How can delirium be prevented in older adults?

Environmental factors in the hospital can make delirium more likely, including being in the intensive care unit, having a catheter or an IV, being in pain, disturbed sleep and being in restraints.

When an older adult is hospitalized, the healthcare team needs to assess medications and do a thorough workup for all medical issues. A catheter should be inserted only if needed, and restraints should be avoided. Efforts should be made to keep the patient's sleep/wake cycle as normal as possible. If the patient has eyeglasses or hearing aids, they should be used. A familiar person, such as a family member or friend, should be with the patient as much as possible, and a patient who has had surgery needs to be up and moving as soon as his or her condition permits, using walking aids if necessary.

Additional strategies for the prevention of delirium recommended by the National Institute for Health and Clinical Excellence include conducting a risk assessment for delirium, providing care tailored to the patient's individual needs, placing a clock and a calendar in an easily viewable location, ensuring adequate fluid intake to prevent dehydration and constipation, and providing appropriate pain management if needed.