Steps to identification

Think: How might you decide if the confusion Mr. Williams has developed is delirium or not?

The following steps are a guide to enable you with the detection of delirium(1).

Step 1: Change in the Patient's Behaviour

Apparent changes in a person's usual behaviour and determining a history about these changes is an important first step in delirium recognition. This history can be obtained from informants who have known the person for a period of time and are familiar with their baseline mental status, most usually family members, caregivers, other nursing staff or other patients in the room.

Questions to ask include:

  1. What is/are the change/s in behaviour you have noticed?
  2. When did this change or changes start?
  3. What, in your opinion might be causing this change or changes?

Step 2: Formal Assessment

A formal assessment of the patient will include:

A cognitive screen (e.g. MiniCog (PDF file, 101KB) ) & delirium detection using The Confusion Assessment Method.

Step 3: First Line Management Strategies

If delirium is detected first line management must be commenced immediately. This first line management includes notifying other staff members and the medical officer.

Priority must be given to finding the cause.