Delirium is a sudden, fluctuating change in mental state, which disturbs thinking and attention, and results in changed behaviour.
If delirium is not recognized, it can lead to permanent disability or death.
This information is for anyone who supports an elder who develops a delirium – family members and health care professionals alike.
Delirium is a change in mental state which comes on suddenly, fluctuates over 24 hours, alters consciousness, disturbs thinking and attention and results in changed behaviour. Symptoms include problems with attention, thinking, memory, psychomotor changes and disruption of the sleep-wake cycle (Lipowski, 1989; Ignatavicious, 1999; Bater, 2006; DSM-5, 2013).
Delirium affects older persons in all areas of health care. All staff must be skillful in recognizing and responding to it.
The statistics are shocking. Despite the fact that Delirium is treatable,
In Acute Care:
50% of older persons may develop delirium in hospital
40-50% of older persons develop delirium after hip surgery
70% of person 65+ admitted to intensive care (National Guidelines, 2014)
In Residential Care:
Winner of a 2007 Gold Questar International Award for Video Communication.
Winner of the 2006 International Medical Media Award for Geriatrics (The Freddies)
Tools for Seniors and Families, and for Clinicians, including the National Guidelines for Assessment and Treatment of Delirium and more: https://ccsmh.ca/projects/delirium/
Nursing Best Practice Guideline and Caregiving Strategies for Older Adults with Delirium, Dementia and Depression. RNAO - Nursing Best Practices
Talk to a nurse by phone, or contact them for algorithms for delirium. In British Columbia, dial 8-1-1. http://www.healthlinkbc.ca/
Delirium Clinical Practice Guidelines; links and resources from BC's Clinical Nurse Specialists in geriatrics, gerontology, geropsychiatry, and geriatric rehabilitation. http://www.acgnn.ca/delirium.html
http://www.ihi.org/topics/SedationDeliriumMobility/Pages/default.aspx
http://www.icudelirium.org/
http://www.medpagetoday.com/CriticalCare/GeneralCriticalCare/42029
http://pathways.nice.org.uk/pathways/delirium#path=view%3A/pathways/delirium/delirium-overview.xml&content=view-index
http://www.nice.org.uk/guidance/QS63/chapter/introduction
Information about delirium for families and health care professionals, including tools, flow sheets, learning tools and professional practice information.
Delirium in the Older Person. Overview of delirium; tools for recognition, assessment and treatment of delirium are placed in context. This is a useful teaching handout. Bibliography.
Island Health Delirium Clinical Standards Guidelines [Please contact us]
Drugs that can Cause Delirium
You Can Prevent Delirium Poster
Information Pamphlet for Families
Information Pamphlet for Health Care Providers
2 Ds Differentiating Delirium from Dementia
3 Ds Differentiating Delirium from Dementia and Depression
Physiological Changes with Aging
Age-Related Changes
Confusion Assessment Method (CAM)
CAM Training Manual
CAM-ICU
CAM-ICU Training manual
Laboratory Investigations
Behaviour Monitoring Chart
Sleep-Wake Monitoring Chart
Sleep Hygiene Log
Symptom Screening
Search for Cause (legal-size)
Search for Solutions (legal-size)
Hallucinations and Delusions
Age-Related Changes (read before playing game below)
Jeopardy!
Delirium Crossword
2D Quiz Delirium, Dementia or Depression? - answer key included
3D Quiz Delirium, Dementia or Depression? - answer key included
Pre and Post Learning Test - answer key included
Acute Care
The Assessment and Treatment of Delirium - Canadian Coalition for Seniors’ Mental Health 2014 Guideline Update
Delirium Watch - Alert
For additional tools used within Island Health, see Seniors Health or contact us.
Delirium at End of Life
End of Life Care National Health Service, U.K.
The documents available on this Delirium website are designed as a general reference for dealing with delirium in the older person.
The information contained herein was written for use within Island Health and we make no warranty, expressed or implied. While care has been taken to ensure accuracy of the information, it is not intended to provide medical advice or to replace the specific recommendations of physicians and other health team members. Since Best Practice and Standards of Care are constantly evolving, it is advised that this site not be used as the sole source of information. You are encouraged to also consult other current references.
