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)
- 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)
- 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.