Minnesota Hospital Association
4800600274320704850457200Could this be delirium?Recognizing and addressing delirium How does delirium present?SuddenTemporary (lasts from hours to weeks)Fluctuates throughout the dayConfusion which causes changes in peoples’ thought and behaviors which may include:Trouble thinking clearly or problems paying attentionShort-term memory lossDisorientation Problems with language Hallucinations or paranoia Anxious/fearful/restless Daytime sleepiness or insomnia Unusually quiet and withdrawnThree simple steps to avoid perpetuating delirium for older adult patientsMedications: Avoid high-risk medications or minimize exposure (e.g., lower dosages)Sensory: Ensure patients have glasses, hearing aids, dentures, pocket talkersPain: Appropriately assess and manage painTop medications that perpetuate delirium - ABCsAntihistamines (e.g., Benadryl)Benzodiazepines (e.g., Ativan)anti-Cholinergics (e.g.., Prochlorperazines)Other High-risk Medications: Narcotics (e.g., Morphine, Demerol); Sedatives – Hypnotics(e.g., Ambien, Restoril); Tricyclics (e.g., Elavil/Amitriptyline); Hydroxyzine (e.g., Vistaril); Lithium; MeclizineBefore prescribing one of these medications, consider:Medications do not treat delirium; they manage behaviors and increase the risk of perpetuating delirium.Are there alternatives for managing the behaviors?What is the baseline function of the patient?What medications are still in their system?Minimizing exposure – can a lower-risk substitute or lower dosage be prescribed? ................
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