Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible [...]

Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible [...]

Background: Hospital-acquired delirium induced via disruptions of the sleep cycle contributes to increased mortality and morbidity in hospitalized patients (1,2). Surveys of hospitalized general internal medicine patients at our institution, a tertiary academic medical center, have found that sleep duration is decreased in the hospital, with inpatients sleeping on average 4-6 hours, and reporting worse [...]

Case Presentation: A 67 year-old woman presented with six weeks of worsening disorientation. Her husband reported severe insomnia, abnormal behaviors, decreased short-term memory, and very labile mood. She had a history of well-controlled bipolar disorder on chronic lithium therapy. She had a forty pack-year smoking history. She was diagnosed with a urinary tract infection and [...]