Storytelling May Help Reduce Delirium


 
Artist-in-residence Elizabeth Vander Kamp laughs with a patient during an Arts in Medicine visit.

Many hospitalized patients, especially older adults, are at risk of developing delirium, a risk that is increased by the presence of cognitive, functional, visual or hearing impairment or depression. Performing arts programs that include storytelling and poetry may be beneficial in lowering that risk, suggests a study from UAB.

Storytelling and poetry recitation are arts-based experiences designed to enhance healing. These activities provide cognitive stimulation, says Katrina Booth, MD, 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 said. "For each prevented case of delirium, the health care system saves $2,500."

The study, published in Innovation in Aging, is, to the best of Booth's knowledge, the first to evaluate this association between storytelling intervention and changes in measures of cognitive dysfunction in hospitalized older adults.

The pilot study of 50 patients age 65 or older was conducted in the UAB ACE unit at UAB Highlands Hospital in 2016. Two artists-in-residence, part of UAB's Institute for Arts in Medicine, visited the patients once for 15 minutes of bedside storytelling or poetry during their hospital stay. Patients were asked if they would like to hear a story or poem, and could choose the type, whether it be religious, humorous, a folk tale, or a legend. The session was designed to be interactive, with the patient's having the opportunity to reflect on the story.

The effect of the experience on delirium screening scores and patient satisfaction was evaluated and found that an artist-in-residence-delivered storytelling experience was associated with a lower delirium score at discharge. The result remained significant after adjusting for age, baseline cognitive impairment and general well-being. Patients with severe agitation or delirium, those who needed medication for delirium, and those who refused or did not want to participate were excluded.

"Despite advances in the management of delirium, pain, and anxiety in the elderly population, challenges still remain," says lead study author Maria Danila, MD, associate professor of medicine in the Division of Clinical Immunology and Rheumatology. "Arts in medicine programs have opened doors to different ways to promote healing. Our study results suggest that the arts in medicine program may assist patients with their recovery."

 
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