The Reach-Out Delirium Service has been designed to screen all over 65s, and anyone known to memory services, when they are admitted to hospital. It aims to prevent and help treat delirium across the hospital site. It also provides interventions for those who develop delirium while in hospital. It is hoped this will reduce length of stay for those patients by an average of two days.
The many disciplines in the hospital will be working together to try to minimise the effects and length of time that the delirium is present until it resolves.
These steps include:
- Ensuring adequate lighting
- Ensuring that any eyesight or hearing problems are addressed
- Encouraging mobilising (walking)
- Ensuring adequate diet and fluids are taken
- Assessing and treating pain
- Promoting good sleep patterns by minimising night time disruptions and noise
- Encouraging family support
- Minimising unnecessary moves around the ward and hospital
- Making sure that the correct medications are prescribed and any unnecessary medications are discontinued
- Avoid unnecessary procedures
- Providing cognitive stimulation (getting the brain working with activities such as reminiscing)
Who is the service for?
The ‘Reach-out’ service is for all admissions over 65 years of age who are at higher risk of delirium. delirium. The known risk factors include:
• Increased age, being 65 years of age or older
• Having pre-existing cognitive impairment (memory loss)
• Severe illness such as renal or heart failure
• Hip fractures
Things that cause delirium are wide ranging and delirium can be caused by just one or a combination of these factors. Sometimes we are not able to identify the specific cause of the delirium.
How to refer
The ‘Reach-out’ service will check on Hospital Patient Information systems for all admissions over 65 years of age and proactively case find these patients who are at higher risk of delirium. Referral will also be accepted from any health professional within the hospital where delirium is suspected or already present or where the patient has dementia or other high risk factors.