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Help from staff

There are things staff will do to try and reduce the risk of patients experiencing a delirium. These can be broken down into three categories, clinical, environmental and medication (pharmacological)

 

Clinical:

  • Providing adequate regular pain relief
  • Ensuring glasses and hearing aids are in use (and in working order) if appropriate
  • Ensuring food and fluid needs are met
  • Creating a toileting plan to help with toileting needs
  • Encouraging patients to mobilise
  • Removing indwelling catheters when no longer clinically required
  • Medication review
  • Adult Behaviour Observation Log (this is a chart that tracks the behaviour of a patient that may be experiencing a sudden change in behaviour)

 

Environmental:

  • Reorientation to time and place (clocks and calendars)
  • Encouraging family/carer to visit and bring some personal belongings such as a photo and or other mementos
  • Encouraging wakefulness during the day and sleep at night by
      • Ensuring the curtains are open during the day, activities and distractions are available during waking hours
      • Limiting day time sleeping
      • Closing curtains at night, reducing lights in the room and minimal noise
  • Encouraging family and/or carers at the bedside (some facilities have the capability to have a carer stay overnight)
  • Avoiding multiple bed movements between wards

 

Medication Review (pharmacological)

  • There is no medication recommended for the management of delirium. However, in exceptional circumstance and only as a last resort, medication may be prescribed when some behaviours may put patients and others at risk of serious harm.
  • The aim of medication is not to sedate the patient, but rather reduce their distress and risk of harm to themselves and others.
  • Medication that might be contributing to the delirium should be identified and stopped.