Carers toolkit can make delirium less frightening and less dire: Study | UniSC | University of the Sunshine Coast, Queensland, Australia

University of the Sunshine Coast health academic Dr Alison Caswell was part of the pilot study, published recently in the Journal of General Internal Medicine Carers, which evaluated the Prevention and Early Delirium Identification Carer Toolkit, called PREDICT.

Dr Caswell said delirium manifested as a sudden decline in a person’s usual mental function and was frightening for people experiencing it and those caring for them.

“Delirium is a stress-response, usually caused by a number of underlying acute, short-term illnesses and medical complications, including urinary tract infection, pneumonia or post-surgery,” Dr Caswell said.

It is the most common hospital-acquired complication worldwide and was associated with higher rates of illness, death, residential care home admission, dementia, and carer stress and burden.

The research team said that embedding the prevention and management of delirium as part of standard hospital care remained challenging.

Their study found that using the interactive assessment offered by the PREDICT Toolkit could support carers to partner with nurses to address the risks of delirium and implement strategies to prevent and manage it.

 As well as giving carers a key role in the management of loved ones affected by the confused mental state, it also provided valuable information that supports their own wellbeing.

Lead investigator Dr Christina Aggar, Associate Professor of Nursing at Southern Cross University and Conjoint Northern NSW Local Health District said the emotional and financial toll to the patient and the carer from delirium was extremely significant.

 “Delirium is often mistaken for dementia because both conditions have similar symptoms, such as confusion, agitation and delusions. However, unlike dementia, delirium comes on very quickly and is potentially reversible.

“If a healthcare professional doesn’t know the patient, it can be difficult to tell the difference. This is why carers are well-placed to recognised subtle changes indicative of delirium and why we’ve involved them in the pilot,” Dr Aggar said.

The research team involved UniSC, Southern Cross University, the University of Saskatchewan (Canada), the University of Canberra and the Northern NSW Local Health District. The pilot study was conducted at the Tweed Hospital.

 Dr Craswell said collaboration ensured the robustness of the toolkit.

“This project has brought together a team of experts working with lived experience consumers, who have all cared for others, to make sure the toolkit is fit for purpose,” said Dr Craswell.

“The collaboration with our colleagues in Canada has ensured the research has an international reach and has led to Canadian funding to pilot the toolkit in Saskatchewan province.” Professor of Gerontological Nursing at the University of Canberra Kasia Bail said the use of PREDICT proved life-changing for carers.

“This research aims to empower carers and potentially reduce further complications such as increased length of stay, functional and cognitive decline, and avoidable admissions to residential care,” Professor Bail said.

“We’d like to make this common complication less common, and less dire than it can be.”

The research team’s next step is to secure funding to develop a larger trial at hospitals around the country.