People with dementia admitted to hospital for acute care must always be assessed for the possibility of delirium.
Delirium is a condition which is more common among those people living with dementia. Being assessed for delirium means that you can receive treatment for that condition earlier if you have it. The hospital can also help lower the risk of you developing delirium during your stay in hospital.
For extra information, evidence and best practice please scroll down to the bottom of the page.
Regional offerings
Delirium Toolkits in Greater Manchester; Dementia United
Weblink: https://dementia-united.org.uk/delirium/
National offerings
Age UK
Telephone: Advice line 0800 678 1602 free to call 8am - 7pm 365 days of the year
Weblink: https://www.ageuk.org.uk
Alzheimer’s Society
Telephone: National Dementia Helpline: 0300 222 1122. Open 9.00am. – 5.00pm. Monday to Friday & 10.00am. – 4.00pm. Saturday and Sunday.
Weblink: https://www.alzheimers.org.uk/
Dementia UK
Telephone: 0800 88 6678
Email: direct@dementiauk.org
Weblink: https://www.dementiauk.org/
Lewy Body Society
Telephone: 01942 914000
Weblink: https://www.lewybody.org/
NICE Dementia Guidance
Weblinks:
We have provided links to the NICE guideline for dementia and a further link is provided to guidance on how to delay or prevent the onset of dementia.
National Institute for Health and Clinical Excellence (NICE) NG16 (2015) Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset: https://www.nice.org.uk/guidance/ng16
National Institute for Health and Clinical Excellence (NICE) (2019) Dementia: assessment, management and support for people living with dementia and their carers: https://www.nice.org.uk/guidance/ng97
Evidence
Royal College of Psychiatry 2018: The medical and nursing directors for each trust should create procedures to be implemented across the hospital for: assessing, recording and following up people with a diagnosis of delirium by ensuring that all staff likely to treat people with delirium have appropriate training on how to recognise, investigate and manage people with delirium, including the different types / clinical presentations of delirium and approaches for managing them and ensuring effective communication about delirium throughout admission and to GPs on discharge.
NICE Quality Statement, Delirium in adults: "Adults newly admitted to hospital or long-term care who are at risk of delirium are assessed for recent changes in behaviour, including cognition, perception, physical function and social behaviour. Statement 2 Adults newly admitted to hospital or long-term care who are at risk of delirium receive a range of tailored interventions to prevent delirium. Delirium is potentially preventable, and interventions can be effective in preventing delirium in adults who are at risk. These preventative measures should be tailored to each person's needs, based on the results of an assessment for clinical factors that may contribute to the development of delirium. Such clinical factors include cognitive impairment, disorientation, dehydration, constipation, hypoxia, infection or other acute illness, immobility or limited mobility, pain, effects of medication, poor nutrition, sensory impairment and sleep disturbance.
People with frailty may present differently from other patients. They often have nonspecific signs and symptoms, such as delirium, reduced mobility and a history of falling, and not the ‘textbook’ diagnostic indicators of a particular condition. Their condition should not be interpreted as lacking seriousness or urgency because of this – it relates to the underlying pathophysiological processes emerging across several body systems simultaneously and to communication challenges. Both the underlying medical conditions and the presenting syndrome need attention. "
National audit of dementia round 4 report online: "Medical Directors and Directors of Nursing should ensure that people with dementia admitted as an emergency are assessed for delirium using a standardised tool such as the 4AT"
Best Practice Resources
Assessment of delirium: use of 4AT and Delirium TIME bundle for early management and prevention of delirium.