Transcript Presentation: Patients Experiencing Delirium

Patients Experiencing
Delirium
Delirium
• Also known as an “acute state of confusion”
• It is considered a serious acute medical problem
• Indicates there may be a serious medical
problem
• Patients describe delirium as:
– The twigh light zone
– Fog bank
– A state of constant terror
Delirium can be described as:
• Starting and stopping
suddenly
• Lasting a few hours, a
few days or a few weeks
• Patient’s alertness
fluctuates
• Patient knows person but
not time and place
• Their attention is
distracted easily, can not
stay on one subject for
very long
• They have NO short term
memory
• Their thinking is
disorganized and they
ramble
• They have delusions and
visual hallucinations
4 Key Features
1. Difficulty concentrating
2. No short term memory,
disorientated, seeing
things
3. Sudden onset, can go
from very active to very
sleepy
4. Delirium is caused by a
medical problem such
as a new medication or
alcohol withdrawal
3 Types of Delirium
Hyperactive
• Agitated state with
increase activity and
increased verbal
behaviors
Hypoactive
• More comment in elderly.
Quietly confused with
some anxiety. Tired and
withdrawn
Mixed
• Patients move from
hyperactive to hypoactive
states
What Causes Delirium
Outside hospital
• Illness
– Pneumonia, UTI’s
• Depression
• New medications
• Alcohol and drug
withdrawal
• Post operative
• Previous delirium
Inside hospital
• Dehydration, malnutrition
• Surgery
• Infections
• Not sleeping
• Not mobilizing
• Unfamiliar environment
• Sensory overload
• Isolation and no windows
What to Do
Communication:
• Eye contact at eye level
• Identify self
• Call patient by preferred
name
• Be calm and speak slowly
• Validate fears and
concerns
• Use short and simple
sentences
• Re orientate frequently
Environment:
• Minimize noise and staff
changes
• Provide food and fluids
• Ask family for familiar
objects
• Music
• Promote sleep
• Use clocks and calendars
to re orientate
• Limit visitors
• Have family sit with
patient
What to Do
Physiological:
• Look for signs of pain
• Check for
constipation
• Check for urinary
retention
• Toileting routines
• Mobilize lots
Safety:
• Use bed and chair
alarms
• Move patient closer to
nursing station
• Remove sharp
objects
• Have patient wear
clean glasses and
working hearing aides
Other Interventions to Consider
• No restraints, they
only increase
agitation
• Read the paper or
your magazine to the
patient. Let them read
as well
• Elder Friendly
Program has a TV for
DVD’s and Videos
QUESTIONS?