Date Published: March 14, 2017
Publisher: Public Library of Science
Author(s): Thomas A. Jackson, John R. F. Gladman, Rowan H. Harwood, Alasdair M. J. MacLullich, Elizabeth L. Sampson, Bart Sheehan, Daniel H. J. Davis
Abstract: In an Essay, Andrew Jackson and colleagues discuss challenges in the diagnosis and management of older people with dementia and delirium in acute hospitals.
Partial Text: Assessing cognitive impairment, adverse events risk, and BPSDs should become routine. Delirium prevention, active management of underlying precipitants, and a patient safety approach to minimise harms are especially important . Hospital care requires appropriate environmental adjustments (colour, light, visual interest, orientation, and furniture) and processes (person-centred care, attention to meals, activity, and sleep promotion), delivered by increased and upskilled staff. Proper attention should be given to legal aspects, especially around consent, and to risk enablement . The recent interdisciplinary collaboration between the American Delirium Society and the American Nurses Association is an example of moving this evidence into practice . Delirium and dementia patients will be slower to recover, and return to home living should be based on “adaptive” rather than “restorative” rehabilitation.