Delirium Care Pathways

Strategies to Prevent Delirium

Page last updated: 07 November 2011

The following table lists the environmental strategies and clinical practice strategies to prevent delirium.

Environmental StrategiesClinical Practice Strategies
Lighting appropriate to time of day - windows with a view to outside, curtains and blinds open during the day, and minimal lighting at night may reduce disorientation

Provision of single room - reduces the disturbance caused by staff attending other patients in the same room

Quiet environment especially at rest times - noise reduction strategies (eg: use of vibrating pagers rather than call bells)

Provision of clock and calendar that clients can see

Encourage family and carer involvement - includes encouraging them to visit

Encourage family/carer to bring in client's personal and familiar objects

Avoid room changes - frequent changes may increase disorientation
Encourage/assist with eating and drinking to ensure adequate intake

Ensure that patients who usually wear hearing and visual aids are assisted to use them

Regulation of bowel function - avoid constipation

Encourage and assist with regular mobilisation

Encourage independence in basic ADLs

Medication review

Promote relaxation and sufficient sleep - can be assisted by regular mobilisation, massage, encouraging wakefulness during the day

Manage discomfort or pain

Provide orienting information including name and role of staff members

Minimise use of indwelling catheters

Avoid use of physical restraints

Avoid psychoactive drugs

Use of interpreters and other communication aids for CALD patients/clients

Use of ATSI liaison officer for ATSI populations

Adapted from: Clinical Epidemiology and Health Services Evaluation Unit 2006, Clinical Practice Guidelines for the Management of Delirium in Older People, Victorian Government Department of Human Services, Melbourne, Victoria