A Qualitative Study of the Experience of Delirium in Older People After Hip Fracture

Delirium is a condition that is under-researched in comparison with equally common conditions (Adamis, Martin, Treloar & Macdonald, 2005). This is especially evident in the paucity of research into the lived experience of delirium. One group of patients who frequently become delirious is older people who have undergone surgery for a fractured hip.

This study examines the experiences of delirium in elderly hip fracture patients, to explore how people make sense of their experiences both while still in hospital and three-months later once they have been discharged. Nine older people who had experienced an episode of delirium following surgery for a fractured hip were interviewed in hospital. Four of these were interviewed three months later once they had returned home. Interpretative Phenomenological Analysis (Smith, 1995) was used to analyse the data collected from the semi-structured interviews.

Participants struggled to make sense of their experiences, and used defensive strategies to manage their anxieties. Participants appeared to have concerns about the implications of their experiences for their mental health, and the potential consequences for dependence on others. Some participants felt inadequately supported by nursing staff during their delirious experiences. At three-month follow-up participants still struggled to make sense of their experiences and the concerns they expressed did not appear to have substantially changed from the time they were in hospital.

Despite its small size, this study offers some important considerations for clinical practice. Possible avenues for future research are also discussed.