Timely review and monitoring is needed of people with delirium to confirm that they are improving and responding to treatment, where cognitive impairment persists people are referred on for further assessment.
If somebody diagnosed with delirium is not responding to treatment and cognitive impairment persists they should be referred onward for further assessment and treatment.
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
Healthwatch
Telephone: Call: 03000 683 000 between the hours of 08:30 – 17:30 Monday to Friday
Email: enquiries@healthwatch.co.uk
Weblink: https://www.healthwatch.co.uk/your-local-healthwatch/list
Evidence
- Cognitive tests administered on admission and again before discharge.
- Delirium screening and assessment fully documented in the patients notes (regardless of the outcome).
- Care offered in concordance with the delirium evidence-base recommendations when the assessment indicates symptoms of delirium.
- Results recorded on the electronic discharge summary.
- Ensure staff receive training in delirium and its relationship to dementia, manifestations of pain, and behavioural and psychological symptoms of dementia.
- Risk factors for delirium in dementia include sensory impairment, pain, polypharmacy, dehydration, intercurrent illnesses, such as urinary tract infections or faecal impaction, and an unfamiliar or changing environment.
- Delirium in older people should prompt consideration of underlying dementia.
- No definitive evidence that any medication improves delirium in people with dementia exists: cholinesterase inhibitors, antipsychotics, and sedating benzodiazepines are ineffective and antipsychotics and benzodiazepines are associated with mortality and morbidity.
- People with delirium without known dementia are more likely to be diagnosed with dementia in the future than others, either because of pre-existing undiagnosed dementia or cognitive impairment, present, or because delirium has neurotoxic effects and so precipitates dementia.
Best Practice Resources
Assessment of delirium: use of 4AT and Delirium TIME bundle for early management and prevention of delirium.