Guideline on the Assessment and Treatment of Delirium in Older Adults at the End of Life

Delirium is a common and serious condition encountered in older persons. Compared to similarly aged individuals, older hospitalized persons who are delirious have a worse prognosis. They have prolonged lengths of hospital stay, worse functional outcomes, higher institutionalization rates, increased risk for cognitive decline and higher mortality rates (Leentjens & van der Mast, 2005; Rockwood, 2001). In many cases, delirium is not recognized or is misdiagnosed as another condition such as dementia or depression.

The occurrence of delirium is not inevitable.With funding from the Public Health Agency of Canada Population Health Fund, CCSMH was able to collaborate with experts in the fields of geriatrics and delirium to develop evidence-based recommendations on the assessment and treatment of delirium in older adults. From 2007-2010, pilot projects were launched to disseminate information and implement recommendations from the guidelines. http://ccsmh.ca/pdf/guidelines/NatlGuideline_DeliriumEOLC.pdf

All documents can be downloaded at no charge. If you prefer a hard copy of the material, or need multiple copies for your team or class, contact Kimberly Wilson, Executive Director, kwilson@baycrest.org (416-785-2500 ext. 6331).

New Resources at the Canadian Coalition for Seniors' Mental Health

• Tool on the Assessment & Treatment of Behavioural Symptoms of Older Adults Living in Long Term Care Facilities (clinician pocket card)
• Delirium: Assessment and Treatment for Older Adults (clinician pocket card)

Gaps in Patient Care Practices to Prevent Hospital-acquired Delirium

The objective of this research was to evaluate the current patient care practices that address the predisposing and precipitating factors contributing to the prevention of hospital-acquired delirium in the elderly.

The article is downloadable from the Canadian Family Physician website at:

http://www.cfp.ca/cgi/reprint/55/10/e41.pdf

Bulletin of Geriatrics and Stroke Medicine: July 2009 issue

This newsletter is edited by Declan O'Kane, MD, FRCP, Consultant Physician, Stroke and Geriatric Medicine, East and North Hertfordshire, NHS.

Articles in the July 2009 issue include:

• hospital acquired infections
• comprehensive guide to delirium
• managing diabetes in the elderly

http://www.dok.org.uk/BGSM_july2009.pdf

Delirium Resources

Developed by the Vancouver Island Health Authority, this page contains information about delirium and its prevention, recognition, assessment, and intervention for famiies and health care professionals.

Included are tools, flow sheets, quizzes and information specifically designed for acute  home and community, residential and end of life care.

http://www.viha.ca/mhas/resources/delirium/tools.htm

BP Blogger: Delirium

The latest edition of the BP Blogger (Cutting Through the Foggy Myths Using Best
Practice Guidelines in Long Term Care) for April-May 2008 is now available.

BP Blogger is produced by the Centres of Excellence in Inter-professional Practice and Collaborative Geriatric Care and The Long-Term Care Resource Centre (SHRTN), Hamilton, Ontario.

The April-May issue focuses on Delirium.

http://www.rgpc.ca/best/newsletters.cfm