Infuse Issue 14 October 2021 - Page 34

HOW CAN YOU PREVENT AND MANAGE DELIRIUM ?
There is no simple fix for delirium . No drugs can effectively prevent or treat it . Instead , delirium requires a whole-of-team-and-hospital management approach which focuses on mobility , optimising nutrition and increasing engagement in meaningful activities 6 , 7 .
Hospital mealtimes are a key target for preventing delirium or supporting a patient experiencing it . Mealtimes in hospital are often chaotic and do not simulate a usual home eating environment . This can be confusing and unsettling for a patient with delirium and lead to poor oral intake .
Dietitians and other hospital staff can help to prevent delirium by :
Encouraging patients to prepare for the mealtime
- Sitting out of bed - Clearing and / or adjusting the table - Turning the lights on
Proactively providing high protein and energy meals , snacks and finger foods for patients at high risk of delirium and malnutrition
For example , older medical and surgical patients .
Creating shared dining experiences
For example , enabling patients to eat together or encouraging family or volunteers to eat with patients .
Orienting the patient to time and place
For example , “ Your breakfast will be delivered soon ”, “ It ’ s nearly dinner time ”, or “ Tuesday night is apple pie night !”.
Providing encouragement during the meal
Ensuring nutritious food is available on the ward at all times of the day and night
Being flexible in timing of meals Minimising distractions
Educating other staff and family members about delirium and supportive mealtimes
Examining mealtime practices through initiatives like audits and patient feedback with the multidisciplinary team
Providing assistance For example , opening packages , cutting food into manageable pieces , placing cutlery in the patient ’ s hands or facilitating the use of adaptive aids .
© Dietitian Connection 34 Infuse | October 2021