View source for DELIRIUM-NON PHARMACOLOGICAL MANAGEMENT

===== [[Summary Article|'''SUMMARY''']] =====
<br/>1. Simple measures:
<br/>- Ensure patient is well hydrated and nourished
<br/>- Treat constipation &amp; urinary retention
<br/>- For elderly: ensure patient is wearing hearing aids and glasses
<br/>- Manage pain
<br/>
<br/>2. Reduce the level of stimulation in the environment:
<br/>- Place patient in quiet, private room
<br/>- Remove noxious stimuli if possible—tubes, catheters, restraints, traction
<br/>- Limit unnecessary sounds—TV, radio, background conversations
<br/>- Limit number of visitors
<br/>- Staff to behave in a calm and reassuring manner
<br/>- Limit number and length of therapy sessions
<br/>- Provide therapies in patient room
<br/>
<br/>3. Prevent harm to self or others:
<br/>- Place patient in a floor bed with padded side panels (Craig bed).
<br/>- Assign 1:1 or 1:2 sitter to observe patient and ensure safety.
<br/>- Avoid taking patient off unit.
<br/>- Place patient in locked ward.
<br/>- Use of equipment/devices: alarm and non-slip mats.
<br/>
<br/>4. Reduce cognitive confusion:
<br/>- Deconstruct complex tasks into smaller steps
<br/>- Communicate with patient briefly and simply, one idea at a time
<br/>- One person speaking to patient at a time
<br/>- Maintain staff to work with patient
<br/>- Minimize contact with unfamiliar staff
<br/>- Reorient the patient frequently: placing an orientation board with date, location, placing a clock, photos of family members
<br/>- Bowel and bladder care: timed toileting, avoid constipation,      avoid overflow incontinence by titrating fibre in diet and aperients
<br/>
<br/>5. Tolerate restlessness when possible:
<br/>- Allow patient to thrash about in floor bed
<br/>- Allow patient to pace around unit with 1:1 supervision
<br/>- Allow confused patient to be verbally inappropriate


==Reference(s)==
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. [https://amzn.to/3YHrI6K Get it on Amazon.]
<br/>Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. [https://amzn.to/3k7WSW0 Get it on Amazon.]
<br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
<br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].

[[Category:Delirium]]
[[Category:Neurology]]
[[Category:Medicine]]