1. Dr Sarah Constantine Consultant Psychiatrist Basingstoke
Delirium

2. Delirium Has a low prevalence in the community
Usually transitory and associated with other illness
Within hospital population is common
Varies with demographic of ward

3. Definition of Delirium 1
Impairment of attention and concentration- variable
Global cognitive disturbance- affecting memory and new learning
May present with disordered thought and logic processes
Impairment of orientation, particularly to time and place
Psychomotor disturbance- hyper- or hypo- activity which may switch

4. Definition of delirium 2
Disturbance of sleep/wake cycle- insomnia, sleep reversal, daytime drowsiness, dreams
Emotional disturbance- anxiety, euphoria, apathy, irritability, fear, depression
Transient and fluctuant intensity

5. Predisposing factors to delirium
Age
Disease of the brain (including dementia)
Environment
Sleep disturbance
Drugs and alcohol- acute and chronic effects and withdrawal

6. Precipitating factors for delirium
Any physical illness
Drugs

7. Treatment of delirium
Aim to establish the diagnosis and then treat the cause
Person centred care
Underlying condition specific treatments
Fluids
Nourishment
Excretion
Reality orientation
Reassurance
Rest
Sedation

8. Risks of delirium A highly risky condition Death Self harm
Harm to others
Falls
Wandering

9. Capacity and delirium Remember, fluctuant nature
Remember, transitory condition
Remember, need to assess only what is immediately necessary
Remember, need to assess when is at best
Best interests
Least restrictive option