other changes in their behaviour. On the other hand, ‘quiet’ delirium makes people drowsy and less able to concentrate. Detecting delirium early is important in order to treat the underlying cause and to help you recover.

Dementia in hospital

Dementia affects a person’s ability to think, remember, understand, make decisions, communicate and interact with other people. Patients with dementia may need more support while staying in hospital and after they leave.

Detecting the symptoms of dementia in hospital is important, so that staff can help people stay as well as possible during and after their stay.

Depression in hospital

Depression is not a normal part of health or ageing. It is a low mood, or loss of interest or pleasure, that lasts for more than two weeks and also includes at least four of:

• major change in appetite or weight
• loss of energy
• trouble sleeping or sleeping too much
• feeling worthless
• often having thoughts of death or suicide
• confusion or agitation.

Depression is not general sadness or grief following the loss of a loved one. It is a serious condition, but it can be treated.

Keeping your mind healthy while in hospital

Sticking to your normal routine as much as possible and trying to feel comfortable and aware of your surroundings can help your mind and mood while in hospital.

Tips include:

• Try to keep your regular sleeping and night-time routine. Turn on the lights during the day and turn them off at night. Where possible, avoid daytime napping, unless being tired makes your condition worse.
• Try to keep as active as possible. This may include setting regular times throughout the day to take a walk (even a short walk to the bathroom), or practise some regular movement exercises if you are confined to bed.
• Drink plenty of water each day (unless your doctor tells you not to) and eat regular main meals and snacks.
• If needed, wear your glasses and hearing aids. Make sure your hearing aids are turned on and that the batteries are working.
• Continue activities you enjoy and can safely do in hospital. This could include reading, doing word or number puzzles, talking to friends, or using a laptop or tablet device, if you have one with you.
• Bring any items from home that give you comfort, such as photos, favourite music or your pillow.
• Get to know the layout of your hospital room and ward with a family member or carer. Find out where the toilets are and where your nursing call bell is (to ring for a nurse if you need help).

Tell hospital staff if you are worried about your mental state

There are ways you can help staff find any problems and treat or manage them, such as:

• Tell hospital staff if you feel confused or ‘can’t think clearly’, or if you are feeling low or depressed.
• Tell hospital staff if you are in pain, as it can affect your mood and your ability to think and concentrate (your mental state).
• Because dementia, delirium and depression are common in hospital, hospital staff may need to ask you questions to check for these. Answer any questions honestly and to the best of your ability. This is not an insult to, or a test of, your intelligence, but it is a way of checking if you need further care while in hospital or when you return home.
• Tell your doctor about all the medication you are taking (including supplements, vitamins and non-prescription and natural medicines).
• Talk about anything that is worrying you with hospital staff or someone you trust.
• As a family member or carer of someone in hospital, tell hospital staff if you notice a sudden change in the person’s mental state, or if the person has dementia or depression. Also tell staff about the person’s usual routines and preferences.

Where to get help

• Your GP (doctor)
• Allied health staff
• Patient liaison officer
• Nursing staff