How often does misdiagnosis occur? Frequently. Delirium is misdiagnosed 95 percent of the time by doctors. This results in a serious problem for the elderly because the underlying disease or condition causing the delirium then goes untreated.
Research shows that 15 to 26% of all elderly people who become delirious die within a year, usually of the disease or condition that caused the delirium. This means that it’s very important that the diagnosis is correct so that the underlying cause can also be diagnosed, treated, and usually prevented from recurring.
This means that delirium is a huge red flag that can be a tremendous asset to the elderly and their caregivers if they recognize that the sudden onset of confusion is a fire alarm to get medical doctors involved in diagnosis and treatment.
On February 22, 2006, the New York Times published an article by David Leonhardt wrote titled “Why Doctors So Often Get It Wrong.” It illustrates the importance of advocating for a correct diagnosis.
“[W]e still could be doing a lot better. Under the current medical system, doctors, nurses, lab technicians and hospital executives are not actually paid to come up with the right diagnosis. They are paid to perform tests and to do surgery and to dispense drugs.
“There is no bonus for curing someone and no penalty for failing, except when the mistakes rise to the level of malpractice. So even though doctors can have the best intentions, they have little economic incentive to spend time double-checking their instincts, and hospitals have little incentive to give them the tools to do so.”
“You get what you pay for,” Mark B. McClellan, who runs Medicare and Medicaid, told me. “And we ought to be paying for better quality.”
There are some bits of good news here. Dr. McClellan has set up small pay-for-performance programs in Medicare, and a few insurers are also experimenting. But it isn’t nearly a big enough push. We just are not using the power of incentives to save lives. For a politician looking to make the often-bloodless debate over health care come alive, this is a huge opportunity.”
You can read the entire article here.
To download Appendix D from my book Taking Charge: Good Medical Care for the Elderly and How to Get It, click here. You’ll find this appendix useful in pinpointing the underlying causes of delirium. As Taking Charge makes clear: the hallmark of delirium is the sudden onset of confusion. Most family members can pinpoint the day, and sometimes the hour that their loved one became delirious. As a family caregiver, you’ll be in the best position to make sure that a doctor or nurse doesn’t confuse delirium with dementia.
