According to abbreviationfinder, Hospitalism can take many forms. It was formerly also known as deprivation syndrome and summarizes all negative psychological or physical long-term consequences of a stay in a home or hospital. Basically, however, hospitalism is due to inadequate care in the institutions mentioned above.
What is hospitalism?
In medicine, the term hospitalism summarizes various negative consequences of long-term inpatient accommodation. Alternatively, hospitalism is referred to as emotional frustration syndrome or separation syndrome, for example.
Depending on the symptoms that occur, a distinction can be made between physical (physical) and psychological hospitalism; Possible symptoms of physical hospitalism include atrophy of the muscles, restricted mobility or thrombosis (blood clotting). Symptoms of mental hospitalism include, for example, depressive moods, stereotyped movements (such as bobbing or rocking with the upper body) or autoaggression (aggressive actions against oneself).
Hospitalism can occur regardless of age. For example, people of all ages can be affected after a long hospital stay. Likewise, hospitalism can also be found in some children or elderly people who are or were housed in children’s homes or nursing homes.
There are many possible causes of hospitalism and they differ depending on the symptoms that occur. Physical hospitalism is usually caused by faulty or inadequate nursing measures during the storage/long-term accommodation of a person.
In bedridden patients, for example, physical damage can be caused by physical repositioning that is too infrequent, a lack of hygienic measures and/or a lack of physiotherapy exercises.
Psychological hospitalism is usually caused by factors such as a lack of emotional attention, a lack of employment opportunities, and a lack of acoustic and visual stimulation (such as music, colors, or images). Open rejection by carers can also encourage mental hospitalism.
Symptoms, Ailments & Signs
The symptoms of hospitalism are varied and extensive. They may vary from case to case. The age of the person concerned is also important. Mental disorders such as anxiety, depression, suicidal thoughts, borderline personality disorder, passive mood, listlessness to the point of apathy, lack of self-confidence, auto-aggressive behavior and resignation are particularly common.
Mental disorders often result in disorders in social behavior. Those affected develop fear of attachment, adjustment and communication disorders and can tend towards aggressive behavior and poor personal hygiene. In addition, sensory disorders such as a changed or delayed pain sensation, fear of contact or hypersensitivity are possible.
Cognitive disorders are common. Those affected often have learning disabilities, but also perception disorders. Rarely, memory lapses or even loss of long- or short-term memory can occur. In many cases, those affected also show motor disorders such as monotonous movements and stereotypies (e.g. banging their heads against the wall) or a greatly reduced ability to react.
Another symptom of hospitalism can be impaired wound healing due to confinement to bed. In some cases, affected children also experience developmental delays ( e.g. short stature or cognitive deficits) and increased thumb sucking. They develop a lack of feeling of security and a disturbed basic trust, which can sometimes have a massive impact on the further development of the child.
Diagnosis & History
Hospitalism is to be diagnosed, for example, on the basis of typical symptoms that occur in an affected person and a medical history with at least one longer inpatient stay. However, physical hospitalism can usually be diagnosed more easily, since physical symptoms can be more clearly assigned to specific influencing factors. A clear connection of psychological symptoms with certain influencing factors is usually more difficult.
The course of hospitalism varies from person to person and depends on various factors: the physical/mental constitution of the person affected, the period for which the person concerned was/is exposed to the damaging influence and the severity of the symptoms that occur play a role.
With early intervention, it is possible for the corresponding symptoms to subside almost completely. The course of hospitalization can be more protracted if the person concerned has already developed serious psychological/physical complications. It is possible that interventions may result in an improvement in symptoms, but not a complete cure.
Hospitalism can cause very different complaints and symptoms, from which the patient can die in the worst case. In many cases, death occurs when treatments and care are provided with a low standard of hygiene and inflammation and infection then occur. The person affected usually suffers from weight loss and loss of appetite.
There are also side effects from any medications you may be taking. The mental state of the patient is also restricted by the hospitalism, leading to confusion, panic attacks and depression. Due to the lack of movement in the hospital, there is also muscle atrophy and thus a reduced resilience of the patient. The quality of life decreases significantly due to the symptoms and the affected person feels ill.
The mental state can also continue to deteriorate if the underlying disease does not develop positively and cannot be properly cured. As a rule, the symptoms disappear relatively quickly if the causes of the hospitalism can be treated and removed. Complications arise when no treatment is given. This can still lead to the death of the patient.
When should you go to the doctor?
If symptoms such as loss of appetite, apathy and personality changes are noticed, medical advice is required. Hospitalism always occurs in connection with a stay in the hospital. Therefore, if the symptoms mentioned occur, the treating physicians should be spoken to. In most cases, the necessary assistance is provided before serious symptoms arise. If acute symptoms develop, the nursing staff must be informed. In cooperation with the doctor responsible, suitable aids can be made available to reduce the suffering of the person concerned.
In the case of physical complaints, further treatment is required. Any ulcers must be examined and cleaned, and infections require prompt medical treatment. Whether the patient or a caregiver notices these symptoms, immediate medical attention is required. Although hospitalism is usually not a serious condition, the patient must be closely monitored and medically cared for. If the symptoms reappear after leaving the clinic, it is best to inform the family doctor immediately.
Treatment & Therapy
In order to be able to successfully combat various forms of hospitalism, a first important behavioral measure consists above all in adapting the external circumstances to the needs of the person concerned. Whether such a change is possible in the previous environment or whether it makes sense to switch to an alternative environment depends on the individual case. Corresponding improvements in the environment of the affected person often contribute to the healing process of various symptoms. As a rule, the earlier the necessary interventions take place, the better the treatment successes in hospitalism.
Therapy measures that take place in a second step depend on the symptoms present in hospitalism: Physical damage and/or functional impairments that have occurred must be counteracted individually, for example with medication or with physiotherapy measures. Psychological impairments in the context of hospitalism can be positively influenced, among other things, by consistently addressing and employing a person affected and by creating a stimulating environment (e.g. through colours, pictures, texts or sounds in the form of radio, books or television).
If, as a result of long-term neglect, serious symptoms have developed as part of mental hospitalism, longer-term psychotherapeutic measures may also be necessary.
Outlook & Forecast
The recovery from hospitalism in its psychological manifestations depends strongly on the length of hospitalization and the age of the patient concerned. Although short-term deprivation can already trigger symptoms of hospitalism, these usually disappear more quickly than after a long stay in the hospital or a similar facility.
Adult patients are also more resilient, while children and especially small children and infants can suffer from sensitive psychological damage. Nowadays, fortunately, great care is taken to enable young patients in particular to have regular and intensive contact with their parents and also to give them the attention they need from the nursing staff in order to keep the symptoms of hospitalism to a minimum from the outset.
Cases of hospitalism associated with abuse have particularly long healing processes. These are often criminal cases in which the person concerned has been isolated for a long time. In these cases, the hospitalism can increase to Kaspar-Hauser syndrome, which is considered the most severe form of hospitalism. The physical manifestation of hospitalism, the nosocomial infection, is a complication that must be taken seriously. As a rule, antibiotics no longer help in the case of infection with hospital germs, so that the patient’s immune system has to deal with the infection itself. Such infections are often fatal in poor health.
Hospitalism can often be prevented by need-oriented care or care of those in custody. A development of psychological hospitalism in infants, for example, who for medical reasons have to spend longer periods in the hospital after birth, can often be prevented by early and regular physical contact with the caregivers. A stimulating and appreciative environment often has a preventive effect against mental hospitalism.
In hospitalism, follow-up care depends on how severe the condition is. A slight hospitalism usually subsides on its own as soon as the patient experiences the necessary affection. After a few days or weeks, you should consult your family doctor again. The doctor can perform a physical examination and, if necessary, prescribe an appropriate medication.
Severe hospitalism usually requires therapeutic treatment. After completing therapy, the patient must maintain an active, fulfilling lifestyle. Since there is often a fear of hospitals, suitable alternatives must be sought. Before returning to hospital, the patient should speak to the therapist. You may need to take sedatives or antidepressants.
Affected small children have to experience permanent maternal care. This is achieved by placing the sick child in a foster family or by the parents building up an intimate relationship with the child as part of mother-child therapy. Hospitalism is rare these days, which is why targeted therapy must always be carried out with regard to the respective physical, mental and emotional symptoms. In the case of severe hospitalization, accommodation in a specialist facility may be necessary.
You can do that yourself
In order to treat hospitalism, the external circumstances of the person concerned must first be adjusted. If possible, the patient should be transferred to more suitable accommodation and must be cared for there individually and in relation to his needs. At the same time, the resulting mental and physical impairments must be treated. Which measures have to be taken in detail depends entirely on the respective complaints.
In most cases, physiotherapy is recommended because physical exercise is an important therapeutic tool. Psychological complaints are alleviated in addition to therapeutic treatment by regularly dealing with the person concerned. Daily conversations, as well as pursuing hobbies or just being in contact with friends and family members, can significantly alleviate hospitalism. The patient’s environment should be designed in an appealing way, be it through pictures, colors or sounds in the form of radio, books, television or other employment opportunities.
Should the hospitalism occur after leaving the clinic or nursing home, the sufferer will also need care and attention. In less severe cases, the hospitalism recedes on its own and the patient is fit again after a few weeks or months. In any case, a doctor must be informed about the symptoms.