Materiały źródłowe

• #1 Clinical Practice Guidelines for Management of Delirium in Elderly

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5840908/

  Delirium is an acute, transient, usually reversible neuropsychiatric syndrome, seen in medical-surgical set-ups. […] Due to all these negative consequences, it is very important to prevent the development of delirium in medically ill patients. It is also important to detect this entity at the earliest and manage the same to reduce the associated morbidity, mortality and distress among patients and their caregivers. […] The new guidelines are an attempt to provide updated information on the subject and use the newer information in formulating the guidelines. […] Once a patient is diagnosed with delirium, management should involve identification of possible causes, correction/removal of the etiological factors, and management of symptoms of delirium by using both pharmacological and non-pharmacological treatment.

• #2 Delirium | health.vic.gov.au

  https://www.health.vic.gov.au/older-people-in-hospital/cognition-dementia-delirium-and-depression/delirium

  Delirium is an acute disturbance in a persons attention, awareness and cognition that can be caused by an acute medical condition or medication changes. Delirium is serious and may be the only sign of a deteriorating patient. […] Delirium should be treated as a medical emergency. […] Delirium can often be prevented and can be treated and managed. […] We must recognise and respond to delirium as we would any other medical emergency[if we dont] the outcome is as bad for older patients as if they experienced an acute myocardial infarct (Geriatrician, Clinical Leadership Group on Care of Older People in Hospital). […] Delirium can cause longer lasting cognitive impairments in patients after surgery and may lead to permanent cognitive decline and dementia in some patients. […] Discharge planning should be documented, include the patient, carers and other professionals, and incorporate referrals to community health and support services where required. […] Reducing, ceasing or avoiding the use of psychoactive drugs is recommended as they may worsen the delirium. […] Pharmacological therapy should only be considered in severe cases of behavioural or emotional disturbance because there is no strong evidence they effectively improve prognosis.

• #3 Delirium – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delirium/diagnosis-treatment/drc-20371391

  The first goal of delirium treatment is to address any causes or triggers. That may include stopping certain medicines, treating an infection or treating an imbalance in the body. Treatment then focuses on creating the best setting for healing the body and calming the brain. […] Supportive care aims to prevent complications. Here are steps to take: Protect the airway, Provide fluids and nutrition, Assist with movement, Treat pain, Address a lack of bladder control, Avoid the use of physical restraints and bladder tubes, Avoid changes in surroundings and caregivers when possible, Include family members or familiar people in care. […] If you’re a family member or caregiver of someone who has delirium, talk with the health care provider about medicines that may trigger the symptoms. The provider may suggest that the person avoid taking those medicines or that a lower dose is given. Certain medicines may be needed to control pain that’s causing delirium.

• #4 Patient education: Delirium (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/delirium-beyond-the-basics

  Delirium TREATMENT […] There is no specific treatment for delirium. Instead, treatment focuses on several basic principles: […] Avoid factors known to cause or aggravate delirium, such as certain medications […] Identify and treat the underlying illness […] Provide supportive and restorative care […] Control dangerous and disruptive behaviors to avoid harm to the patient or others […] In people with a first episode of delirium, the initial treatment is often provided in a hospital setting. This allows the health care provider to monitor the patient, begin treatment of the underlying problem, and develop a long-term care plan with the patient and/or family. […] Supportive care — The goal of supportive care is to maintain the patient’s health, prevent additional complications, and avoid those factors that can aggravate delirium. This includes:

• #5 Delirium Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/288890-treatment

  Following recovery, patient’s memories of events of the delirium are variable. Be sure to educate the patient, family, and primary caregivers about future risk factors. […] When delirium is diagnosed or suspected, the underlying causes should be sought and treated. Despite every effort, no cause for delirium can be found in a small percentage of patients. Components of delirium management include supportive therapy and pharmacological management. […] Reorientation techniques or memory cues such as a calendar, clocks, and family photos may be helpful. The environment should be stable, quiet, and well-lighted. […] A meta-analysis of 7 studies that focused on the usefulness of interventions such as physical or occupational therapy, daily reorientation, and the avoidance of sensorial deprivation found a significant reduction in the development of delirium among elderly inpatients.

• #6 Managing Delirium | What Clinicians Should Know | Palliative in Practice | Center to Advance Palliative Care

  https://www.capc.org/blog/managing-delirium-what-clinicians-should-know/

  Part two, below, shares strategies that palliative care clinicians can use for managing and preventing delirium in their patients with serious illness, with a focus on behavioral interventions. […] The first and most important step in managing delirium is identifying its underlying cause and treating this precipitant directly. While that work-up and management is being pursued, behavioral interventions and psychotropic medications may target specific symptoms associated with delirium. […] Behavioral interventions are key in both the management and prevention of delirium. […] Implementing appropriate behavioral interventions is an important first step in managing delirium. For certain patients, medications may be required for additional management. […] In general, medications are not used to treat delirium itself but may be used to treat its associated symptoms.

• #7 Patient education: Delirium (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/delirium-beyond-the-basics

  Delirium TREATMENT […] There is no specific treatment for delirium. Instead, treatment focuses on several basic principles: […] Avoid factors known to cause or aggravate delirium, such as certain medications […] Identify and treat the underlying illness […] Provide supportive and restorative care […] Control dangerous and disruptive behaviors to avoid harm to the patient or others […] In people with a first episode of delirium, the initial treatment is often provided in a hospital setting. This allows the health care provider to monitor the patient, begin treatment of the underlying problem, and develop a long-term care plan with the patient and/or family. […] Supportive care — The goal of supportive care is to maintain the patient’s health, prevent additional complications, and avoid those factors that can aggravate delirium. This includes:

• #8 Delirium – symptoms, diagnosis and treatment | Alzheimer’s Society

  https://www.alzheimers.org.uk/get-support/daily-living/delirium

  Delirium is a serious but often treatable condition that can happen suddenly to someone who is unwell. […] The key to getting better is to find the causes of delirium and then try to resolve them. If this is done, most people will get better in a few days. However, some may take longer than this. […] Once a person has been diagnosed with delirium, healthcare professionals will try to work out what is causing it. This will do a physical examination to check for pain or other health problems. […] The only way to treat delirium is to resolve the health problem that’s causing it. […] Delirium is treated by resolving the health problems that have caused it. Once this is done, it’s important to make conditions as ideal as possible for the person’s brain to recover. […] Some causes of delirium can be treated very quickly. Others may take several days or more to get better for example, if they have a serious infection. However, the symptoms of delirium will usually improve once its causes are found and treated.

• #9 Patient education: Delirium (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/delirium-beyond-the-basics

  Delirium TREATMENT […] There is no specific treatment for delirium. Instead, treatment focuses on several basic principles: […] Avoid factors known to cause or aggravate delirium, such as certain medications […] Identify and treat the underlying illness […] Provide supportive and restorative care […] Control dangerous and disruptive behaviors to avoid harm to the patient or others […] In people with a first episode of delirium, the initial treatment is often provided in a hospital setting. This allows the health care provider to monitor the patient, begin treatment of the underlying problem, and develop a long-term care plan with the patient and/or family. […] Supportive care — The goal of supportive care is to maintain the patient’s health, prevent additional complications, and avoid those factors that can aggravate delirium. This includes:

• #10 Delirium – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470399/

  Delirium is a clinical syndrome that usually develops in the elderly. It is characterized by an alteration of attention, consciousness, and cognition, with a reduced ability to focus, sustain or shift attention. […] The diagnosis is often missed, especially the hypoactive type, due to its subtle clinical manifestation. Delirium is dangerous, often preventable, and associated with a significant cost burden and increased morbidity and mortality. Efforts should focus on prevention, early diagnosis, and treatment of the underlying cause. This activity reviews the evaluation and management of delirium and the role of interprofessional team members in collaborating to provide well-coordinated care and improve patient outcomes. […] The main treatments for delirium are based on non-pharmacologic interventions, as there are no FDA-approved medications for the treatment or prevention of delirium. Preventing delirium from occurring is the most efficacious intervention. Identifying patients at risk for delirium and taking special precautions to prevent delirium is crucial.

• #11 Caring for Someone With Delirium | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/delirium

  Delirium is a sudden (quick) change in the way a person thinks and acts. […] Once the cause of the delirium is found, treatment can start. There are no medications that treat delirium itself. […] Instead, the persons healthcare provider may give them medication to treat what is causing the delirium. Or, they may give them medication to treat certain delirium symptoms. For example, if the person is upset or nervous, they may get medication to help them relax. […] The best way to treat delirium is to find and treat the thing thats causing it. Sometimes, the persons healthcare provider may need to order many tests to find the cause of the delirium. These tests can include blood tests, X-rays, brain imaging (such as MRIs and CT scans), and electrocardiograms (EKGs).

• #12 Caring for Someone With Delirium | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/delirium

  Delirium is a sudden (quick) change in the way a person thinks and acts. […] Once the cause of the delirium is found, treatment can start. There are no medications that treat delirium itself. […] Instead, the persons healthcare provider may give them medication to treat what is causing the delirium. Or, they may give them medication to treat certain delirium symptoms. For example, if the person is upset or nervous, they may get medication to help them relax. […] The best way to treat delirium is to find and treat the thing thats causing it. Sometimes, the persons healthcare provider may need to order many tests to find the cause of the delirium. These tests can include blood tests, X-rays, brain imaging (such as MRIs and CT scans), and electrocardiograms (EKGs).

• #13 Managing Delirium | What Clinicians Should Know | Palliative in Practice | Center to Advance Palliative Care

  https://www.capc.org/blog/managing-delirium-what-clinicians-should-know/

  Part two, below, shares strategies that palliative care clinicians can use for managing and preventing delirium in their patients with serious illness, with a focus on behavioral interventions. […] The first and most important step in managing delirium is identifying its underlying cause and treating this precipitant directly. While that work-up and management is being pursued, behavioral interventions and psychotropic medications may target specific symptoms associated with delirium. […] Behavioral interventions are key in both the management and prevention of delirium. […] Implementing appropriate behavioral interventions is an important first step in managing delirium. For certain patients, medications may be required for additional management. […] In general, medications are not used to treat delirium itself but may be used to treat its associated symptoms.

• #14 Caring for Someone With Delirium | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/delirium

  Delirium is a sudden (quick) change in the way a person thinks and acts. […] Once the cause of the delirium is found, treatment can start. There are no medications that treat delirium itself. […] Instead, the persons healthcare provider may give them medication to treat what is causing the delirium. Or, they may give them medication to treat certain delirium symptoms. For example, if the person is upset or nervous, they may get medication to help them relax. […] The best way to treat delirium is to find and treat the thing thats causing it. Sometimes, the persons healthcare provider may need to order many tests to find the cause of the delirium. These tests can include blood tests, X-rays, brain imaging (such as MRIs and CT scans), and electrocardiograms (EKGs).

• #15 Delirium – symptoms, diagnosis and treatment | Alzheimer’s Society

  https://www.alzheimers.org.uk/get-support/daily-living/delirium

  Delirium is a serious but often treatable condition that can happen suddenly to someone who is unwell. […] The key to getting better is to find the causes of delirium and then try to resolve them. If this is done, most people will get better in a few days. However, some may take longer than this. […] Once a person has been diagnosed with delirium, healthcare professionals will try to work out what is causing it. This will do a physical examination to check for pain or other health problems. […] The only way to treat delirium is to resolve the health problem that’s causing it. […] Delirium is treated by resolving the health problems that have caused it. Once this is done, it’s important to make conditions as ideal as possible for the person’s brain to recover. […] Some causes of delirium can be treated very quickly. Others may take several days or more to get better for example, if they have a serious infection. However, the symptoms of delirium will usually improve once its causes are found and treated.

• #16 Delirium | Canadian Cancer Society

  https://cancer.ca/en/treatments/side-effects/delirium

  Delirium is often caused by a combination of these problems. […] Talk to your healthcare team about treatments for delirium and how these treatments fit with your decisions about care. Treatment doesnt always improve delirium in people with advanced cancer. In some cases, especially if the person with cancer is nearing the end of life, you may decide not to treat delirium. […] The type of treatment offered for delirium will depend on the test results. Treatments may include: changing medicines or doses of medicines, or stopping medicines; giving fluids with needles placed in the skin (subcutaneous) to treat dehydration; antibiotics to treat an infection; pain control; giving oxygen; removing a catheter from the bladder. […] If the person with delirium is becoming distressed or upset or if it seems they might harm themselves or someone else, the healthcare team may use medicine to help ease these symptoms.

• #17 Delirium – symptoms, diagnosis and treatment | Alzheimer’s Society

  https://www.alzheimers.org.uk/get-support/daily-living/delirium

  Delirium is a serious but often treatable condition that can happen suddenly to someone who is unwell. […] The key to getting better is to find the causes of delirium and then try to resolve them. If this is done, most people will get better in a few days. However, some may take longer than this. […] Once a person has been diagnosed with delirium, healthcare professionals will try to work out what is causing it. This will do a physical examination to check for pain or other health problems. […] The only way to treat delirium is to resolve the health problem that’s causing it. […] Delirium is treated by resolving the health problems that have caused it. Once this is done, it’s important to make conditions as ideal as possible for the person’s brain to recover. […] Some causes of delirium can be treated very quickly. Others may take several days or more to get better for example, if they have a serious infection. However, the symptoms of delirium will usually improve once its causes are found and treated.

• #18 Managing Delirium | What Clinicians Should Know | Palliative in Practice | Center to Advance Palliative Care

  https://www.capc.org/blog/managing-delirium-what-clinicians-should-know/

  Part two, below, shares strategies that palliative care clinicians can use for managing and preventing delirium in their patients with serious illness, with a focus on behavioral interventions. […] The first and most important step in managing delirium is identifying its underlying cause and treating this precipitant directly. While that work-up and management is being pursued, behavioral interventions and psychotropic medications may target specific symptoms associated with delirium. […] Behavioral interventions are key in both the management and prevention of delirium. […] Implementing appropriate behavioral interventions is an important first step in managing delirium. For certain patients, medications may be required for additional management. […] In general, medications are not used to treat delirium itself but may be used to treat its associated symptoms.

• #19 Managing Delirium | What Clinicians Should Know | Palliative in Practice | Center to Advance Palliative Care

  https://www.capc.org/blog/managing-delirium-what-clinicians-should-know/

  Part two, below, shares strategies that palliative care clinicians can use for managing and preventing delirium in their patients with serious illness, with a focus on behavioral interventions. […] The first and most important step in managing delirium is identifying its underlying cause and treating this precipitant directly. While that work-up and management is being pursued, behavioral interventions and psychotropic medications may target specific symptoms associated with delirium. […] Behavioral interventions are key in both the management and prevention of delirium. […] Implementing appropriate behavioral interventions is an important first step in managing delirium. For certain patients, medications may be required for additional management. […] In general, medications are not used to treat delirium itself but may be used to treat its associated symptoms.

• #20 Delirium – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delirium/diagnosis-treatment/drc-20371391

  The first goal of delirium treatment is to address any causes or triggers. That may include stopping certain medicines, treating an infection or treating an imbalance in the body. Treatment then focuses on creating the best setting for healing the body and calming the brain. […] Supportive care aims to prevent complications. Here are steps to take: Protect the airway, Provide fluids and nutrition, Assist with movement, Treat pain, Address a lack of bladder control, Avoid the use of physical restraints and bladder tubes, Avoid changes in surroundings and caregivers when possible, Include family members or familiar people in care. […] If you’re a family member or caregiver of someone who has delirium, talk with the health care provider about medicines that may trigger the symptoms. The provider may suggest that the person avoid taking those medicines or that a lower dose is given. Certain medicines may be needed to control pain that’s causing delirium.

• #21 Delirium – symptoms, diagnosis and treatment | Alzheimer’s Society

  https://www.alzheimers.org.uk/get-support/daily-living/delirium

  A supportive and calm environment can also help someone recover from delirium. […] Medications to reduce hallucinations, delusions or aggressive behaviour should be considered only if the person poses a risk of harm to themselves or others, or if their symptoms are causing them severe distress. In either case a doctor may try a low dose of a sedative or an antipsychotic for a few days. […] For many people the symptoms of delirium usually improve in a few days, once the underlying causes have been treated. However, some people don’t make a quick or full recovery and may still be having problems with memory and thinking several weeks or even months after becoming unwell.

• #22 Delirium – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delirium/diagnosis-treatment/drc-20371391

  The first goal of delirium treatment is to address any causes or triggers. That may include stopping certain medicines, treating an infection or treating an imbalance in the body. Treatment then focuses on creating the best setting for healing the body and calming the brain. […] Supportive care aims to prevent complications. Here are steps to take: Protect the airway, Provide fluids and nutrition, Assist with movement, Treat pain, Address a lack of bladder control, Avoid the use of physical restraints and bladder tubes, Avoid changes in surroundings and caregivers when possible, Include family members or familiar people in care. […] If you’re a family member or caregiver of someone who has delirium, talk with the health care provider about medicines that may trigger the symptoms. The provider may suggest that the person avoid taking those medicines or that a lower dose is given. Certain medicines may be needed to control pain that’s causing delirium.

• #23 Delirium Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/288890-treatment

  Following recovery, patient’s memories of events of the delirium are variable. Be sure to educate the patient, family, and primary caregivers about future risk factors. […] When delirium is diagnosed or suspected, the underlying causes should be sought and treated. Despite every effort, no cause for delirium can be found in a small percentage of patients. Components of delirium management include supportive therapy and pharmacological management. […] Reorientation techniques or memory cues such as a calendar, clocks, and family photos may be helpful. The environment should be stable, quiet, and well-lighted. […] A meta-analysis of 7 studies that focused on the usefulness of interventions such as physical or occupational therapy, daily reorientation, and the avoidance of sensorial deprivation found a significant reduction in the development of delirium among elderly inpatients.

• #24 Delirium Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/288890-treatment

  Following recovery, patient’s memories of events of the delirium are variable. Be sure to educate the patient, family, and primary caregivers about future risk factors. […] When delirium is diagnosed or suspected, the underlying causes should be sought and treated. Despite every effort, no cause for delirium can be found in a small percentage of patients. Components of delirium management include supportive therapy and pharmacological management. […] Reorientation techniques or memory cues such as a calendar, clocks, and family photos may be helpful. The environment should be stable, quiet, and well-lighted. […] A meta-analysis of 7 studies that focused on the usefulness of interventions such as physical or occupational therapy, daily reorientation, and the avoidance of sensorial deprivation found a significant reduction in the development of delirium among elderly inpatients.

• #25 Recommendations | Delirium: prevention, diagnosis and management in hospital and long-term care | Guidance | NICE

  https://www.nice.org.uk/guidance/cg103/chapter/1-guidance

  Ensure that people at risk of delirium are cared for by a team of healthcare professionals who are familiar to the person at risk. Avoid moving people within and between wards or rooms unless absolutely necessary. […] The tailored multicomponent intervention package should be delivered by a multidisciplinary team trained and competent in delirium prevention. […] If indicators of delirium are identified, a health or social care practitioner who is competent to do so should carry out an assessment using the 4AT. […] In people diagnosed with delirium, identify and manage the possible underlying cause or combination of causes. […] Ensure effective communication and reorientation (for example explaining where the person is, who they are and what your role is) and provide reassurance for people diagnosed with delirium.

• #26 Clinical Practice Guidelines for Management of Delirium in Elderly

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5840908/

  Non-Pharmacological treatment involves providing unambiguous, supportive environment to improve the orientation and maintain the competence of the patients. […] A wide range of pharmacological agents has been evaluated for the management of delirium. […] Antipsychotics are considered as the medication of choice in the management of delirium. […] Benzodiazepines can worsen the cognitive functions and lead to excessive sedation. Hence, benzodiazepines are not considered as the first line agent for the management of delirium. […] Studies have also evaluated the role of paralytic agents in conjunction with use of mechanical ventilation for the management of delirium in ICU settings. […] Ideally patients with delirium must be kept in the hospital until the delirium resolves. […] Considering the fact that delirium is associated with significant negative health related outcomes, efforts must be made to prevent the same.

• #27 Patient education: Delirium (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/delirium-beyond-the-basics

  Avoiding overstimulation (eg, multiple visitors, loud noise), which can worsen delirium, but also avoiding understimulation (darkened room, complete silence) […] Making hearing aids and eyeglasses available at the hospital if the patient uses these at home […] Managing behaviors — Some people with delirium have disruptive behaviors, potentially causing them to harm themselves or others. The person may say or do things that are obscene or offensive, but such behaviors do not reflect the person’s true beliefs. The person may also be at risk for falling, wandering off, or inadvertently removing intravenous lines. […] Sitter — Allowing a family member or other caregiver to stay with the patient at the bedside may help to manage the patient’s behavior. This person can provide reassurance, answer questions, reorient the patient, and notify staff if the person needs assistance. In some cases, the hospital is able to provide a sitter if a family member is unavailable. However, a familiar and trusted family member or friend can provide additional reassurance to the patient.

• #28 Reddit – The heart of the internet

  https://www.reddit.com/r/medicine/comments/11gstuu/what_are_the_best_ways_to_treat_hospital_delirium/

  I know all the ways to prevent it- encourage out of bed activity, allow uninterrupted rest, maintain day/night rhythm, lights on and curtain open during the day, lights off at night, avoid deleriogenic meds, etc. […] So delirium happens. Do we have any good ways to actually treat it? […] Honestly Ive not seen much at all work other than family presence (though sometimes they make it worse too by getting so upset at seeing their delirious loved one). What seems to happen is the patient gets wilder and wilder until they finally crash and sleep 12+ hours and then start to very slowly improve. […] So once delirium sets it, what should we be doing? How can we resolve the delirium but also keep the patient and staff safe and maintain medical treatment in the meantime?

• #29 Patient education: Delirium (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/delirium-beyond-the-basics

  Avoiding overstimulation (eg, multiple visitors, loud noise), which can worsen delirium, but also avoiding understimulation (darkened room, complete silence) […] Making hearing aids and eyeglasses available at the hospital if the patient uses these at home […] Managing behaviors — Some people with delirium have disruptive behaviors, potentially causing them to harm themselves or others. The person may say or do things that are obscene or offensive, but such behaviors do not reflect the person’s true beliefs. The person may also be at risk for falling, wandering off, or inadvertently removing intravenous lines. […] Sitter — Allowing a family member or other caregiver to stay with the patient at the bedside may help to manage the patient’s behavior. This person can provide reassurance, answer questions, reorient the patient, and notify staff if the person needs assistance. In some cases, the hospital is able to provide a sitter if a family member is unavailable. However, a familiar and trusted family member or friend can provide additional reassurance to the patient.

• #30 Delirium – symptoms, diagnosis and treatment | healthdirect

  https://www.healthdirect.gov.au/delirium

  Delirium is a sudden change in the way you think and behave. […] Delirium is often caused by changes in your health, such as an infection or a medicine change. […] If you’re in hospital and at risk, your doctor will provide care to prevent delirium. […] Treatment for delirium focuses on finding and addressing the cause and providing supportive care. […] Your doctor may treat delirium by changing your prescription medicines, giving you intravenous fluids, prescribing antibiotics if you have an infection, and prescribing antipsychotic medicines when other methods to manage delirium don’t work. […] It can be reassuring for someone with delirium to see familiar faces. You may be encouraged to stay with your loved one if they are in hospital and have delirium. […] Delirium can be prevented with proper care. If you are at risk, your doctor may check your medicines and adjust those that may increase your risk, encourage you to eat and drink to stay hydrated and nourished, and help you stay active. […] If you are in hospital, your healthcare team can try to prevent delirium by developing a delirium prevention plan with you and your family or carer, communicating clearly, and managing your pain effectively.

• #31 How to Help a Loved One with Post-operative Delirium

  https://www.asahq.org/brainhealthinitiative/publications-news-videos/articlesandnews/helpalovedone

  The HELP program can be helpful for managing delirium in the hospital and at home. […] Delirium after surgery is often temporary, but it can affect your loved ones recovery, leading to a longer hospital stay or discharge to a rehabilitation facility instead of directly to home. […] Most people with delirium after surgery recover within a month to six months. […] Dr. Ohs recommendations are based on principles of the Hospital Elder Life Program (HELP), a comprehensive patient-care program staffed by volunteers that helps prevent delirium and loss of functioning for older adults that doesnt involve medication. […] Although the HELP program is a well-known program for prevention of delirium, many aspects of the HELP program can also be helpful for managing delirium, Dr. Oh says. […] Here are Dr. Ohs recommendations for helping your loved one recover faster from delirium after surgery at home.

• #32 Delirium – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470399/

  While prevention and nonpharmacologic interventions are the mainstays of treatment for delirium, it may occasionally be necessary to utilize pharmacologic therapies, which are only considered appropriate in limited circumstances. […] The primary treatment for delirium is based on prevention and non-pharmacologic interventions because there are no FDA-approved medications for the treatment or prevention of delirium. The Hospital Elder Life Program (HELP) has been shown to reduce the incidence of delirium in elderly patients, falls, and overall healthcare costs.

• #33 Treatment of Delirium in Older Persons: What We Should Not Do!

  https://www.mdpi.com/1422-0067/21/7/2397

  Primary prevention with non-pharmacological multicomponent approaches is widely accepted as the most effective strategy for delirium. […] The most famous approach is the Hospital Elder Life Program (HELP), a multicomponent intervention strategy including reorientation, therapeutic activities, reduced use and doses of psychoactive drugs, early mobilization, promotion of sleep, maintenance of adequate hydration and nutrition, and provision of vision and hearing adaptations. […] The systematic identification and treatment of potential causes (medications, acute illness, etc.) is highly recommended. […] Specific attention should be also devoted to detecting and assessing the causes of and treat agitation and/or distress using non-pharmacological means only if possible. […] Aim to prevent complications of delirium, such as immobility, falls, pressure sores, dehydration, malnourishment, and isolation.

• #34 Treatment of Delirium in Older Persons: What We Should Not Do!

  https://www.mdpi.com/1422-0067/21/7/2397

  Primary prevention with non-pharmacological multicomponent approaches is widely accepted as the most effective strategy for delirium. […] The most famous approach is the Hospital Elder Life Program (HELP), a multicomponent intervention strategy including reorientation, therapeutic activities, reduced use and doses of psychoactive drugs, early mobilization, promotion of sleep, maintenance of adequate hydration and nutrition, and provision of vision and hearing adaptations. […] The systematic identification and treatment of potential causes (medications, acute illness, etc.) is highly recommended. […] Specific attention should be also devoted to detecting and assessing the causes of and treat agitation and/or distress using non-pharmacological means only if possible. […] Aim to prevent complications of delirium, such as immobility, falls, pressure sores, dehydration, malnourishment, and isolation.

• #35 Delirium Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/288890-treatment

  Following recovery, patient’s memories of events of the delirium are variable. Be sure to educate the patient, family, and primary caregivers about future risk factors. […] When delirium is diagnosed or suspected, the underlying causes should be sought and treated. Despite every effort, no cause for delirium can be found in a small percentage of patients. Components of delirium management include supportive therapy and pharmacological management. […] Reorientation techniques or memory cues such as a calendar, clocks, and family photos may be helpful. The environment should be stable, quiet, and well-lighted. […] A meta-analysis of 7 studies that focused on the usefulness of interventions such as physical or occupational therapy, daily reorientation, and the avoidance of sensorial deprivation found a significant reduction in the development of delirium among elderly inpatients.

• #36 Delirium – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470399/

  While prevention and nonpharmacologic interventions are the mainstays of treatment for delirium, it may occasionally be necessary to utilize pharmacologic therapies, which are only considered appropriate in limited circumstances. […] The primary treatment for delirium is based on prevention and non-pharmacologic interventions because there are no FDA-approved medications for the treatment or prevention of delirium. The Hospital Elder Life Program (HELP) has been shown to reduce the incidence of delirium in elderly patients, falls, and overall healthcare costs.

• #37 Care and Treatment Options for Delirium | American Geriatrics Society | HealthInAging.org

  https://www.healthinaging.org/a-z-topic/delirium/care-treatment

  The best way to deal with delirium is to prevent it. […] Delirium is a medical emergency which requires quick treatment. The main goal of treatment is to identify and correct the cause of delirium. […] To reduce the risk of delirium or treat its symptoms: […] Medications are generally not effective in delirium and can cause severe side effects, including death. Rarely, medications such as anti-psychotics or sedatives may be necessary in the case of severe symptoms of delirium. […] For older adults experiencing delirium, the basis of treatment is creating a safe, familiar, and supportive environment.

• #38 Delirium in Older Persons: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html

  Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. […] Treatment of delirium should focus on identifying and managing the causative medical conditions, providing supportive care, preventing complications, and reinforcing preventive interventions. Pharmacologic interventions should be reserved for patients who are a threat to their own safety or the safety of others and those patients nearing death. […] Physicians should train nursing staff, home health aides, and family members/caregivers on recognizing and treating delirium. […] Antipsychotic medications should be used as a last resort in treating delirium and should not be used indiscriminately in persons with delirium who have not been properly evaluated.

• #39 Care and Treatment Options for Delirium | American Geriatrics Society | HealthInAging.org

  https://www.healthinaging.org/a-z-topic/delirium/care-treatment

  The best way to deal with delirium is to prevent it. […] Delirium is a medical emergency which requires quick treatment. The main goal of treatment is to identify and correct the cause of delirium. […] To reduce the risk of delirium or treat its symptoms: […] Medications are generally not effective in delirium and can cause severe side effects, including death. Rarely, medications such as anti-psychotics or sedatives may be necessary in the case of severe symptoms of delirium. […] For older adults experiencing delirium, the basis of treatment is creating a safe, familiar, and supportive environment.

• #40 SOP: treatment of delirium | Neurological Research and Practice | Full Text

  https://neurolrespract.biomedcentral.com/articles/10.1186/s42466-021-00110-7

  Delirium is a frequent complication in hospitalised patients, often leading to difficulties in patient management and is associated with increased morbidity and mortality. […] The most important measures to prevent and treat delirium are recognition and removal of risk factors and causes. […] Although delirium is a very common and serious complication, evidence for pharmacological treatment is poor, and guidelines remain controversial. […] Accordingly, non-pharmacological treatments have gained increasing attention and should be applied. […] The treatment of delirium should encompass the elimination of potential causes and non-pharmacological interventions. […] Pharmacological treatment should be used in a time-limited manner and in the lowest possible dose for the management of highly stressful symptoms or high-risk behaviour.

• #41 Delirium Medication: Antipsychotics, Benzodiazepines, Vitamins, Hypnotic, Miscellaneous

  https://emedicine.medscape.com/article/288890-medication

  A randomized, double-blinded, placebo-controlled, multicenter trial in intensive care unit patients showed rivastigmine did not decrease duration of delirium and increased mortality in these patients. […] A review of 7 trials of anticholinesterase inhibitors found that in 5 of the studies there was no benefit from the medications in either the prevention or management of delirium. […] Recent clinical trials showed that the melatonin supplement and its receptor agonist ramelteon may be useful in the prevention and management of delirium. […] This class of drugs are the medication of choice in the treatment of psychotic symptoms of delirium. […] Antipsychotics can be associated with adverse neurological effects such as extrapyramidal symptoms, neuroleptic malignant syndrome, and tardive dyskinesia.

• #42 Clinical Practice Guidelines for Management of Delirium in Elderly

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5840908/

  Non-Pharmacological treatment involves providing unambiguous, supportive environment to improve the orientation and maintain the competence of the patients. […] A wide range of pharmacological agents has been evaluated for the management of delirium. […] Antipsychotics are considered as the medication of choice in the management of delirium. […] Benzodiazepines can worsen the cognitive functions and lead to excessive sedation. Hence, benzodiazepines are not considered as the first line agent for the management of delirium. […] Studies have also evaluated the role of paralytic agents in conjunction with use of mechanical ventilation for the management of delirium in ICU settings. […] Ideally patients with delirium must be kept in the hospital until the delirium resolves. […] Considering the fact that delirium is associated with significant negative health related outcomes, efforts must be made to prevent the same.

• #43 Logo for Cambridge Core from Cambridge University Press. Click to return to homepage.

  https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/active-management-of-delirium-improving-detection-and-treatment/743CE2DA1D39AE5C0445F3D62D5ABB6B

  Pharmacological management of delirium is currently based on empirical knowledge rather than well-designed efficacy studies. […] The lack of good-quality evidence is reflected in inconsistent treatment guidelines and wide variations in clinical practice. […] Although drug-related causes are implicated in 30% of cases of delirium and delirium risk has been linked to most psychotropic agents and to polypharmacy, the need to rationalise medications should not be mistaken as a call always to reduce or discontinue them. […] Timely intervention, with careful dose titration and monitoring for adverse effects, can reduce both the degree and duration of delirium. […] Haloperidol remains the standard agent used to treat delirium because it has the most convincing evidence for benefit and is available in oral, intramuscular and intravenous preparations.

• #44 Logo for Cambridge Core from Cambridge University Press. Click to return to homepage.

  https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/active-management-of-delirium-improving-detection-and-treatment/743CE2DA1D39AE5C0445F3D62D5ABB6B

  The use of antipsychotic agents in delirium is associated with clinical improvement in two-thirds of patients within 1 week. […] Pharmacological treatment of delirium should continue until symptoms have fully resolved. […] The combination of non-drug strategies with judicious use of pharmacological treatments can shorten episode duration and reduce the likelihood of complications that contribute to prolonged hospitalisation and adverse outcomes.

• #45 Delirium Medication: Antipsychotics, Benzodiazepines, Vitamins, Hypnotic, Miscellaneous

  https://emedicine.medscape.com/article/288890-medication

  Delirium that causes injury to the patient or others should be treated with medications. The most common medications used are antipsychotic medications. While this is a common and seemingly useful strategy, the literature is still mixed. A 2015 meta-analysis of 15 studies found that second-generation antipsychotics (SGAs) may treat delirium better than placebo, usual care, or haloperidol. […] A 2016 meta-analysis of 19 studies found that antipsychotic use was not associated with change in delirium duration, severity, or hospital or ICU length of stay. […] Benzodiazepines often are used for alcohol and benzodiazepine withdrawal states. […] Since decreased anticholinergic activity may be associated with delirium, anticholinesterase inhibitors have been tried. Even though case reports showed evidence that cholinesterase inhibitors may play a role in the management of delirium, larger trials and systematic review did not support this use.

• #46 Managing delirium in older patients – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/managing-delirium-in-older-patients.html

  Delirium requires urgent medical assessment. Unfortunately, the diagnosis is often missed. It is best treated by multidisciplinary intervention, addressing risk factors, treating underlying causes and minimising harm. […] Part of its management may be pharmacological, firstly ceasing drugs which may precipitate delirium especially those with anticholinergic properties and secondly, cautious use of antipsychotics for hyperactive symptoms. […] Drug therapy is reserved for patients who are at risk of harming themselves or others, for example by pulling out essential medical devices or lines. […] If drugs are needed, antipsychotics are generally accepted as first-line, except in delirium tremens. […] Suggested initial doses are haloperidol 0.5 mg, risperidone 0.5 mg or olanzapine 2.5 mg.

• #47 Managing delirium in older patients – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/managing-delirium-in-older-patients.html

  Delirium requires urgent medical assessment. Unfortunately, the diagnosis is often missed. It is best treated by multidisciplinary intervention, addressing risk factors, treating underlying causes and minimising harm. […] Part of its management may be pharmacological, firstly ceasing drugs which may precipitate delirium especially those with anticholinergic properties and secondly, cautious use of antipsychotics for hyperactive symptoms. […] Drug therapy is reserved for patients who are at risk of harming themselves or others, for example by pulling out essential medical devices or lines. […] If drugs are needed, antipsychotics are generally accepted as first-line, except in delirium tremens. […] Suggested initial doses are haloperidol 0.5 mg, risperidone 0.5 mg or olanzapine 2.5 mg.

• #48 Delirium Medication: Antipsychotics, Benzodiazepines, Vitamins, Hypnotic, Miscellaneous

  https://emedicine.medscape.com/article/288890-medication

  A randomized, double-blinded, placebo-controlled, multicenter trial in intensive care unit patients showed rivastigmine did not decrease duration of delirium and increased mortality in these patients. […] A review of 7 trials of anticholinesterase inhibitors found that in 5 of the studies there was no benefit from the medications in either the prevention or management of delirium. […] Recent clinical trials showed that the melatonin supplement and its receptor agonist ramelteon may be useful in the prevention and management of delirium. […] This class of drugs are the medication of choice in the treatment of psychotic symptoms of delirium. […] Antipsychotics can be associated with adverse neurological effects such as extrapyramidal symptoms, neuroleptic malignant syndrome, and tardive dyskinesia.

• #49 Clinical Practice Guidelines for Management of Delirium in Elderly

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5840908/

  Non-Pharmacological treatment involves providing unambiguous, supportive environment to improve the orientation and maintain the competence of the patients. […] A wide range of pharmacological agents has been evaluated for the management of delirium. […] Antipsychotics are considered as the medication of choice in the management of delirium. […] Benzodiazepines can worsen the cognitive functions and lead to excessive sedation. Hence, benzodiazepines are not considered as the first line agent for the management of delirium. […] Studies have also evaluated the role of paralytic agents in conjunction with use of mechanical ventilation for the management of delirium in ICU settings. […] Ideally patients with delirium must be kept in the hospital until the delirium resolves. […] Considering the fact that delirium is associated with significant negative health related outcomes, efforts must be made to prevent the same.

• #50 Delirium Medication: Antipsychotics, Benzodiazepines, Vitamins, Hypnotic, Miscellaneous

  https://emedicine.medscape.com/article/288890-medication

  Benzodiazepines are preferred over neuroleptics for treatment of delirium resulting from alcohol or sedative hypnotic withdrawal. […] Melatonin is a naturally occurring hormone secreted by the pineal gland. […] Ramelteon is a melatonin receptor agonist with high selectivity for human melatonin MT1 and MT2 receptors.

• #51 Delirium Tremens: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25052-delirium-tremens

  Delirium tremens is a life-threatening form of alcohol withdrawal. While treatable, this condition needs immediate medical care. This condition is avoidable with professional medical guidance and specialized programs that help people who want to lower their alcohol intake or stop drinking entirely. […] DTs isnt curable, but its very treatable. Because confusion is a key symptom of DTs, people with this condition cant make informed choices about their care. It may be necessary for family or loved ones to make decisions if you cant make choices for yourself. […] One of the priorities in treating this condition is to lower nervous system activity. A healthcare provider will treat this using drugs that reduce how active your CNS is. Multiple types of medication can help with this. […] Treating DTs generally starts with sedatives. They help lower activity in your CNS, which is the source of most of the dangerous problems with DTs. The most common sedatives are benzodiazepines, but other drug types are possible, too.

• #52 Delirium Tremens: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25052-delirium-tremens

  Delirium tremens is a life-threatening form of alcohol withdrawal. While treatable, this condition needs immediate medical care. This condition is avoidable with professional medical guidance and specialized programs that help people who want to lower their alcohol intake or stop drinking entirely. […] DTs isnt curable, but its very treatable. Because confusion is a key symptom of DTs, people with this condition cant make informed choices about their care. It may be necessary for family or loved ones to make decisions if you cant make choices for yourself. […] One of the priorities in treating this condition is to lower nervous system activity. A healthcare provider will treat this using drugs that reduce how active your CNS is. Multiple types of medication can help with this. […] Treating DTs generally starts with sedatives. They help lower activity in your CNS, which is the source of most of the dangerous problems with DTs. The most common sedatives are benzodiazepines, but other drug types are possible, too.

• #53 Delirium Medication: Antipsychotics, Benzodiazepines, Vitamins, Hypnotic, Miscellaneous

  https://emedicine.medscape.com/article/288890-medication

  A randomized, double-blinded, placebo-controlled, multicenter trial in intensive care unit patients showed rivastigmine did not decrease duration of delirium and increased mortality in these patients. […] A review of 7 trials of anticholinesterase inhibitors found that in 5 of the studies there was no benefit from the medications in either the prevention or management of delirium. […] Recent clinical trials showed that the melatonin supplement and its receptor agonist ramelteon may be useful in the prevention and management of delirium. […] This class of drugs are the medication of choice in the treatment of psychotic symptoms of delirium. […] Antipsychotics can be associated with adverse neurological effects such as extrapyramidal symptoms, neuroleptic malignant syndrome, and tardive dyskinesia.

• #54 Delirium Medication: Antipsychotics, Benzodiazepines, Vitamins, Hypnotic, Miscellaneous

  https://emedicine.medscape.com/article/288890-medication

  Benzodiazepines are preferred over neuroleptics for treatment of delirium resulting from alcohol or sedative hypnotic withdrawal. […] Melatonin is a naturally occurring hormone secreted by the pineal gland. […] Ramelteon is a melatonin receptor agonist with high selectivity for human melatonin MT1 and MT2 receptors.

• #55 SOP: treatment of delirium | Neurological Research and Practice | Full Text

  https://neurolrespract.biomedcentral.com/articles/10.1186/s42466-021-00110-7

  Antipsychotic treatment should be limited to the management of symptoms imposing a safety risk for the patient or medical staff or which are highly stressful for the patient. […] Benzodiazepines have only proven to be beneficial in combination with haloperidol but not in monotherapy. […] In the ICU-setting, the alpha2-agonist dexmedetomidine has the most promising results in the treatment of delirium by shortening its duration and by shortening the duration of mechanical ventilation as well as the length of stay in the ICU. […] There is no conclusive data supporting the use of medication for the prevention of delirium. […] Prevention and treatment of delirium should be based on the elimination of potential causes and on non-pharmacological interventions. […] Pharmacological treatment should be used in a time-limited manner and in the lowest possible dose for the management of highly stressful symptoms or high-risk behaviour if non-pharmacological treatment is not effective. […] More randomized controlled trials are needed to improve evidence for the best treatment of delirium.

• #56 Hypoactive delirium: a complex syndrome, Don´t forget deseases and treatment options | The BMJ

  https://www.bmj.com/content/357/bmj.j2047/rr-2

  Delirium is one of the oldest forms of disorder in Psychopathology and Psychiatry (described by Hippocrates). […] Treatment of delirium involves two main strategies: first, treatment of the underlying presumed acute cause or causes, secondly, optimizing conditions with adequate oxygenation and hydration. […] The treatment for delirium with medications depends on its cause; therapy should be initiated promptly. […] Antipsychotics, particularly haloperidol, are the most commonly used drugs for delirium and the most studied. […] Thiamine treatment is indicated in malnourished patients, such as patients with an alcohol addiction associated with a thiamine deficiency, which can cause disorders including Wernicke’s encephalopathy and Korsakoff’s psychosis.

• #57

  https://link.springer.com/article/10.1007/s11864-022-00987-9

  Delirium is a common medical complication in people living with cancer, particularly with more advanced disease. Delirium is associated with significant symptom burden which causes distress and impacts quality of life. As recommended by international guidelines, a high degree of suspicion is needed to ensure delirium is detected early. […] Non-pharmacological approaches that can be considered essential elements of care are effective in reducing the risk of delirium. […] The gold standard approach based on expert consensus is to institute management for delirium precipitants supported by non-pharmacological essential care, with the support of an interdisciplinary team. Medication management should be used sparingly and for a limited period of time wherever possible for severe perceptual disturbance or agitation which has not improved with non-pharmacological approaches.

• #58

  https://myhealth.alberta.ca/Alberta/Pages/Treatment-and-how-can-I-help.aspx

  There is no treatment for delirium itself. The goal is to treat the cause of delirium and keep you as comfortable as possible. […] Delirium can also happen in the last days and hours of life. The focus at the end of life is to keep you, your friend or family member comfortable. […] If you have questions about delirium or dementia call Health Link at 811. You can talk to a registered nurse and ask about the Dementia Advice Line.

• #59 Diagnosis and Treatment of Terminal Delirium | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/diagnosis-and-treatment-of-terminal-delirium/

  Delirium can be characterized by a hyperactive/agitated state, a hypoactive state, or a mixture of the two. […] „Terminal delirium” is not a distinct diagnosis, although it is a commonly used phrase. It implies delirium in a patient in the final days/weeks of life, where treatment of the underlying cause is impossible, impractical, or not consistent with the goals of care. […] Non-Pharmacologic Treatments: These are the mainstay in delirium management and should be utilized regardless of the type of delirium. […] Pharmacologic Treatments: There is no clear consensus about the role of medications to treat delirium. Antipsychotic medications have long been used to treat delirium. […] Patients with terminal delirium should be treated pharmacologically if it is the judgment of their caregivers that the delirium is a source of suffering.

• #60 Delirium and Cancer Treatment – Side Effects – NCI

  https://www.cancer.gov/about-cancer/treatment/side-effects/delirium

  Talk with your loved ones doctor to identify the causes of delirium and the best way to treat or manage it. […] Ways to treat delirium in people with cancer […] Steps that can be taken to treat symptoms related to delirium include: […] Treat the causes of delirium: If medicines are causing delirium, then reducing the dose or stopping them may treat delirium. If conditions such as dehydration, poor nutrition, and infections are causing the delirium, then treating these may help. […] Control surroundings: If the symptoms of delirium are mild, it may help to keep the room quiet and well lit, with a clock or calendar and familiar possessions. Having family members around and keeping the same caregivers, as much as possible, may also help. […] Consider medicines: Medicines are sometimes given to treat the symptoms of delirium. However, these medicines have serious side effects and patients receiving them require careful observation by a doctor. […] Sometimes sedation may help: After discussion with family members, sedation is sometimes used for delirium at the end of life, if it does not get better with other treatments. The doctor will discuss the decisions involved in using sedation to treat delirium with the family.

• #61 Managing delirium and psychological symptoms in the last days of life

  https://bpac.org.nz/2023/last-days-of-life/delirium.aspx

  When delirium occurs in the last days of life it is usually irreversible. Pharmacological treatment is only required for patients experiencing significant distressing symptoms, e.g. hallucinations, agitation. […] Non-pharmacological strategies are first-line for patients whose symptoms are not causing distress, e.g. re-orientation cues, creating a safe environment with a comfortable room temperature, a low level of noise and adequate lighting. […] Psychological symptoms, e.g. anxiety, depression, emotional or spiritual distress, are also common in the last days of life and should be managed as they can exacerbate delirium and other physical symptoms, e.g. breathlessness. […] Evidence suggests that non-pharmacological interventions are preferable to pharmacological treatments in patients experiencing mild symptoms of delirium.

• #62

  https://link.springer.com/article/10.1007/s11940-019-0599-5

  Delirium occurs frequently in critically ill patients and is associated with adverse outcomes in both the short and long term. […] Multicomponent non-pharmacologic interventions have been shown to be efficacious in non-ICU populations, and multicomponent strategies such as the ABCDEF bundle have been adopted in the ICU with several studies showing a potential benefit in delirium outcomes. […] Effective and proven delirium management strategies are still largely lacking, though there is evidence to support the use of some non-pharmacologic interventions. Future studies of novel non-pharmacologic interventions and pharmacologic agents other than antipsychotics are warranted. […] Two negative randomized clinical trials of antipsychotics in ICU patients (REDUCE and MIND-USA) have provided strong evidence that such medications neither prevent nor shorten the duration of delirium.

• #63

  https://link.springer.com/article/10.1007/s11940-019-0599-5

  Delirium occurs frequently in critically ill patients and is associated with adverse outcomes in both the short and long term. […] Multicomponent non-pharmacologic interventions have been shown to be efficacious in non-ICU populations, and multicomponent strategies such as the ABCDEF bundle have been adopted in the ICU with several studies showing a potential benefit in delirium outcomes. […] Effective and proven delirium management strategies are still largely lacking, though there is evidence to support the use of some non-pharmacologic interventions. Future studies of novel non-pharmacologic interventions and pharmacologic agents other than antipsychotics are warranted. […] Two negative randomized clinical trials of antipsychotics in ICU patients (REDUCE and MIND-USA) have provided strong evidence that such medications neither prevent nor shorten the duration of delirium.

• #64 Management of Delirium in the ICU

  https://www.icudelirium.org/medical-professionals/delirium/management-of-delirium-in-the-icu

  Protocols and evidence-based strategies for prevention and treatment of delirium will no doubt emerge as more evidence becomes available from ongoing randomized clinical trials of both nonpharmacological and pharmacological strategies. […] Strategies for the prevention and management of delirium in the ICU are important areas for future investigation. […] The first step in pharmacologic management of delirium is to assess the patients current medications for any offending agents that may be causing or exacerbating the delirium. […] The current Pain, Agitation, Delirium, Immobility, and Sleep Disruption (PADIS) Guidelines, recommend against using haloperidol or an atypical antipsychotic to treat delirium. […] Antipsychotics remain viable for short-term control of agitation (e.g., alcohol or drug withdrawal) or severe anxiety with need to avoid respiratory suppression (e.g., heart failure, COPD, or asthma).

• #65 Management of Delirium in the ICU

  https://www.icudelirium.org/medical-professionals/delirium/management-of-delirium-in-the-icu

  Protocols and evidence-based strategies for prevention and treatment of delirium will no doubt emerge as more evidence becomes available from ongoing randomized clinical trials of both nonpharmacological and pharmacological strategies. […] Strategies for the prevention and management of delirium in the ICU are important areas for future investigation. […] The first step in pharmacologic management of delirium is to assess the patients current medications for any offending agents that may be causing or exacerbating the delirium. […] The current Pain, Agitation, Delirium, Immobility, and Sleep Disruption (PADIS) Guidelines, recommend against using haloperidol or an atypical antipsychotic to treat delirium. […] Antipsychotics remain viable for short-term control of agitation (e.g., alcohol or drug withdrawal) or severe anxiety with need to avoid respiratory suppression (e.g., heart failure, COPD, or asthma).

• #66 Post-operative delirium: a review of diagnosis and treatment strategies – Cunningham – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/4361/html

  Delirium, a syndrome characterized by disturbances in consciousness and attention, is a serious post-operative complication. […] Failure to diagnose and adequately treat delirium creates harmful situations for patients. […] For patients experiencing POD, geriatric consultation and multi-component interventions have both been shown to reduce the incidence of delirium. […] Current literature does not support the use of antipsychotics, benzodiazepines, cholinesterase inhibitors, or melatonin in the management of POD. […] At this time, non-pharmacological measures remain the hallmark of treatment. […] Geriatricians are trained to manage delirium, and so hospitals have begun using geriatric consultants to assist with or co-manage elderly surgical patients in an attempt to reduce incidence and sequelae of delirium.

• #67 Post-operative delirium: a review of diagnosis and treatment strategies – Cunningham – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/4361/html

  Delirium, a syndrome characterized by disturbances in consciousness and attention, is a serious post-operative complication. […] Failure to diagnose and adequately treat delirium creates harmful situations for patients. […] For patients experiencing POD, geriatric consultation and multi-component interventions have both been shown to reduce the incidence of delirium. […] Current literature does not support the use of antipsychotics, benzodiazepines, cholinesterase inhibitors, or melatonin in the management of POD. […] At this time, non-pharmacological measures remain the hallmark of treatment. […] Geriatricians are trained to manage delirium, and so hospitals have begun using geriatric consultants to assist with or co-manage elderly surgical patients in an attempt to reduce incidence and sequelae of delirium.

• #68 Post-operative delirium: a review of diagnosis and treatment strategies – Cunningham – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/4361/html

  Delirium, a syndrome characterized by disturbances in consciousness and attention, is a serious post-operative complication. […] Failure to diagnose and adequately treat delirium creates harmful situations for patients. […] For patients experiencing POD, geriatric consultation and multi-component interventions have both been shown to reduce the incidence of delirium. […] Current literature does not support the use of antipsychotics, benzodiazepines, cholinesterase inhibitors, or melatonin in the management of POD. […] At this time, non-pharmacological measures remain the hallmark of treatment. […] Geriatricians are trained to manage delirium, and so hospitals have begun using geriatric consultants to assist with or co-manage elderly surgical patients in an attempt to reduce incidence and sequelae of delirium.

• #69 Post-operative delirium: a review of diagnosis and treatment strategies – Cunningham – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/4361/html

  Delirium, a syndrome characterized by disturbances in consciousness and attention, is a serious post-operative complication. […] Failure to diagnose and adequately treat delirium creates harmful situations for patients. […] For patients experiencing POD, geriatric consultation and multi-component interventions have both been shown to reduce the incidence of delirium. […] Current literature does not support the use of antipsychotics, benzodiazepines, cholinesterase inhibitors, or melatonin in the management of POD. […] At this time, non-pharmacological measures remain the hallmark of treatment. […] Geriatricians are trained to manage delirium, and so hospitals have begun using geriatric consultants to assist with or co-manage elderly surgical patients in an attempt to reduce incidence and sequelae of delirium.

• #70 Assessment and Management of Delirium in Pediatric Patients

  https://www.psychiatrist.com/pcc/assessment-and-management-of-delirium-in-pediatric-patients/

  Prevention of delirium often focuses on manipulating behavioral components as well as on screening and reducing biomedical conditions (eg, hypotension, hypoxemia) (Table 4). […] Currently, there are no widely accepted medications for delirium prevention. […] Delirium is a common and frequently overlooked complication in children who are admitted to the hospital. Contributing factors include worsening underlying medical problems, disruption of sleep-wake cycles, and use of medications that are deliriogenic. Management of delirium should focus on addressing underlying medical problems and managing pain.

• #71 Assessment and Management of Delirium in Pediatric Patients

  https://www.psychiatrist.com/pcc/assessment-and-management-of-delirium-in-pediatric-patients/

  Prevention of delirium often focuses on manipulating behavioral components as well as on screening and reducing biomedical conditions (eg, hypotension, hypoxemia) (Table 4). […] Currently, there are no widely accepted medications for delirium prevention. […] Delirium is a common and frequently overlooked complication in children who are admitted to the hospital. Contributing factors include worsening underlying medical problems, disruption of sleep-wake cycles, and use of medications that are deliriogenic. Management of delirium should focus on addressing underlying medical problems and managing pain.

• #72 Assessment and Management of Delirium in Pediatric Patients

  https://www.psychiatrist.com/pcc/assessment-and-management-of-delirium-in-pediatric-patients/

  Have you wondered about whether and how you can prevent and treat delirium in children and adolescents? […] Delirium develops acutely and can be described as a fluctuation in cognition due to an underlying medical condition (such as the etiologies listed previously) (Table 1). Risk factors for delirium include infectious or inflammatory diagnoses, age2 years, receiving mechanical ventilation, and using benzodiazepines, narcotics, corticosteroids, or anticholinergic medications. […] Management of delirium is best accomplished by treating the precipitating problem as specifically as possible. In addition, environmental interventions can reduce deliriums behavioral accompaniments. […] To address the agitation, irritability, and restlessness seen with hyperactive delirium, use of atypical antipsychotics (including risperidone, olanzapine, and quetiapine) or first-generation antipsychotics (eg, haloperidol) has led to positive outcomes (Table 3).

• #73 Assessment and Management of Delirium in Pediatric Patients

  https://www.psychiatrist.com/pcc/assessment-and-management-of-delirium-in-pediatric-patients/

  Have you wondered about whether and how you can prevent and treat delirium in children and adolescents? […] Delirium develops acutely and can be described as a fluctuation in cognition due to an underlying medical condition (such as the etiologies listed previously) (Table 1). Risk factors for delirium include infectious or inflammatory diagnoses, age2 years, receiving mechanical ventilation, and using benzodiazepines, narcotics, corticosteroids, or anticholinergic medications. […] Management of delirium is best accomplished by treating the precipitating problem as specifically as possible. In addition, environmental interventions can reduce deliriums behavioral accompaniments. […] To address the agitation, irritability, and restlessness seen with hyperactive delirium, use of atypical antipsychotics (including risperidone, olanzapine, and quetiapine) or first-generation antipsychotics (eg, haloperidol) has led to positive outcomes (Table 3).

• #74 Care and Treatment Options for Delirium | American Geriatrics Society | HealthInAging.org

  https://www.healthinaging.org/a-z-topic/delirium/care-treatment

  The best way to deal with delirium is to prevent it. […] Delirium is a medical emergency which requires quick treatment. The main goal of treatment is to identify and correct the cause of delirium. […] To reduce the risk of delirium or treat its symptoms: […] Medications are generally not effective in delirium and can cause severe side effects, including death. Rarely, medications such as anti-psychotics or sedatives may be necessary in the case of severe symptoms of delirium. […] For older adults experiencing delirium, the basis of treatment is creating a safe, familiar, and supportive environment.

• #75 Ask the Expert: Prevention and Treatment of Post-Operative Delirium | HealthInAging.org

  https://www.healthinaging.org/tools-and-tips/ask-expert-prevention-and-treatment-post-operative-delirium

  Delirium is a term meaning sudden confusion. It refers to a sudden change in mental function. Delirium can cause people to be either aggressive and agitated, or sleepy and inactive or sometimes a combination of both. […] Post-operative delirium is delirium that happens after an older adult has an operation (surgery) and is the most common post-operative complication in older adults. […] Studies have shown delirium is preventable up to 40% of the time for older adults in the hospital. Some causes of delirium can be managed so they do not happen or get worse. […] The American Geriatrics Society Clinical Guideline for Post-Operative Delirium recommends the following to treat postoperative delirium: Healthcare professionals should consider working with an interdisciplinary team to use multiple approaches to treatment. These can include approaches such as improving sleep, helping to reorient the older person to their surroundings, or engaging in therapeutic activities.

• #76 Delirium: What It Is, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/15252-delirium

  There arent any medications that treat delirium directly. Instead, medications treat underlying causes or specific delirium symptoms. […] Theres no specific treatment or medication for delirium. Instead, healthcare providers will treat causes and contributing factors they can identify. Helping people with mobility and activity or removing tethers can help delirium get better. […] Delirium is often preventable, but most preventive measures are things only clinical personnel should do. However, family, friends and loved ones can play a very important role in reducing the risk of delirium. […] Healthcare providers use to prevent delirium include regular delirium assessments, making natural lighting a priority, using glasses and hearing aids, early mobility, minimizing tether effects, and mental exercise.

• #77 Delirium: What It Is, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/15252-delirium

  There arent any medications that treat delirium directly. Instead, medications treat underlying causes or specific delirium symptoms. […] Theres no specific treatment or medication for delirium. Instead, healthcare providers will treat causes and contributing factors they can identify. Helping people with mobility and activity or removing tethers can help delirium get better. […] Delirium is often preventable, but most preventive measures are things only clinical personnel should do. However, family, friends and loved ones can play a very important role in reducing the risk of delirium. […] Healthcare providers use to prevent delirium include regular delirium assessments, making natural lighting a priority, using glasses and hearing aids, early mobility, minimizing tether effects, and mental exercise.

• #78 Delirium Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/288890-treatment

  Psychiatric consultation may be indicated for management of behavioral problems such as agitation or aggressive behavior. […] Prevention should be the goal because delirium is associated with adverse outcomes and high healthcare costs. […] A multicomponent intervention study that targeted cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and dehydration showed significant reduction in the number and duration of episodes of delirium in older patients who were hospitalized. […] Physicians should become familiar with prescribing practices for patients who are elderly, keeping dosages low and avoiding medications that cause delirium. […] Monitoring the patient’s mental status as a vital sign helps to diagnose delirium early.

• #79 Delirium Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/288890-treatment

  Psychiatric consultation may be indicated for management of behavioral problems such as agitation or aggressive behavior. […] Prevention should be the goal because delirium is associated with adverse outcomes and high healthcare costs. […] A multicomponent intervention study that targeted cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and dehydration showed significant reduction in the number and duration of episodes of delirium in older patients who were hospitalized. […] Physicians should become familiar with prescribing practices for patients who are elderly, keeping dosages low and avoiding medications that cause delirium. […] Monitoring the patient’s mental status as a vital sign helps to diagnose delirium early.

• #80 Delirium Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/288890-treatment

  Psychiatric consultation may be indicated for management of behavioral problems such as agitation or aggressive behavior. […] Prevention should be the goal because delirium is associated with adverse outcomes and high healthcare costs. […] A multicomponent intervention study that targeted cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and dehydration showed significant reduction in the number and duration of episodes of delirium in older patients who were hospitalized. […] Physicians should become familiar with prescribing practices for patients who are elderly, keeping dosages low and avoiding medications that cause delirium. […] Monitoring the patient’s mental status as a vital sign helps to diagnose delirium early.

• #81 Delirium: What It Is, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/15252-delirium

  If you have delirium, the disruption in your brain function means you wont be truly aware of or able to understand whats happening to you. […] The outlook for delirium can vary widely. In general, the outlook tends to be worse when delirium goes undiagnosed for long periods, or when its particularly severe.

• #82 Delirium – symptoms, diagnosis and treatment | Alzheimer’s Society

  https://www.alzheimers.org.uk/get-support/daily-living/delirium

  A supportive and calm environment can also help someone recover from delirium. […] Medications to reduce hallucinations, delusions or aggressive behaviour should be considered only if the person poses a risk of harm to themselves or others, or if their symptoms are causing them severe distress. In either case a doctor may try a low dose of a sedative or an antipsychotic for a few days. […] For many people the symptoms of delirium usually improve in a few days, once the underlying causes have been treated. However, some people don’t make a quick or full recovery and may still be having problems with memory and thinking several weeks or even months after becoming unwell.

• #83 Delirium: What It Is, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/15252-delirium

  Delirium is a type of confusion that happens when the combined strain of illnesses, environmental circumstances or other risk factors disrupts your brain function. Its more common in adults over 65. This condition is serious and can cause long-term or permanent problems, especially with delays in treatment. However, its also often preventable. […] Delirium is a fast-developing type of confusion that affects your ability to focus your attention and awareness. It happens when theres widespread disruption in brain activity, usually because of a combination of factors. Delirium is more common in medical settings, such as during long hospital stays or in long-term care facilities. […] Today, they know its a serious problem that should be recognized and prevented whenever possible. […] Delirium can also accelerate your development of dementia or make existing dementia worse.

• #84 Delirium: Emergency Evaluation and Treatment

  https://www.psychiatrictimes.com/view/delirium-emergency-evaluation-and-treatment

  Delirium is a disorder that lies at the interface of psychiatry and medicine. It is an acute organic syndrome caused by an underlying medical condition and is defined clinically by disturbances in cognitive function, attention, and level of consciousness. Delirium is considered a syndrome because of the constellation of signs and symptoms associated with the disorder, coupled with a wide variety of potential etiologies. […] Appropriate assessment and subsequent identification of delirium are important because delirium has multiple adverse effects on patient outcomes. Delirium can increase length of hospitalization, result in higher health care costs, and increase rates of nursing home placement. Delirium may also herald possible future cognitive decline. In addition, medical complications, such as decubitus ulcers, feeding issues, and urinary problems, have been reported to occur more frequently among patients with delirium compared with nondelirious controls.

• #85 How to Help a Loved One with Post-operative Delirium

  https://www.asahq.org/brainhealthinitiative/publications-news-videos/articlesandnews/helpalovedone

  The HELP program can be helpful for managing delirium in the hospital and at home. […] Delirium after surgery is often temporary, but it can affect your loved ones recovery, leading to a longer hospital stay or discharge to a rehabilitation facility instead of directly to home. […] Most people with delirium after surgery recover within a month to six months. […] Dr. Ohs recommendations are based on principles of the Hospital Elder Life Program (HELP), a comprehensive patient-care program staffed by volunteers that helps prevent delirium and loss of functioning for older adults that doesnt involve medication. […] Although the HELP program is a well-known program for prevention of delirium, many aspects of the HELP program can also be helpful for managing delirium, Dr. Oh says. […] Here are Dr. Ohs recommendations for helping your loved one recover faster from delirium after surgery at home.

• #86 Ask the Expert: Prevention and Treatment of Post-Operative Delirium | HealthInAging.org

  https://www.healthinaging.org/tools-and-tips/ask-expert-prevention-and-treatment-post-operative-delirium

  The healthcare professional should identify and manage underlying causes of delirium. […] The healthcare professional should not prescribe antipsychotic or benzodiazepine medications for older delirious patients who are not agitated or threatening substantial harm to themselves or others. […] Delirium can affect how an older person recovers from illness or surgery. If delirium is not treated, or treatment is delayed, it can cause an older persons mental and physical functions to get worse. […] Delirium is a true medical emergency that requires immediate professional attention and treatment.

• #87 Delirium | health.vic.gov.au

  https://www.health.vic.gov.au/older-people-in-hospital/cognition-dementia-delirium-and-depression/delirium

  Delirium is an acute disturbance in a persons attention, awareness and cognition that can be caused by an acute medical condition or medication changes. Delirium is serious and may be the only sign of a deteriorating patient. […] Delirium should be treated as a medical emergency. […] Delirium can often be prevented and can be treated and managed. […] We must recognise and respond to delirium as we would any other medical emergency[if we dont] the outcome is as bad for older patients as if they experienced an acute myocardial infarct (Geriatrician, Clinical Leadership Group on Care of Older People in Hospital). […] Delirium can cause longer lasting cognitive impairments in patients after surgery and may lead to permanent cognitive decline and dementia in some patients. […] Discharge planning should be documented, include the patient, carers and other professionals, and incorporate referrals to community health and support services where required. […] Reducing, ceasing or avoiding the use of psychoactive drugs is recommended as they may worsen the delirium. […] Pharmacological therapy should only be considered in severe cases of behavioural or emotional disturbance because there is no strong evidence they effectively improve prognosis.

• #88 Treatment of Delirium in Older Persons: What We Should Not Do!

  https://www.mdpi.com/1422-0067/21/7/2397

  Primary prevention with non-pharmacological multicomponent approaches is widely accepted as the most effective strategy for delirium. […] The most famous approach is the Hospital Elder Life Program (HELP), a multicomponent intervention strategy including reorientation, therapeutic activities, reduced use and doses of psychoactive drugs, early mobilization, promotion of sleep, maintenance of adequate hydration and nutrition, and provision of vision and hearing adaptations. […] The systematic identification and treatment of potential causes (medications, acute illness, etc.) is highly recommended. […] Specific attention should be also devoted to detecting and assessing the causes of and treat agitation and/or distress using non-pharmacological means only if possible. […] Aim to prevent complications of delirium, such as immobility, falls, pressure sores, dehydration, malnourishment, and isolation.

• #89 Delirium – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/delirium/

  Delirium is a neurocognitive disorder characterized by impairments in attention and awareness (reduced orientation to the environment), as well as other cognitive disturbances (e.g., in memory, language, or perception). […] Management of delirium focuses on treating the underlying illness and providing supportive care until the confusion resolves. Antipsychotic medications may be used to manage agitation if other measures fail. […] Delirium should be considered a medical emergency until proven otherwise; it can be a sign of severe underlying pathology and is associated with increased mortality. […] Do not discharge patients from ambulatory settings unless delirium resolves with initial management and an underlying cause has been identified and treated. […] A comprehensive care strategy involving multidisciplinary health providers and family members is preferred to prevent and address complications of delirium.

• #90 Delirium – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/delirium/

  For agitation in patients with dementia, see Management of dementia. […] Avoid physical restraints as much as possible in older patients with delirium, as they can worsen distress and agitation, as well as contribute to preventable injuries. […] Medications should be reserved for refractory agitation. […] Antipsychotics are commonly used for managing agitation in delirium. […] Benzodiazepines are deliriogenic. Do not treat delirious patients with benzodiazepines unless the delirium is due to alcohol or benzodiazepine withdrawal. […] Over one-third of cases of delirium can be prevented with nonpharmacological strategies. […] Regularly assess at-risk patients using the CAM tool to detect delirium early. […] Pharmacological prophylaxis: Some medications (e.g., dexmedetomidine, melatonin) have been used to prevent delirium in the critical care/postoperative settings, but benefits are still uncertain.

• #91 Delirium (Causes, Symptoms, and Treatment) | Doctor

  https://patient.info/doctor/delirium-pro

  Pharmacological management should be approached with caution, as using drugs to treat delirium can lead to adverse effects and worsening of delirium. Antipsychotics may be beneficial in selected patients, particularly those who are aggressive. […] Management post-discharge is important as symptoms of delirium may last longer than the underlying condition, and families and carers may need support and reassurance.

• #92 Delirium – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/delirium/

  For agitation in patients with dementia, see Management of dementia. […] Avoid physical restraints as much as possible in older patients with delirium, as they can worsen distress and agitation, as well as contribute to preventable injuries. […] Medications should be reserved for refractory agitation. […] Antipsychotics are commonly used for managing agitation in delirium. […] Benzodiazepines are deliriogenic. Do not treat delirious patients with benzodiazepines unless the delirium is due to alcohol or benzodiazepine withdrawal. […] Over one-third of cases of delirium can be prevented with nonpharmacological strategies. […] Regularly assess at-risk patients using the CAM tool to detect delirium early. […] Pharmacological prophylaxis: Some medications (e.g., dexmedetomidine, melatonin) have been used to prevent delirium in the critical care/postoperative settings, but benefits are still uncertain.

• #93 Delirium in Older Persons: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html

  Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. […] Treatment of delirium should focus on identifying and managing the causative medical conditions, providing supportive care, preventing complications, and reinforcing preventive interventions. Pharmacologic interventions should be reserved for patients who are a threat to their own safety or the safety of others and those patients nearing death. […] Physicians should train nursing staff, home health aides, and family members/caregivers on recognizing and treating delirium. […] Antipsychotic medications should be used as a last resort in treating delirium and should not be used indiscriminately in persons with delirium who have not been properly evaluated.

• #94 Delirium

  https://www.rwjbh.org/rwjbarnabas-health-ambulatory-care-center/treatment-care/senior-health/delirium/

  Delirium is a common, serious, and often preventable problem in hospitalized older adults. […] Delirium can slow the healing and recovery process and requires immediate treatment. […] Tell the nurse or doctor immediately if you notice any symptoms of delirium. Family members are often the first to notice subtle changes. […] Talk to your loved one about the delirious episode. This can help lessen the anxiety, fear, frustration, or anger that might otherwise develop.

• #95 Family Guidance | American Delirium Society

  https://americandeliriumsociety.org/patients-families/family-guidance/

  Delirium is a warning sign that a person needs help right away. […] This video was developed to guide families through the initial phases of delirium treatment. […] Do not directly dispute hallucinations and delusions expressed by your loved ones. Instead, provide reassurance.

• #96 Delirium

  https://www.rwjbh.org/rwjbarnabas-health-ambulatory-care-center/treatment-care/senior-health/delirium/

  Delirium is a common, serious, and often preventable problem in hospitalized older adults. […] Delirium can slow the healing and recovery process and requires immediate treatment. […] Tell the nurse or doctor immediately if you notice any symptoms of delirium. Family members are often the first to notice subtle changes. […] Talk to your loved one about the delirious episode. This can help lessen the anxiety, fear, frustration, or anger that might otherwise develop.

• #97 How to Help a Loved One with Post-operative Delirium

  https://www.asahq.org/brainhealthinitiative/publications-news-videos/articlesandnews/helpalovedone

  On the other hand, undertreating pain can also lead to delirium. […] Thats why its important to reach out to a medical provider who knows your loved one well to do what we call medication reconciliation, Dr. Oh says. […] Medication reconciliation is a process of comparing medications that were prescribed to what the patient has been taking. […] Your loved ones delirium could simply be related to misunderstanding about what medication(s) he/she should or should not be taking. […] In fact, sleeping may be a sign of hypoactive (quiet) delirium. […] Instead, keep your loved one mentally engaged throughout the day by with conversation and activities he/she likes to do. […] If you’re not drinking or eating and taking your medication as directed, it catches up with you, Dr. Oh says. […] Keeping a regular sleep/wake schedule, such as going to bed by 10 p.m., is important for everyones brain function, but especially those with delirium after surgery. […] All of these things are critical for helping someone recover from delirium faster.

• #98 How to Help a Loved One with Post-operative Delirium

  https://www.asahq.org/brainhealthinitiative/publications-news-videos/articlesandnews/helpalovedone

  On the other hand, undertreating pain can also lead to delirium. […] Thats why its important to reach out to a medical provider who knows your loved one well to do what we call medication reconciliation, Dr. Oh says. […] Medication reconciliation is a process of comparing medications that were prescribed to what the patient has been taking. […] Your loved ones delirium could simply be related to misunderstanding about what medication(s) he/she should or should not be taking. […] In fact, sleeping may be a sign of hypoactive (quiet) delirium. […] Instead, keep your loved one mentally engaged throughout the day by with conversation and activities he/she likes to do. […] If you’re not drinking or eating and taking your medication as directed, it catches up with you, Dr. Oh says. […] Keeping a regular sleep/wake schedule, such as going to bed by 10 p.m., is important for everyones brain function, but especially those with delirium after surgery. […] All of these things are critical for helping someone recover from delirium faster.

• #99 How to Help a Loved One with Post-operative Delirium

  https://www.asahq.org/brainhealthinitiative/publications-news-videos/articlesandnews/helpalovedone

  If you notice symptoms of delirium such as confusion or agitation in your loved one after coming home from the hospital, dont wait until the home health nurse is scheduled to arrive in a few days or for your loved ones official follow-up surgical appointment, Dr. Oh says. […] Medication miscommunication is a reason many older patients land back in the hospital or may contribute to changes in mental status, Dr. Oh says. […] For example, narcotic pain medication can increase the risk of delirium after surgery. […] If your loved one has been prescribed a 30-day supply of prescription pain relievers with instructions on the bottle to take three times daily, you may not know that its not always necessary to take the maximum dose and that narcotic pain medication can increase the risk of delirium.

• #100 How to Help a Loved One with Post-operative Delirium

  https://www.asahq.org/brainhealthinitiative/publications-news-videos/articlesandnews/helpalovedone

  On the other hand, undertreating pain can also lead to delirium. […] Thats why its important to reach out to a medical provider who knows your loved one well to do what we call medication reconciliation, Dr. Oh says. […] Medication reconciliation is a process of comparing medications that were prescribed to what the patient has been taking. […] Your loved ones delirium could simply be related to misunderstanding about what medication(s) he/she should or should not be taking. […] In fact, sleeping may be a sign of hypoactive (quiet) delirium. […] Instead, keep your loved one mentally engaged throughout the day by with conversation and activities he/she likes to do. […] If you’re not drinking or eating and taking your medication as directed, it catches up with you, Dr. Oh says. […] Keeping a regular sleep/wake schedule, such as going to bed by 10 p.m., is important for everyones brain function, but especially those with delirium after surgery. […] All of these things are critical for helping someone recover from delirium faster.

• #101 How to Help a Loved One with Post-operative Delirium

  https://www.asahq.org/brainhealthinitiative/publications-news-videos/articlesandnews/helpalovedone

  On the other hand, undertreating pain can also lead to delirium. […] Thats why its important to reach out to a medical provider who knows your loved one well to do what we call medication reconciliation, Dr. Oh says. […] Medication reconciliation is a process of comparing medications that were prescribed to what the patient has been taking. […] Your loved ones delirium could simply be related to misunderstanding about what medication(s) he/she should or should not be taking. […] In fact, sleeping may be a sign of hypoactive (quiet) delirium. […] Instead, keep your loved one mentally engaged throughout the day by with conversation and activities he/she likes to do. […] If you’re not drinking or eating and taking your medication as directed, it catches up with you, Dr. Oh says. […] Keeping a regular sleep/wake schedule, such as going to bed by 10 p.m., is important for everyones brain function, but especially those with delirium after surgery. […] All of these things are critical for helping someone recover from delirium faster.

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