"Care partners of people with dementia often feel isolated. A dementia-friendly community provides a network of support for care partners, connecting them with resources and other people who understand their experience." — Dementia Friendly America

"I was in a fever, and everything seemed to be spinning around me." Gitanjali (Poem), Rabindranath Tagore #delirium

“Nobody used the word delirium. I thought I’d lost my mind.” — Delirium survivor ➡️ Always provide clear information, including telling the patient they have delirium, during the episode. Then explain & de-brief afterwards.

Emergency Department (ED) staff: screen ALL patients over 65 for delirium. Emergency departments are where it's most missed and most dangerous. Make it as routine as checking blood pressure.

😞 Social isolation and loneliness in older people. 🇨🇦 From the Canadian Coalition for Seniors' Mental Health. #DementiaCare #MedTwitter

Delirium develops over hours/days, dementia over months/years. "Dad was fine yesterday, today he's a different person" = think delirium, not dementia progression.

"Providing person-centered care is essential for improving the quality of life for people with dementia. This involves tailoring care to the individual's unique needs, preferences, and values." — National Council of Certified Dementia Practitioners (NCCDP)

"He saw visions of his ancestors, they were calling him, he could not understand." Love in the Time of Cholera, Gabriel García Márquez #delirium

“I needed to be told the date every time. Repetition ≠ patronising.” #delirium

Does your patient need you to provide reassurance? Kindness goes a long way in #delirium.

Factsheet - Frailty and deterioration #frailty

Explain delirium in accessible terms: "The brain isn't processing information normally right now." This helps families understand why repeating basics about what is going on, as well as being reassuring over and over again, can help the person experiencing #delirium.

"Family caregivers are essential partners in the care of people with dementia, and their needs must be recognized and addressed by the healthcare system." — The College of Family Physicians of Canada (CFPC)

"In the deepest slumber—no! In #delirium—no! In a swoon—no! In death—no! even in the grave all is not lost. Else there is no immortality for man." The Pit and the Pendulum by Edgar Allan Poe

“My brain was the enemy; it told me the nurses were killers.” — Delirium survivor Psychological care of delirium starts with reality anchoring: “You’re safe, you’re in hospital, I’m your nurse.”

Emergency Department (ED) staff: screen ALL patients over 65 for delirium. Emergency departments are where it's most missed and most dangerous. Make it as routine as checking blood pressure.

Falls prevention in over 65s. #falls

All these informal terms - avoiding saying "delirium" - makes care FAR less effective. Use #DELIRIUM.

"Up to 40% of antipsychotic use in long-term care may be inappropriate, leading to an increased risk of falls, fractures, and death." — Healthcare Excellence Canada

"But if you notice anything - #delirium or fever - wake me at once." "Crime and Punishment by Dostoevsky

A feeling of loneliness or isolation is commonly reported in people experiencing #delirium. Don't leave them feeling like this. Speak kindly, explain what is happening, involve family.

"Have you been having a difficult time?" "Is there anything I can do to help you?" ➡️ Questions to help provide comfort to those with #delirium & #dementia

Useful facts on Alzheimer's Disease. Note especially the huge contribution that carers make.

"I can't remember" – Patients who have had #delirium often experience a feeling of 'lost time'. You can help by clearly explaining what delirium is & answering their questions. Give them a narrative of what has happened to them.

"Between 60-90% of people with dementia will experience Behavioural and Psychological Symptoms of Dementia (BPSD) at some point during their illness." —  Dementia Support Australia

"But they beckoned; leaves were alive; trees were alive. And the leaves being connected by millions of fibres with his own body, there on the seat, fanned it up and down." Mrs Dalloway by Virginia Woolf #delirium

“The nurse who explained every procedure was the only ‘good guy’ in my #delirium story.” -- Delirium survivor Be that nurse. Be that doctor. Be that therapist.

Emergency Department (ED) staff: screen ALL patients over 65 for delirium. Emergency departments are where it's most missed and most dangerous. Make it as routine as checking blood pressure.

10 warning signs of #dementia.

Every hospital should have a delirium champion. We have stroke and sepsis champions - why not #delirium? #PatientSafety

"Understanding the person and what might be contributing to their behaviour is the first step in providing support. This includes considering their physical health, emotional state, and the environment around them." — Dementia Support Australia

"At every jolt he again felt unendurable pain; his feverishness increased and he grew delirious." - Leo Tolstoy, War and Peace #delirium

“The hiss of the oxygen was the soundtrack to my hallucinations.” #delirium

Does your patient need you to provide reassurance? Kindness goes a long way in #delirium.

Falls-related injuries in older people. From Public Health Agency of Canada. #falls

Some studies show that in some undergraduate degrees nurses get no formal #delirium training. For an emergency that affects 1 in 6 hospital patients. Help me understand why this is.

"For carers, managing behavioural and psychological symptoms can be one of the most challenging aspects of dementia. Accessing support and advice is crucial." — Dementia Support Australia

"He saw ships sailing through the sky, and heard voices from the sea." Seven Samurai (Movie), Akira Kurosawa #delirium

"I was so afraid, so afraid, and I cried and shouted…. I was certainly very afraid… I was convinced that they were going to kill me." #Delirium

Emergency Department (ED) staff: screen ALL patients over 65 for delirium. Emergency departments are where it's most missed and most dangerous. Make it as routine as checking blood pressure.

Depression in older adults - resources. www.ccsmha.ca

Missed #delirium = longer stays, more complications, higher mortality, massive costs. But hey, at least we saved 2 minutes by not doing a 4AT in the ED.

"ADI calls for a new approach to dementia that is based on recognising dementia as a disability and on promoting the social inclusion of people with dementia." — Alzheimer's Disease International (ADI)

"I see her, she’s talking to me, she’s alive!" (Hallucinating under medication) Taxi Driver, Martin Scorcese

"It was so real, and I was so scared. I was paralyzed on a bed and being burned alive. Just in time, someone rescued her, but suddenly, she was turned into an ice sculpture on a cruise ship buffet. Next, she was in an experiment in a lab in Japan. Then she was being attacked by cats." #delirium

"Have you been having a difficult time?" "Is there anything I can do to help you?" ➡️ Questions to help provide comfort to those with #delirium & #dementia

Terrifying for families. Horrifying to patients afterwards. See a lot of feelings of guilt and shame about delirium-driven agitation at our post-ICU clinic. #Delirium #ICUDelirium #ICU #IntensiveCare #PICS

Physical activity for adults & older adults

Shocking reality: 1 in 4 older hospital patients develop #delirium, yet most families have never heard the word. We need to do much better in improving public awareness of delirium.

"The number of people with dementia in the UK is projected to increase to over 1 million by 2025 and over 1.6 million by 2040." — National Institute for Health and Care Excellence (NICE)