‘​It’s everybody’s business’ – understanding delirium on World Awareness Day

​Ulster Hospital’s Dementia Companion Rebekah Coey said: “It’s really scary for the patient who has delirium coming into hospital as it is a new environment. I try my best to make bonds and relationships with my patients and I find that helps while they are here.”

Delirium (acute confusional state) is when someone’s mental function has a sudden change. It comes on quickly, often over hours or days.

As well as showing confusion, people with delirium can be sleepy, agitated, have altered beliefs or see hallucinations. Delirium is often triggered by: illness. the side affects of medication; an injury or having surgery.

World Delirium Awareness Day is held on March 12 to raise awareness about delirium and its impact on patients, their families and healthcare systems.

The day is to highlight the importance of early recognition, intervention and educate patients and families who are at risk of delirium or affected by delirium.

Rebekah explained how she helps to comfort patients on the ward: “By keeping them settled while they are in the hospital by playing games, through painting and the patients love their cups of tea!”

South Eastern Trust Consultant Psychiatrist Dr Pratibha Nirodi detailed how the majority of patients in an acute hospital setting, especially the elderly, have confusion.

“The first thing relatives and staff can do is look for signs to see if that person is more confused than they normally are.”

“Delirium is everybody’s business,” said Dr Nirodi. “If we can prevent people from becoming delirious, then that can reduce their hospital stay or potentially that person going into a care facility. If we can recognise delirium, whether it’s at home or whether it’s in a care facility early – we can treat it early.”

Dr Nirodi stressed that a checklist is in place called ‘PINCH ME’ to prevent a patient experiencing delirium.

“P is to firstly recognise if that person is in pain, I is to look for any signs of an infection, N is for nutrition – is that person eating their meals? C is for constipation, H is for hydration, M is for medication and E is for environment. It is much better to have a room, an environment with familiar objects if that person has been brought into hospital, a simple thing like a large clock helps tremendously in keeping with the time, day and date.”

Dr Nirodi added how specific treatment methods can help for those experiencing delirium. “We can all play our part, especially family members in keeping the patient calm when they are in hospital, through ensuring patients eat and drink and making the setting as familiar as possible.”

Rebekah added:“My patients love doing word searches, they love jigsaws and colouring in. I have found that old movies and country music, especially a particular song helps settle a patient. For a patient with delirium, I do think having these things in place, is very beneficial to support them.”

South Eastern Trust Dementia Service Improvement Lead Tracy Kane added: “The most important part of identifying delirium is noticing a sudden change in a person’s mental state – that they’re ‘not themselves’. Family, friends and carers are often best placed to do this because they know their loved one best. World Delirium Awareness Day is an opportunity to raise awareness about delirium, the importance of prevention, early recognition and treatment.”