Neither Dazed nor Confused

Note: This interview was recorded in 2019. For updates on Inouye's work during the coronavirus pandemic and the link between COVID-19 and delirium, read our new Q&A.

Each year, more than 7 million hospitalized people in the U.S. slide into delirium: an acute state of confusion that raises risk of serious health complications and death.

Only a few decades ago, medical professionals believed they couldn't do anything to prevent delirium. Then Sharon Inouye proved otherwise. Her programs, adopted by hundreds of hospitals, have helped reduce cases of the condition by an estimated 40 percent.

Inouye is a professor of medicine at Harvard Medical School and director of the Aging Brain Center in the Marcus Institute for Aging Research at Hebrew SeniorLife.

In this episode, Inouye shares the story of how she became interested in delirium, describes how caregivers and clinicians can identify and prevent it, and explores the connection between delirium and dementia. She also talks about the family roots of her interest in medicine, her forays into English literature and harpsichord in college, dipping her toe into health policy—and how she struggled to stop her own father, a physician who treated survivors of atomic bombings, from developing delirium.

Download the full transcript [PDF].

Episode guide:

• 0:05 Introduction
• 2:25 Father as role model
• 6:45 Family roots of humanism in medicine
• 9:15 Turned to English and harpsichord in college
• 12:05 Early application to medical school on a dare
• 15:20 What is delirium and why is it an important issue
• 17:40 Discovery that delirium doesn't "just happen"
• 23:00 Risks for delirium and what family members, clinicians and researchers can do to mitigate them
• 26:55 Delirium prevention in health care settings
• 29:35 Father's delirium and the importance of teams
• 33:00 Turn to health policy
• 35:00 Connection between delirium and dementia
• 38:25 Conclusion

Related links:

• Principal investigator of SAGES, Successful AGing after Elective Surgery
• Hospital Elder Life Program (HELP) for delirium prevention
• Confusion Assessment Method, the most widely used checklist for delirium identification [PDF]

Producer: Rick Groleau

Music: Bach, "English Suite No. 1 in A Major, BWV 806," via Pond5