Acute Care Geriatric Nurse Network

GENI - Geriatric Emergency Nursing Initiative

Delirium

Purpose

To recognize symptoms of delirium.
To provide appropriate interventions to clients experiencing delirium.

Background

Delirium is a leading mental health problem for older adults. Prevalence of the disorder ranges from 10% - 56% (Lacko et al, 2000 p. 2). It is reported that between 10% and 40% of the elderly exhibit delirium on admission to hospital and another 10 - 15% develop delirium during hospitalization. McConnell '97, found 51% incidence of delirium in elderly persons with hip fractures. "Health care professionals do not adequately assess elderly clients and often blame altered behaviour on age or "senility" which leads to increased length of hospitalization, inappropriate placement in long term care facilities, increased morbidity and mortality, an increased incidence of falls and incontinence and perhaps inappropriate use of restraints and psychotropic medications" (Buckwalter '98).

Delirium is often not recognized or is misdiagnosed. There is a failure to use consistent terms as well as consistent diagnostic and assessment criteria. This contributes to deterioration of physical and cognitive functioning and a decrease in quality of life for the client as well as increasing costs and resource utilization by the health care system. Thus, it is important to increase our understanding and detection of delirium and implement appropriate, evidence based treatment options.

It is an important part of our clinical care to recognize symptoms of delirium and to provide appropriate interventions to clients experiencing it. For the latest clinical practice guideline for delirium, please contact awestervelt@providencehealth.bc.ca. (the following files may be out of date but of use for information purposes)

Downloads

Delirium In The Elderly
Delirium - Appendix 1 - Delirium - Screening Tool
Delirium - Appendix II - Physician's Directives
Delirium - Appendix III - Patient and Family Info Sheet
Delirium - Appendix IV A - Behaviours in the Elderly
Delirium - Appendix IV B - Behaviours in the Elderly

Delirium Vingettes (DVD Order Form)

FormTassonyi (coming soon)

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Disclaimer: These materials have been prepared for health care providers' personal learning use for appropriate clinical use. The authors have done their best to produce accurate and useful quick reference information. However, all health care professionals remain responsible for using their own discretion in adapting this material to their clinical practice. The authors of this material cannot be held liable for any errors or consequences arising from the use of the information contained herein.