Most of us are aware that hospitalization of the elderly comes with risks. Of course, there are many times when there is little or no choice but to have someone hospitalized, no matter what their age.

This was brought to my attention, once more, by an article published by The National Institutes on Aging titled Severe sepsis associated with later cognitive, physical decline. Generally, we feel that if someone survives a serious illness such as sepsis, which is caused by the body’s overwhelming immune response to severe infection, the person will then fully recover.

However, according to the NIA article, “Older adults who survive hospitalization involving severe sepsis…are at higher risk for cognitive impairment and physical limitations than older adults hospitalized for other reasons, researchers have found.”

This research, conducted by the University of Michigan and supported primarily by the National Institute on Aging, shows that “…survivors often have severe problems for years afterwards.” The article also states that, “The risk of progression to moderate or severe cognitive impairment in sepsis survivors was 3.33 times higher than their risk before hospitalization.”

This information isn’t news to many caregivers who have asked questions in e-mails and on forums about their elder’s obvious cognitive decline after hospitalization. Some of these elders had sepsis, and others had problems stemming from the anesthesia used during surgery. Some had neither, but the trauma of a hospital stay seems to have affected their elders negatively, anyway.

When it comes to hospitalizing an elder, particularly for surgery, unless there is no choice, I’d think twice. There are risks for elders we often don’t consider seriously. My family found out, as I discussed in How Risky is Anesthesia for the Elderly?, that bad things don’t only happen to “other people.”

As a result of mail that I’ve personally received, I know that the cognitive decline of many elders following hospitalization is not just in the imagination of a few tired caregivers, like myself. This decline may have differing reasons, depending on the elder, and some elders sail through hospitalizations and surgeries with no negative effects. However, many elders do not recover well, so we need to be alert to this fact.

At this point, there may be little we can do, other than to be aware of the risks and only use hospitals when to not do so is more risky than hospital care can be. Even for younger people, the risk of infection from a hospitalization is not negligible, but for elders the risk is significantly greater. We can hope that researchers and clinicians will soon find more ways to reduce or eliminate the sometimes secondary outcome issues for elders who undergo hospitalization.

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