In this fourth episode, we consider what we can do to try and support patients with complex, difficult and prolonged cases of delirium that don't resolve as quickly or as easily as we would like them to. We consider the concept that behaviour of any kind is a form of communication that is often driven by a need, and we talk through the benefits of therapeutic interactions, including communication, validation, distraction and reminiscence therapies. We explore the role of the mental health liaison service and also consider, when all else fails, when it may be appropriate to consider pharmacological interventions. This series really encourages open and honest conversations in exploring the difficulties that can be encountered in an acute hospital setting as we seek to care for our patients with delirium.

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We look forward to catching up with you in our next episode when we will be discussing how to communicate about delirium with family members and we hear directly from some families about the impact delirium has had on their loved ones.

In this third episode, we move on to the next step and focus on the management of delirium. How do we look after patients affected by delirium? Can we expect them to make a full recovery? And if so, how long does that process normally take? We recognise that the management of delirium is multifaceted and it is crucial that we aim to identify and treat the underlying causes. We also dip into some strategies we can put into practice when looking after patients with delirium, such as therapeutic activities, cognitive stimulation, and effective communication skills, as well as exploring the role that medications play. Finally, our Falls Coordinator briefly highlights the link that there can be between delirium and falls, and how we can reduce the risk of falls in patients with delirium on our wards.

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We look forward to catching up with you in our next episode where we consider complex and prolonged delirium in patients, where symptoms are not easily resolving.

In this second episode, we explore the various triggers for delirium and what causes this acute confusional state, as well as consider some methods for preventing it.

We consider questions such as can other medical conditions make someone more likely to get delirium and can multi morbidity play a part? Julie Magee, lead pharmacist, explores the role medications can play in delirium and highlights the importance of a medication review and assessing the anticholinergic burden in patients.

Finally, we reflect on how promoting the Delirium Care Pathway and the Pinch Me memory aid can help us consider the multiple factors that can cause delirium, and help us make the most of the window of opportunity we have, when someone comes in to hospital, to bring about positive change.

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We look forward to catching up with you in our next episode where we consider the big topic of how we manage delirium.

In this episode, we explore what delirium is and why it is so common in the patients that we see across our hospitals. We talk about assessment and what we can do to recognise and diagnose delirium early with a focus on ‘SQID’ and the 4AT, outlined in the Regional Delirium care pathway.

We refer to the ‘PINCH ME’ mnemonic to help us consider the most common causes of delirium and to help us better understand and support our patients who may be experiencing this often frightening and distressing condition. We also explore questions such as ‘how can someone who is normally as sharp as a tack be so suddenly thrown off by this condition?’ as well as exploring the impact of delirium on someone living with dementia, and then finally discussing where mental capacity comes into all of this and are people with delirium able to make decisions for themselves.

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We look for forward to catching up with you in our next episode where we explore the triggers for delirium and what causes this unsettling confusional state.